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By the Versus Team | April 2022 | Category: Healthcare & Family Wellbeing

Reading time: approximately 6 minutes | Audience: Families, Carers, and Individuals

 

There comes a moment in many Italian families — whether you are living in Palermo, Padova, or somewhere in between — when the question can no longer be avoided: how do we best care for the person we love who can no longer fully care for themselves?

It might be an elderly parent who has become unsteady on their feet following a fall. It might be a relative living with dementia whose needs are beginning to exceed what the family can manage alone. It might be a younger person recovering from surgery or managing a long-term condition who needs support to maintain their independence. In each case, the concern is the same: how do we ensure they receive the care they need without uprooting them from the home, the community, and the daily rhythms that give their life meaning?

Domiciliary care — known in Italian health contexts as assistenza domiciliare — is increasingly the answer to that question. This article explains what it is, how it works in practice, what families in Italy can reasonably expect from it, and how to decide whether it is the right option for your situation.

What Domiciliary Care Actually Is

Domiciliary care — sometimes called home care or in-home care — is the provision of personal, social, and sometimes clinical support delivered directly in a person’s own home, rather than in a residential care facility or hospital. It is not a single service but a spectrum, ranging from a carer visiting twice a week to help with bathing and meal preparation, all the way through to full-time live-in support for someone with complex needs.

At its most fundamental level, domiciliary care exists to enable people to remain in their own homes for as long as possible, safely, comfortably, and with their dignity intact. This matters enormously in the Italian context. Italy has one of the oldest populations in Europe, with over 23 percent of residents aged 65 or above. At the same time, family-centred values remain deeply embedded in Italian culture — the expectation that relatives will be cared for within the family unit is strong, particularly in central and southern regions.

But family care, however loving and well-intentioned, has limits. When those limits are reached, domiciliary care offers a professional bridge — one that supports both the person receiving care and the family members who have often been quietly exhausting themselves trying to manage alone.

What Domiciliary Carers Can Help With

The scope of domiciliary care is broader than many families initially realise. A qualified home carer can assist with:

• Personal care — washing, dressing, grooming, oral hygiene, and toileting, carried out with sensitivity and respect for the individual’s preferences and cultural background.
• Medication prompting and administration support — ensuring medications are taken correctly and on schedule, which is particularly important for people managing chronic conditions such as diabetes, hypertension, or heart failure.
• Meal preparation and nutrition monitoring — cooking meals that reflect the person’s dietary requirements, cultural preferences, and medical needs, and observing for signs of poor nutrition or dehydration.
• Mobility and falls prevention — supporting safe movement around the home, assisting with physiotherapy exercises, and identifying hazards that increase the risk of falls.
• Companionship and social engagement — one of the most undervalued aspects of home care. Isolation and loneliness are serious health risks, particularly for older people. A carer who visits regularly, engages in conversation, and takes an interest in the person’s life provides genuine social connection.
• Night care and live-in support — for those who require monitoring or assistance during the night, or whose needs are sufficiently complex to warrant a carer being present around the clock.
• Respite care — temporary support that gives family carers a break, whether for a few hours, a few days, or a longer period.

Domiciliary Care and Italy’s Immigrant Communities

For families from immigrant communities living in Italy, domiciliary care presents both particular relevance and particular challenges. Many immigrant families — from North Africa, sub-Saharan Africa, South Asia, Eastern Europe, China, and beyond — carry traditions of strong intergenerational care. Placing an elderly parent in a care home may feel culturally alien or even shameful. Domiciliary care, which keeps the person in the family home while providing professional support, often resonates far more naturally with these values.

However, language is frequently a barrier. A person receiving care at home must be able to communicate their needs, preferences, discomforts, and concerns to the carer supporting them. If that carer does not share their language, the quality of care — and the person’s experience of it — is fundamentally compromised. At Versus, we specifically match carers to clients based not only on skills and experience but on language and cultural background where possible, recognising that care which is linguistically and culturally compatible is categorically better care.

It is also worth noting that Italy’s immigrant communities include many individuals who have lived and worked in Italy for decades and are now entering older age themselves. For this generation, the question of who will care for them — and in what language — is increasingly pressing.

How to Know if Domiciliary Care is the Right Choice

Every family’s situation is different, but there are several indicators that suggest domiciliary care may be the right step:

1. The person is struggling with daily tasks they previously managed independently — personal hygiene, cooking, managing medications — and this is causing safety concerns or distress.
2. Family carers are experiencing burnout. If you are the primary carer for a relative and you are exhausted, anxious, or feeling overwhelmed, this is not a sign of failure. It is a sign that professional support is needed.
3. There have been falls, near-misses, or hospital admissions that point to increasing vulnerability at home.
4. The person has expressed a clear wish to remain at home rather than move to residential care.
5. Social isolation is becoming a concern, particularly if the person lives alone or has limited contact with others.

How Domiciliary Care is Arranged in Italy

In Italy, domiciliary care can be accessed through several routes. The Servizio Sanitario Nazionale provides a form of home care — Assistenza Domiciliare Integrata (ADI) — for those with medical needs assessed by their GP or a specialist. However, ADI is often limited in scope and hours, and many families find that it does not fully meet their relative’s needs.

Private domiciliary care, arranged through specialist agencies or organisations like Versus, offers greater flexibility — more hours, more personalised matching, and faster access. It also allows families to specify requirements such as language compatibility and cultural sensitivity, which are rarely factored into publicly funded provision.

When assessing a domiciliary care provider, families should ask: Are carers DBS-checked and professionally trained? Is there a proper assessment process before care begins? How are cultural and linguistic needs taken into account? What happens if a carer is unavailable? Is there a named care coordinator the family can contact?

A Note on Dignity

Whatever route families take, one principle should be non-negotiable: the person receiving care must remain at the centre of every decision. Their preferences matter. Their routines matter. The small things — how they like their tea, which chair they prefer to sit in, whether they want the radio on in the morning — are not trivial details. They are the texture of a life, and good domiciliary care protects them.

In a country with Italy’s richness of family culture, domiciliary care need not represent a withdrawal of family involvement. Quite the opposite — professional home care often gives family members the freedom to be present as sons, daughters, and grandchildren rather than exhausted unpaid carers. That, too, is something worth caring for.

The goal of domiciliary care is not to replace the family. It is to make sure the person you love is safe, supported, and surrounded by the life they know.