Caring in the XXI century: the sustainability of long-term care in aging societies-mapping challenges and developing solutions within the Age-It Research Program.

OBJECTIVES: The process of population aging characterizing Italian society will lead to a greater demand for long-term care (LTC) services, while simultaneously reducing the availability of caregivers. Spoke 5 activities develop interdisciplinary solutions to meet the challenges and seize the opportunities that emerge from this transformation. METHODS: The article summarizes the outputs from Spoke 5 of the Age-It research program, highlighting their implications for practitioners and policymakers. The research activities contribute to: (a) mapping care needs and resources; (b) developing innovative digital tools to monitor caregivers' well-being and support them; (c) advancing integrative planning for age-friendly environments; (d) developing e-learning platforms addressing caregivers' needs; (e) identifying existing policy shortcomings. RESULTS: Spoke 5 developed an index of LTC risks that measures the balance between the demand and the potential supply of care at the municipal level; critical areas only partially overlap with traditional socioeconomic cleavages. The analysis of informal care distribution reveals that high socioeconomic status (SES) individuals outsource more demanding caregiving tasks, whereas low-SES families face high-intensity care demands. Innovative digital tools and e-learning platforms are presented. The analysis of policies supporting Italian informal caregivers indicates that they are characterized by a significant geographical and institutional fragmentation. DISCUSSION: The progression of macro sociodemographic trends has pushed Italy's existing "care equilibrium" to its limits; innovative solutions are needed. Adopting a multidimensional and multidisciplinary approach, focusing on the goal of supporting caregivers' well-being and training, and overcoming policy fragmentation are key to creating an LTC system that is socially and economically sustainable.