Family Caregivers in Italy - An invisible yet emotionally crucial reality

Isabella Puddu – Professional Medical Coach & Caregiver Coach

Monica Iurlaro – Medical Doctor & Professional Medical Coach

In Italy, millions of people provide care for a loved one. Often in silence.

Almost always without any protection.

Italy is currently facing an unprecedented demographic challenge. It ranks second in the world, after Japan, in terms of population aging: 23.5% of Italians are over 65, while the birth rate continues to decline.

In this context, the role of the family caregiver has become indispensable to the stability of Italy’s social and healthcare systems”

Yet, this figure remains largely invisible, often lacking legislative, social security, and economic recognition.

According to the report “Embracing Carers” (2020), 65% of Italian caregivers do not feel supported by institutions, a figure higher than the European average (57%).

A clear sign: the problem affects not only families, but the entire country.

Caregiving Statistics: A Social Snapshot

The data speaks for itself.

In Italy, approximately 8 million people provide care at least once a week.

6.9% of the population consists of family caregivers, predominantly women, often between the ages of 45 and 55.

Many of them try to balance work and caregiving.

Many others are forced to abandon their careers to devote themselves entirely to caring for a parent, child, or partner.

Caregiving isn’t limited to adults.

Young people are involved too: 7% of caregivers are millennials, demonstrating that this is a cross-generational phenomenon that spans all ages.

The Impact on Work and Economic Stability

When we look at the workplace, the picture becomes even more critical.

• 57% of caregivers provide round-the-clock care

• 43% struggle to balance home and work

• 9 out of 10 caregivers are not currently in the workforce

Among those who are not working:

• 61.9% had to leave their jobs

• 28.2% were never able to enter the workforce

• only 9.8% are retired

Added to all this is severe financial vulnerability:

• 59.1% receive no financial assistance

• 45% struggle to pay their bills

• 33.4% sell valuables

• 21.6% are forced to go without heating

These figures reveal a reality that is often overlooked, yet one with profound consequences for health, dignity, and the sustainability of care.

Beyond the Numbers: The Emotional Burden of Caregiving

Behind the statistics lies an intense and often painful emotional reality.

Family caregivers face a daily reality marked by:

• constant sacrifices

• loneliness

• a constant sense of responsibility

They must coordinate care, handle administrative tasks, cope with the fear of falling ill, and deal with the knowledge that their absence could have serious consequences for the person they care for.

Physical exhaustion compounds psychological stress, while the lack of social and financial recognition amplifies the sense of isolation.

Visible Needs and Hidden Needs

Being a caregiver today is not an exception. It is an almost inevitable stage in the life cycle.

As Rosalynn Carter, former First Lady of the United States, once said:

“There are only four kinds of people in the world:

those who have been caregivers,

those who are caregivers,

those who will be caregivers,

and those who will need caregivers.”

Caregivers attend to another person’s physical, emotional, spiritual, and practical needs, all while trying to balance work, family, and their personal lives.

In many cases, being a caregiver is like running a business: crises, unexpected events, constant responsibilities, urgent decisions—all with limited resources.

The most visible tasks

• personal care

• medical assistance

• emotional support

• household management

• transportation

• advocacy

• coordination of services

The less visible needs include

• need for respite

• need to be heard

• need for recognition

Caregivers often live in a state of constant alert, without any real breaks.

They feel guilty because they can never be “enough”: neither for those they care for, nor for their own family, nor for themselves.

The New Caregiver Bill: A Turning Point Ten Years in the Making

For those who have been following this issue for some time, the feeling has always been the same: lots of talk, lots of proposals, no legislation.

Over the past ten years, more than thirty parliamentary initiatives have been introduced.

It wasn’t until 2018 that an official definition of a caregiver was finally established.

In January 2026, however, a significant shift is expected.

The new bill on family caregivers finally recognizes the social and human value of those who care for others.

The text cites studies showing that caregivers’ life expectancy can be reduced by up to 17 years if they are not adequately supported.

Protections Provided for in the Bill

Non-Financial Protections

• Inclusion of specific measures in Individual Care Plans (PAI)

• Replacement of the caregiver in case of emergency

• Access to psychological support, in-person visits, and teleconsultations

• Priority access to healthcare services

• Recognition of acquired skills

Workplace Protections

• Adjustment of work hours

• Flexible work arrangements

• solidarity leave and time off

• protections against discrimination

Young caregivers and students

• balancing study, work, and civil service

• exemption from university tuition fees

• recognition of academic credits

Financial protections

• allowance of up to 400 euros per month

• starting in 2027

• annual allocation of 257 million euros

An important step forward, though not a complete solution.

Beyond the Law: The Role of Caregiver Coaching

Alongside legal protections, there is a growing need for complementary support models.

Caregiver Coaching focuses on:

• role awareness

• proactive management of challenges

• development of practical skills

• validation of experience

The caregiver is not merely a recipient of help, but an active participant in a process of adaptation and growth.

Compassion Fatigue and Self-Care

The scientific literature highlights how prolonged caregiving can lead to compassion fatigue: an emotional exhaustion linked to continuous exposure to the suffering of others.

The practice of self-care is not limited to moments of relaxation or recreational activities, but constitutes a genuine strategic process of emotional and physical recharging, essential for sustaining the role of caregiver over the long term through:

• mindfulness

• regenerative breaks

• movement

• support networks

In light of this evidence, integrating interventions such as Caregiver Coaching into support models can offer tangible benefits:

• supporting reflection and awareness of one’s role and emotional responses;

• promoting adaptive coping strategies, including the ability to achieve functional emotional detachment when necessary;

• strengthening sustainable ways of managing emotions and the caregiving burden;

• preventing the onset of psychological or physical exhaustion related to caregiving responsibilities.

Conclusion

Caregivers can become ill too.

Recognizing the caregiver as a person with needs of their own means shifting our perspective.

Caregiving is not just a task to be endured, but an experience to be supported.

Without this holistic approach, there is a risk that caregivers themselves will become ill, with consequences for their quality of life and the sustainability of care.

Caring for caregivers is not an act of kindness AND a social necessity.

Bibliography:

1.     DDL S. 134 - XIX Leg.

2.     GLI ANZIANI E LA LORO DOMANDA SOCIALE E SANITARIA ANNO 2019 -                       RAPPORTO COMMISSIONE PER LA RIFORMA DELL’ASSISTENZA SANITARIA E SOCIOSANITARIA PER LA POPOLAZIONE ANZIANA – ISTAT 

3.     Day JR, Anderson RA. Compassion fatigue: an application of the concept to informal caregivers of family members with dementia. Nursing Research and Practice. 2011. (PubMed)

4.     Abendroth M. Overview and summary: Compassion fatigue: caregivers at risk. OJIN: The Online Journal of Issues in Nursing. 2011. (ojin.nursingworld.org)

5.     Concept analysis of compassion fatigue in family caregivers (PubMed)2012. (PubMed)

6.     Sorenson et al. Compassion fatigue among healthcare workers: systematic review (MDPI). (MDPI)