It is a big decision to pick up roots and plant them in a new country. The excitement of this new adventure in Rome floods your mind with a million thoughts, but I bet you not one of them is about the healthcare system. No, of course not. But it’s something to consider, especially if you yourself are older and having health issues(hence the move) or if you have family members you are taking with you. In fact, it can become complex when you are dealing with healthcare in your new country or entering the world of long-term care for your family member or yourself. You are possibly faced with language barriers, complicated laws, and patient rights that are very different from those at home. As an immigrant from America to Italy, you may find a time when you need to consider these issues and make decisions for yourself or a family member.  This article will give you guidance as to what things to consider for this life-changing, incredibly exciting, long-term move to amazing Italy. What To Know About The Italian Care System Italy's public health system – Rome included – provides public health coverage, and this does include some long-term care.  You may voluntarily sign up for the system, or you might be signed up as a compulsion with your employment. Either way, you must be registered as a resident in order to qualify for the Servizio Sanitario Nazionale (SSN), and families often supplement the covered long-term care with private nursing homes (case di riposo) or live-in caregivers (badanti).  The nuances of the Italian system and long-term care can get very complicated, so it will be necessary to find an advisor who can help you through this.  Where you live, what coverage you have through private insurance, or if you qualify for the LTC through your job or financial background, all play a part.  What Facility To Choose When things progress to a point where choosing a long-term nursing home becomes necessary, look beyond, look beyond the aesthetics: Ask about staff-to-patient ratios. How are carers trained? What social events and activities are offered? Who monitors diets, or is that personal choice? Is there a dietician monitoring special diets or not? Is there a service to take patients to outside appointments/ Trips to the bank? Shopping (depending on level of care needed). What protocols are set up for patients who are immobile? Is the focus on prevention of common issues like bedsores and rashes addressed daily? How are they treated? How often are they turned? The issues that can arise could be minor to start, but progress to severe quickly, so it’ll also be imperative that you are fluent in Italian or have an interpreter who can help understand this complicated system.  Although Italy's SSN is known to be one of the best in the world, it’s no secret that neglect in nursing homes due to staff shortages and facility systematic failures happens all over the world, so it pays to be vigilant. The Silent Alarms For residents who use wheelchairs or are bedridden, it is absolutely imperative that they’re repositioned in their beds, kept clean and dry, and monitored for bed sores.  Suppose there seems to be an irritation that needs to be addressed straight away. If you notice angry red spots or an actual sore, this is a red flag about the kind of care you or your family member is receiving.  These only appear and get worse if there has been a failure in basic nursing care: inadequate turning, poor nutrition and hydration, and unsanitary conditions.  These sores progress quickly and can be a stage 1 bedsore to a stage 4 bedsore within days. If it reaches stage 4, the wound has usually gone so deep that it has reached the muscle and bone, and this poses a life-threatening risk of infection. In a care setting, this is almost always a sign of profound neglect.  This has progressed to a possible fatal situation and will need to be handled medically and perhaps legally.  Knowing Your Rights! Patients in Italy have legally protected rights to adequate care and dignified treatment.  If you or your family member feels you or they have been neglected, you have the right to speak up. Document everything with photos and dates, request a meeting with the facility director, and file a formal complaint with the local health authority, Azienda Sanitaria Locale (ASL). Knowing various laws is one thing. But actually understanding them and interpreting them is another. And if you're in another country, all of this gets to the next level of 'difficult to deal with'. While the legal context differs, families in the United States often face similar severe neglect situations where they seek guidance from specialized legal experts -- lawyers who fully specialize in these types of cases. Here's an example: If a nursing home resident ended up suffering a severe case of bedsores because of the staff's neglect, mistreatment, or even abuse, the U.S. family would require knowledgeable legal support for stage 4 bed sores in nursing homes in order to build a solid case and win in court. In Italy, it's a similar situation, with the difference being that such cases are usually pursued via civil lawsuits (usually settled or they end up with jury awards based on contingency), while in Italy, such lawsuits are more judge-driven. Some cases even end up crossing into criminal law.  In that case, the cost in such scenarios skyrockets for the attorney (plaintiff in the U.S.). Conclusion No one moves their life to another country if they don't love and appreciate where they are going to live.  The admiration for the culture and love of the people is what entices someone away, so they certainly do not want to find themselves in a legal case at all. Getting older has its own issues, and your facility lives up to the Italian reputation for fine care, and it never becomes an issue.  You can spend your twilight years in a place you love, feeling cared for and living your best life.  Vivi la tua vita al meglio! Ph. columbo.photog / Shutterstock.com

