Persons aged 65 and older account for 23.5% of the total population, children under 14 for 12.9%, leaving 63.6% of the population in the segment aged between 15 and 64, where the average age is around 46.
In 2021, half of the people living alone were over 65 and by 2041 it has been estimated the proportion will reach 60%. If the current trend remains unchanged, by 2050, 34.9% of the total Italian population will be over 65.
In any case, the impact on policies of social protection will be significant, as it will be necessary to meet the needs of an increasing number of older citizens. Major reforms will be necessary, in order to have an impact on the quality of life of these elderly people.
Enabling law for the elderly
This is one of the reforms envisaged by the PNRR for the Ministry of Labor and Social Policies, and it was fulfilled through the approval by the end of January 2024 of legislative enabling decrees.
In this way, it will be possible to implement the reform of the system of actions in favor of non-self-sufficient elderly citizens contemplated by Mission 5, Component 2 of the PNRR.
The new law recognizes the right of elderly citizens to continuity of care while living at home and the principle of simplification and integration of the evaluation procedures for non-self-sufficient elderly people.
What the enabling law provides in general
Through implementation of the decrees made possible by the enabling law, it should be possible:
• to introduce a definition of the non-self-sufficient elderly citizen;
• to define a national system for care of the non-self-sufficient elderly population (SNAA);
• to assign to a single entity the task of performing a multi-dimensional assessment, using the “Unified Points of Access” (PUA) to determine a “personal plan of assistance” (PAI), indicating all the healthcare, social welfare and aid services necessary for the elderly individual;
• to indicate a specific national governance of policies in favor of the elderly, with the task of coordinating all the actions in that sector;
• to establish and promote measures that foster active aging and social inclusion;
• to encourage new forms of supportive cohabitation for older people and cohabitation among generations, also in the sphere of family-type homes and assisted living in condominiums open to relatives, volunteers and the providers of social welfare and healthcare services in integrated formats;
• to encourage actions for the prevention of fragility among older people; the inclusion of integrated homecare institutions (ADI) and services of home aid workers (SAD);
• to recognize the right of elderly people to receive palliative treatment at home and in hospice;
• to provide for actions in favor of family members caring for elderly relatives.
One of the most important new elements of the legislative action, subject to a specific enabling law, concerns the introduction, in an experimental and gradual manner, for those non-self-sufficient older citizens who expressly request it, of a universal graduated service according to the specific aid needs of the beneficiary.
The new universal service, which will be the subject of specific financing with the legislative decrees of implementation, will include personal services (social welfare services at home and in communities for the non-self-sufficient) and monetary allowances, for an amount that, in any case, is not inferior to the disability allowance, if received.
Essential levels of welfare services
The reform defines and regulates the LEPS, i.e. essential levels of welfare services.
These are processes, actions, services, activities and integrated procedures concerning the civil and social rights to be secured everywhere in the country (art. 117, section 2, letter m) of the Italian Constitution) according to the principles and general criteria indicated in frame law no. 328 of 2015.
It is implemented through the content of art. 1, section 159, of the 2022 budgetary law (law no. 234 of 2021,) which defined the LEPS for non-self-sufficiency.
Interministry Committee for Policies in Favor of the Elderly (CIPA)
This Committee was established by the Presidency of the Council of Ministers and given the task of fostering the coordination and integrated programming of national policies in favor of the elderly population, with particular regard to the more fragile and non-self-sufficient elements.
Subject to approval by a unified Conference of the social partners and associations representing the disabled and other associations of the sector, the CIPA will adopt a three-year program, subject to annual updates, i.e. the "National plan for active aging, social inclusion and the prevention of fragility in the elderly population" and the "National plan for the assistance and care of fragility and non-self-sufficiency in the elderly population", which will replace the previous Plan for Non-Self-Sufficiency.
On the basis of the national plans, corresponding regional and local plans will be adopted.
The CIPA will also:
• promote the harmonization of the LEPS for non-self-sufficient elderly citizens and the relative goals of service, with the LEA, i.e. Essential Levels of Aid Services;
• promote the integration of the data-processing systems for all the competent authorities assigned to evaluate and provide the services on the national and regional level, and the adoption of a national monitoring system as a way to determine the continuity of the activities performed and the services and aid provided;
• monitor the implementation of the National Plan for Active Aging, Social Inclusion and the prevention of fragility in the elderly population” as well as an “Integrated National Plan for non-self-sufficient persons in the elderly population”, and will approve an annual report on the state of implementation of those Plans, which should also contain information about the actions, measures and sources of financing adopted.
The Committee is chaired by the President of the Council of Ministers or by a person delegated to the position by the Ministry of Labor and Social Policies.