Introduction: The rapid ageing of the Italian population is reflected by a growing demand for LTC services. As families are facing increasing difficulties in providing everyday elder care, the pressure on formal services is growing. At the same time, the current financial crisis is making the public response less and less able to provide the needed resources. As a consequence, the current approach of indirect public support to the private employment of migrant care workers (MCWs) through cash-for-care schemes is likely to continue.

Method: The presentation is based on a detailed analysis of empirical findings and policy documents, outlining the crucial features characterising the Italian LTC system and describing also some of the main differences existing between different regional care approaches.

Results: After adecade of increasing availability of publicly funded LTC services for older people, in some sectors, such as integrated home care, the audience of recipients has started receiving a lower number of hours of care. The mainly monetary focus of the Italian care regime has a clear incentivizing effect to employ foreign migrant care workers, often on an undeclared basis, to provide everyday elder care in Italian homes. Another crucial characteristic is the strong heterogeneity of Italian regions, according to which today different clusters of regions can beidentified, with strong inequalities in LTC provision.

Conclusion : Thelack of a coherent national LTC policy has been recently accompaniedby an increasing focus on cash-for-care payments, which in the future will require a stronger attention to care quality issues.