LTC in Italy: Seniors living La Dolce Vita

Healthy seniors living the good life.

On a recent trip to Italy, I decided to actively investigate how Italy handles LTC needs. If you have been to the top of the Duomo in Florence, the leaning Tower of Pisa, the bridges of Venice or the cobblestone streets of Rome, you know Italy is not exactly senior friendly when compared to American expectations by way of ADA through the installment of handrails, wide door widths, wheelchair ramps, etc.

On this trip I lived in the villages, which allowed me to experience Italian life versus the tourist life. I thought maybe there was a secret built in to Italy; a “non-American” route that Italian seniors take that would be even, have small grade changes, nice widths and appropriated with the proper handrails.

What I found, however, was anything but this. I spent most of my time in an area called Cinque Terra. Cars are not welcome there and the mountains that the towns are built on are butted next to the sea. In order to farm (olives and grapes), the Ligurian Italians terrace the mountains and work the land from the bottom to the top. Houses are built all the way up the mountain. These are reached by ancient paths of stone steps that are uneven, broken and without a handrail at many points. If one were to miss step, tragedy would occur, as witnessed in the many cast arms and wrapped ankles.


So many stairs…

What I observed was that seniors walked these steps everyday to get food and socialize. They were defiantly surer footed than I was. They were also slow but steady and did it and while carrying groceries.

I wondered why they had not created a lift like in the movie Flashdance where she rides up the incline with her bike to see her grandmother. Then I noticed something funny: I did not see walkers, canes or wheelchairs. Maybe they existed but I did not see them. Instead I witnessed healthy, fit seniors upwards of 90 in age, enjoying life through their daily routine and not demanding that the environment be changed as their bodies slowed and became more difficult to move.

It was awesome to see! I am in 3 to 5 senior living homes/facilities every week all over the United States and what I see is a progressive degeneration of the ability to move until finally it’s the bed or a Geri-chair.

I investigated Italy a little further and found nursing homes in the larger cities but could not find assisted living. I did a site visit of one facility 20 minutes north of Cinque Terra and found that the seniors there were very similar to our skilled nursing seniors. Some residents used wheelchairs and others did not. The space was institutional but the floor plan design was very similar to an American plan. The largest difference was that this was uncommon and to be avoided above all. Not to say that anyone wants to go to a nursing home, they just view it more like how Hospice is viewed in the United States. Home health consists of family, neighbors and Ukrainians.

I also noted that Italians seemed less overweight. Being a healthy weight could help to contribute to lessening the need for long-term care as diabetes, heart disease and joint issues are made worse by added weight.

Overall I found that uneven surfaces, lots of stairs and grocery stores that are only large enough to purchase food for one day seemed to have a direct correlation to not seeing canes, walkers and wheelchairs as well as overweight seniors.


An Italian SNF.

So how do they handle the needs of seniors not ready for a nursing home? I found an article where seniors (especially women) put ads in the paper to “adopt a grandma.” Interviews would be done, then a trial period and, if all went well, the senior gained a new family in exchange for helping with the kids and household duties. What a concept—to want to add value to all the days of your life and be in the community. It seemed a far cry from moving to Florida as far away from your kids and grandkids and playing bridge all day. Right or wrong, the distinction between what I see in the United States everyday and what I saw in Italy was like night and day. When I grow old, instead of wearing purple with a red hat, I want to live like an Italian senior: fighting old age to the death, living La Dolce Vita.

Topics: Design , Housing