The eCare Network in Bologna: No Longer Home Alone

Introduction

Population ageing has long been a matter of utmost importance (mainly from a social and economic point of view), and has now become one of the priority actions identified by different bodies at European and world level. In particular, at European level, this issue has become the focus of many action programs, such as the Digital Agenda for Europe (European Commission, 2010) and the European Innovation Partnership on Active and Healthy Ageing (European Commission, 2012).

Italy is experiencing the same demographic phenomenon that characterizes all the Western industrialized countries: the National Institute of Statistics has estimated more than 1 million frail elderly people living in our country (Italian National Institute of Statistics, 2008). This number is expected to double over the next two decades, resulting into a proportional increase in the expenditure for healthcare and welfare service management.

At the same time, the social and family structure is undergoing a substantial and irreversible change both in Italy and elsewhere. Family size is shrinking, very often the elderly live at home alone or in groups consisting of only elderly people. In addition, women’s role within the family is changing: now the vast majority of women (at least in the regions of central and northern Italy) has a job outside the home, so there is less internal domestic support provided to the family by women, who were traditionally the family caregivers entrusted with the task of providing informal care to frail or elderly family members. The exponential growth in demand for both social and healthcare services makes it increasingly clear that a completely different approach is required to secure the economic sustainability of the whole health and welfare system.

The only possible way is to anticipate needs, provided that new ideas and resources are invested: it is no longer acceptable to wait for the elderly to lose their independence before taking action. The first step (also in terms of cultural and organizational structure) is to aim at taking care of elderly people as early as possible, with a special focus on frailty. It is high time to shift from a wait-and-see attitude to taking the initiative, by putting in place a system that is not set in motion when the need presents itself, but is able to anticipate and identify the burgeoning need, thus being able to combat or otherwise manage chronic conditions.

It is also essential that public services and institutions are not the only ones expected to take this situation in charge: the community as a whole must work in liaison with the public sector and implement all the necessary resources and opportunities that can support a healthy and active ageing of the population, in the first place, in parallel with a few low care intensity services, to meet the needs of frail elderly people with a lower risk level, taking advantage of all the help provided by information and communication technologies.

Over the past few years, actions in favor of the elderly have started to evolve towards this direction, in order to avoid institutionalization and delegation of care functions to the welfare system, especially for seniors with limited autonomy. Several projects have also been developed focusing on the issues of ICT technologies and networks applied to health and welfare services and providing support for dependent and frail elderly persons, through the issuing of regional support programs and guidelines of social and prevention networks for frail elderly people (Regional Government Resolution no. 509, 2007) which, in addition to enhancing the contribution provided by all social stakeholders and associations operating in the field, outline a strategic reference framework especially in situations of social distress or emergency.