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Elderly Depend on Immigrant Women for Caregiving
Francesco Screti
March 30, 2005
"I have been living in Italy since 1988 and have been taking care of elderly people for 16 years, first in Naples and later in Rome," Angela Jiménez, a 57-year-old Chilean immigrant, told IPS.
Jiménez, who is fluent in Italian, is more than just a companion to her employer. She cooks, cleans, irons, gives her elderly charge her medicine, and oversees her diet. And because of her employer's advanced age and poor health, Jiménez's job is 24/7.
"I earn 620 euros (800 dollars) a month, pay that does not tally with the effort and work I put in, nor with the responsibility involved in caring for an elderly patient, because her life is in my hands," she said.
Most domestics either clean and cook or dedicate themselves exclusively to caregiving, which includes personal hygiene, feeding, administering medication, helping their elderly employers get around, and companionship.
But others, like Jiménez, do it all.
According to the national labour agreement for this branch of activity, domestics who do not receive room and board in the homes where they work and whose job description is limited to cooking and cleaning should earn at least three euros an hour (equivalent to around 900 dollars a month), while those who also take care of the elderly should earn 4.2 euros an hour (around 1,300 dollars a month).
Figures from the National Social Security Institute (INPS) indicate that most domestic caregivers in Italy come from Ukraine (21 percent), Romania (16.4 percent), the Philippines (9.5 percent), Poland (7.0 percent), Ecuador (6.4 percent), Moldova (5.7 percent) and Peru (5.0 percent).
"Italian society has changed greatly in the past 30 years," and not only in terms of demographics and economic conditions, said Le Quyen Ngo Dinh, the head of immigration matters in the Catholic humanitarian organisation Caritas in Rome.
Part of the change has been brought about "thanks to the inflow of immigrants. The changes in Italian society and the arrival of immigrants have been contemporaneous processes," he commented to IPS.
Another factor was the increasing number of women who have joined the workforce, he added, noting that growing supply and demand for caregiving have coincided.
Italy has an ageing population. The National Statistics Institute reports that more than 19 percent of the country's nearly 58 million people were over 65 in 2003, an age group that accounted for just three percent of the population in Nigeria, for example, according to United Nations figures.
In traditional Italian society, the elderly and disabled lived with their families, and were taken care of by their female relatives.
But today, families are often unable or unwilling to care for their elderly, who at the same time live longer and require greater care over a lengthier period of time.
Ngo Dinh said public social services "do not meet the requirements of the people, whether due to excessive demand or because the Italian social state has never been very solid and has always relied on family networks."
But these networks have shrunk. "Families have become nuclear or monoparental, and many of the things the family did before, immigrant women do today, sometimes with the economic support of regional governments" in a kind of mixed public/private system, said Ngo Dinh.
The authorities are well aware "that the institutionalisation of caregiving for the elderly would be very costly for the government, while a private system costs much less, especially if you're talking about foreign labour power," which is cheaper than Italian labour, he said.
Some regional governments in Italy have actively encouraged such services, through subsidies and reimbursements, "which leads to a win-win situation for everyone. The elderly patients stay in their homes and do not feel alienated in an institution, foreign nationals have a source of income, and the state keeps costs down," said Ngo Dinh.
According to INPS statistics, a total of 51,110 immigrants worked as domestics in Italy in 1994, or nearly 27 percent of all domestic workers, compared to 490,678 -- or 83 percent -- in 2003.
Today, foreign caregivers number more than 600,000, said Rita De Blasis, the president of the national association that represents these workers.
Some 2.2 million immigrants with residency status are registered with the Italian Interior Ministry. But "conservative estimates" by Caritas put the immigrant population at no less than 2.6 million.
An undetermined number of undocumented immigrants work in the toughest, lowest-paid jobs in Italy, especially in the agricultural sector.
Foreign nationals represent an essential "resource" for Italian families "because they provide excellent services in response to a need for caregiving in an ageing population," said Ferruccio Marzano, a professor of economic sociology at the La Sapienza University in Rome.
"They don't take work from anyone, since apart from some sectors and some areas of Italy where there are other sources of labour," immigrant workers are sometimes "the only ones available," said Ngo Dinh.
The Caritas official also said that with the exception of immigrants working in the industrial sector, foreign nationals are paid less than Italians, although he had no specific figures to offer.
But De Blasis said it is impossible to categorically state that foreign caregivers earn less than Italians, because there is no basis for comparison. "Italians don't work as caregivers for the elderly anymore; they are all foreigners now," she said.
Marzano, meanwhile, maintained that the emergence of this kind of activity that is complementary to the country's health system "could be expected to offer better, more personalised services. The patients, since it is private money that is being spent rather than public, are more careful and watchful, and only turn to the health services when they really need them."
In Ngo Dinh's view, the close ties and familiarity generated by caregiving can "boost the integration" of people belonging to different cultures, because prejudice is often a result of ignorance, superficial interactions and lack of in-depth contact.
Many immigrants complain of running up against racial prejudice and xenophobia in Italy, and in Europe at large.
But Marzano called for a more "realistic" analysis. "Integration is a process that takes years, and people must be left in peace, and not continually bombarded" by criticism and opinions on the phenomenon.
"People have to be allowed to mature. We have to allow integration to be a slow, gradual process, and perhaps journalists and sociologists should write about it a bit less," said the professor.
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