A snapshot of Italian nursing homes for people with dementia: A national survey of 1671 facilities

BackgroundNursing homes (NHs) that provide for people with dementia (PWD) are responsible for meeting the needs of patients and their families through medical, personal, and rehabilitative care. However, little is known regarding the Italian facilities.ObjectiveTo describe the characteristics of NHs and to detail the care services and treatments provided.MethodsIn 2023, the Italian National Institute of Health conducted a national survey to assess dementia care services and update the Dementia Observatory's online Map of Services through a detailed facility questionnaire.ResultsOverall, 1671 NHs accommodating PWD participated, representing 46.3% of facilities and 53.1% of beds. Significant disparities emerged when estimating the number of PWD per available NH across macro-area (North 214; Centre 332; South/Islands 850).R2D classification was more frequent in southern than central and northern facilities (28%, 10.9%, and 13.1%, respectively; p<0.001). Northern facilities had more rooms (North: 46, Centre: 28, South and Islands: 29; p<0.001) and beds (North: 87, Centre: 55, South and Islands: 58; p<0.001). Southern NHs had shorter admission wait times and longer stays. Conversely, Northern facilities had more staff, better training, and more digital systems and were more often integrated with day care centers and palliative care services.ConclusionsThis is the first national study assessing the accessibility and affordability of Italian NHs housing PWD. The lack of special units, tailored environments and uneven services distribution and staff highlight the fragmentation of Italy's long-term care system. NH geographical distribution is inconsistent with epidemiological estimates of PWD.