The excitement of this new adventure in Rome floods your mind with a million thoughts, but I bet you not one of them is about the healthcare system. No, of course not. But it’s something to consider, especially if you yourself are older and having health issues(hence the move) or if you have family members you are taking with you.  In fact, it can become complex when you are dealing with healthcare in your new country or entering the world of long-term care for your family member or yourself. You are possibly faced with language barriers, complicated laws, and patient rights that are very different from those at home. As an immigrant from America to Italy, you may find a time when you need to consider these issues and make decisions for yourself or a family member.  This article will give you guidance as to what things to consider for this life-changing, incredibly exciting, long-term move to amazing Italy. Italy's public health system – – provides public health coverage, and this does include some long-term care.  You may voluntarily sign up for the system, or you might be signed up as a compulsion with your employment. Either way, you must be registered as a resident in order to qualify for the , and families often supplement the covered long-term care with private nursing homes (case di riposo) or live-in caregivers (badanti).  The nuances of the Italian system and long-term care can get very complicated, so it will be necessary to find an advisor who can help you through this.  Where you live, what coverage you have through private insurance, or if you qualify for the LTC through your job or financial background, all play a part.  When things progress to a point where choosing a long-term nursing home becomes necessary, look beyond, look beyond the aesthetics:

• Ask about staff-to-patient ratios.
• How are carers trained?
• What social events and activities are offered?
• Who monitors diets, or is that personal choice? Is there a dietician monitoring special diets or not?
• Is there a service to take patients to outside appointments/ Trips to the bank? Shopping (depending on level of care needed).
• What protocols are set up for patients who are immobile? Is the focus on prevention of common issues like bedsores and rashes addressed daily? How are they treated? How often are they turned?

The issues that can arise could be minor to start, but progress to severe quickly, so it’ll also be imperative that you are fluent in Italian or have an interpreter who can help understand this complicated system.  Although Italy's SSN is known to be one of the best in the world, it’s no secret that neglect in nursing homes due to staff shortages and facility systematic failures happens all over the world, so it pays to be vigilant. For residents who use wheelchairs or are bedridden, it is absolutely imperative that they’re repositioned in their beds, kept clean and dry, and monitored for bed sores.  Suppose there seems to be an irritation that needs to be addressed straight away. If you notice angry red spots or an actual sore, this is a red flag about the kind of care you or your family member is receiving.  These only appear and get worse if there has been a failure in basic nursing care: inadequate turning, poor nutrition and hydration, and unsanitary conditions.  These sores progress quickly and can be a stage 1 bedsore to a stage 4 bedsore within days. If it reaches stage 4, the wound has usually gone so deep that it has reached the muscle and bone, and this poses a life-threatening risk of infection. In a care setting, this is almost always a sign of profound neglect.  This has progressed to a possible fatal situation and will need to be handled medically and perhaps legally.  Patients in Italy have legally protected rights to adequate care and dignified treatment.  If you or your family member feels you or they have been neglected, you have the right to speak up. Document everything with photos and dates, request a meeting with the facility director, and file a formal complaint with the local health authority, Azienda Sanitaria Locale (ASL). Knowing various laws is one thing. But actually understanding them and interpreting them is another. And if you're in another country, all of this gets to the next level of 'difficult to deal with'. While the legal context differs, families in the United States often face similar severe neglect situations where they seek guidance from specialized legal experts -- lawyers who fully specialize in these types of cases. Here's an example: If a nursing home resident ended up suffering a severe case of bedsores because of the staff's neglect, mistreatment, or even abuse, the U.S. family would require knowledgeable in order to build a solid case and win in court. In Italy, it's a similar situation, with the difference being that such cases are usually pursued via civil lawsuits (usually settled or they end up with jury awards based on contingency), while in Italy, such lawsuits are more judge-driven. Some cases even end up crossing into criminal law.  In that case, the cost in such scenarios skyrockets for the attorney (plaintiff in the U.S.). No one moves their life to another country if they don't love and appreciate where they are going to live.  The admiration for the culture and love of the people is what entices someone away, so they certainly do not want to find themselves in a legal case at all. Getting older has its own issues, and your facility lives up to the Italian reputation for fine care, and it never becomes an issue.  You can spend your twilight years in a place you love, feeling cared for and living your best life.  Vivi la tua vita al meglio! Ph. columbo.photog / Shutterstock.com