Chapter 5.4 - Dysfunctions and inadequacies in Health Districts and Nursing and Residential Care Facilities for the elderly in Lombardy as highlighted by the Covid-19 epidemic

Abstract

An analysis of long-term nursing and residential care facilities for the elderly in the Lombardy Region and their distribution relative to the elderly population makes it possible to trace correlations between these hospitalization facilities, severely affected by the epidemic, and their territories. As part of a broader field of reflection over the impacts of Covid-19, an assessment of residential facilities for the elderly allows us to pinpoint the key features and critical issues in the current management model over non self-sufficient elderly persons. This study addresses the heterogeneity of residential facilities for the elderly in Lombardy and draws attention to the relationship between densely urbanized areas, often characterized by “mobile and reticular living” ( Casti, 2020 ), and the size of such facilities. Our objective is to expose the criticalities produced by the health crisis around a social healthcare system faced with an unusual event around a specific category of residential facilities designed to host people with marked fragilities. The numerous victims recorded in residences for the elderly, which turned into hotbeds of viral transmission, has highlighted the need to rethink existing models of care and hospitality. This study uses reflexive cartography to cross-reference data on some physical features of Nursing and Residential Care Facilities in Lombardy to social features which relate to the elderly population. Such cross-referencing identifies shortcomings and charts the distribution of different care models in the region, calling attention to the strong ties that exists between large Nursing and Residential Care Facilities and densely urbanized urban contexts.