Residential facilities for older people in Italy: a five-region survey

BACKGROUND AND AIMS: To survey all Residential Facilities (RFs) for older people (more than 50% residents over 65 years of age) in five Italian regions (Calabria, Sardinia, Sicily, Umbria, Veneto), and to evaluate their logistic and organizational characteristics and staff and resident features. METHODS: Structured interviews with RF managers; selected RFs operating in five regions. RESULTS: A total of 853 RFs were operating in the five regions, with an average of 198.0 beds per 10,000 older people - a rate showing marked regional variability. The number of RFs actually surveyed was 754 (88.4% of sample pool). The mean number of RF beds was 59.8 (+/-65.0; median: 34), and the great majority (96%) had 24-hour staff cover. A large proportion (29%) were managed by local municipal authorities, religious non-profit associations (approx. 24%) and other non-profit organizations (approx. 21%). In the RFs 24,456 workers were employed; the number of staff per facility also showed great variability. The mean number of workers directly involved in resident care was 27.8 (+/-39.0; range: 1-331); the median number of staff members was 14, and the resident/staff ratio was 2.1. These 754 RFs hosted 42,687 residents, with an average of 53.5 (+/-58.5) older people in each facility, and 3.2 residents below the age of 65. The mean age of the entire resident sample was 79.3 years (+/-5.2) and there was a high proportion of residents with neurological (including dementia), psychiatric and medical disorders. CONCLUSIONS: The five regions varied considerably in residential bed provision; many other RF characteristics, including staff/resident ratios, showed similar variability. Most RFs hosted older people with a variety of neurological, psychiatric and medical disorders. Future phases of the project will aim at shedding light on many other features in these institutions, which care for 2.1% of the older population in Italy and may serve even greater proportions of older people in the future.