Rsa, years of cuts and increasingly serious guests. “The virus has spread to a fragile system”

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A curve decreasing, which indicates the minutes of assistance that on average each patient in a nursing home for the elderly receives each week. Instead, the one describing the level of severity of the guests rises. In 2009, 74.6% of the hospitalized in Lombardy were over 80 years old, an increase of 4.6 percentage points in the following years. The same goes for the non self-sufficient elderly in the RSA, which went from 90.8% to 94% in Lombardy. This figure is well above the national average, which is below 80%. Fragility accumulated in a system that has found itself helpless in the face of the first wave of the pandemic, put under the lens by Professor Costanzo Ranci, of the Social Policies laboratory of the Politecnico di Milano. Dossier presented by Spi-Cgil pensioners union during a meeting organized with Fnp-Cisl and Uilp Lombardia, who asked the Region for a change of pace on health. Professor Ranci analyzes some of the possible causes that have made the Lombard RSA system particularly vulnerable to the pandemic, with the spread of infections between March and April.

“With the pandemic – summarizes – the knots have come to a head. “And in Lombardy there was a mortality rate in residential structures of 7.5%, much higher than that of the other Italian regions, followed by Trentino with 6.4% and then by Emilia Romagna with 4.2%. Errors, delays and measures that have not been able to stem the infections are part of a system with “an increasingly elderly, fragile population, which requires a high level of health care. It is a trend that has developed over the years – writes Professor Ranci – and in Lombardy it has already been more marked for some time. “Lombardy has also seen a decrease in the number of operators in service with various tasks over the years, accumulating a -15%. Volunteers have grown, the number of paid personnel has dropped by as much as 20%. A minus sign that contrasts with a slight growth recorded at the national level. The presence of doctors is falling, that of health assistants is increasing. The minutes of assistance are decreasing, the elderly are increasing in need of high levels of health care. A “time bomb” that “created favorable conditions for the deployment of a pandemic” combined with the “failure of strategies” to deal with it last February. “The increasing” sanitation “of facilities in the absence of a health policy involved management strategies aimed at combining the response to needs with fragile financial balances, to the detriment of welfare standards ” .

Second Valerio Zanolla, general secretary of Spi-Cgil Lombardia, “the accreditation criteria of the RSA must then be reviewed, favor the community dimension and also pay attention to the number of beds that are claimed must not exceed 120 to allow the health organization to respond more effectively in case of emergency. Strengthen the health care, make the presence of surveillance committees mandatory, open the structures to external society, expand their relief function in support “. All proposals put on the table by the unions, who ask the Region for a general change of gear on health. “In Lombardy – explains Emilio Didonè, secretary general of the regional Fnp-Cisl – the numbers of deaths and infections are too high to speak only of chance, bad luck or tsunami. First of all, territorial medicine must be strengthened. time to intervene – he concludes – but we must do it as soon as possible, before the crisis becomes irreversible “. Among the requests also that of a framework law on self-sufficiency, and investments to reduce the gap with other European countries: for every 100 elderly people there are less than 2 regular workers employed in their service, in Sweden 12.5.