ADI Home Care in Rome: How to Activate Free In-Home Nursing and Support for Elderly or Disabled People
Integrated Home Care (ADI) brings nurses, physiotherapists, and care assistants to your door at no cost. Here's how to request it through your GP.
In a Nutshell
Assistenza Domiciliare Integrata (ADI) — Integrated Home Care — is a free service provided by the SSN (Servizio Sanitario Nazionale — Italy's national health service) that sends a multidisciplinary team to the home of anyone who cannot leave it independently. The team can include nurses, physiotherapists, OSS care workers (Operatori Socio-Sanitari — trained health-and-social-care assistants), and, where needed, specialist doctors and psychologists. In Rome the service is run by the District Health Units of the six ASL (Azienda Sanitaria Locale — your local public-health authority) operating across the city. You start the process through your GP and the healthcare component is entirely free.
At a Glance
| Cost | Free (guaranteed under the LEA — Livelli Essenziali di Assistenza, the nationally mandated minimum health-service package, funded by the SSN). An ISEE-based co-payment may apply for social-care services provided by the Comune (city hall / municipality). |
| Timeline | UVMD assessment: within 15–30 days; care starts within 7–15 days of assessment |
| Where in Rome | PUA (Punto Unico di Accesso — the district one-stop intake desk) at your local ASL district office |
| Documents you need | ID, Tessera Sanitaria (Italian health-insurance card), GP's referral report, disability certificate if you have one |
Who Is Entitled to ADI
ADI is a guaranteed right under the LEA (DPCM 12/1/2017) for:
- Frail elderly people who cannot manage independently (e.g. post-stroke, dementia, bedridden due to a severe fracture).
- People with serious disabilities (Legge 104/92, art. 3 comma 3) of any age.
- Patients with chronic conditions in an unstable phase (COPD, heart failure, complicated diabetes).
- Cancer patients in active treatment or palliative care.
- Post-hospitalisation patients who need continued care at home (e.g. stomas, rehabilitation after a hip fracture).
- People with ALS, multiple sclerosis, or other degenerative neurological conditions.
- Children with complex chronic conditions (Paediatric ADI).
The essential requirement is being registered with the Lazio SSN. Foreign nationals with a valid residence permit are entitled to the service. Holders of an STP code (Straniero Temporaneamente Presente — temporary-presence code for irregular migrants) are guaranteed essential and ongoing care.
How to Activate ADI: Step by Step
1. See your GP (or your family member's GP). Explain the situation — difficulty moving around, need for wound care, physiotherapy, or daily assistance. The GP already knows the patient's medical history and can assess eligibility straight away.
2. The GP completes the ADI referral form (the single Lazio region form) and sends it to the local ASL district office responsible for the patient's address. At the same time, you or a family member can walk in directly to the PUA — Punto Unico di Accesso (the district's single intake point) to submit the request in person.
3. The UVMD visits at home within 15–30 days. The Unità Valutativa Multidimensionale Distrettuale (UVMD — the multidisciplinary assessment team) consists of a geriatrician, a nurse, a social worker, and where relevant a physiotherapist. They assess the patient's condition using standardised scales (InterRAI, ADL/IADL indices) to determine the level of need.
4. You sign the Piano Assistenziale Individuale (PAI) — the individual care plan. The PAI specifies which professionals will visit, how often, and for how long. The patient or their main carer signs it.
5. Care begins within 7–15 days of the UVMD assessment.
Who Comes to the House and What They Do
The ADI team is made up of different professionals activated according to the patient's needs:
- Nurse: injections, wound and pressure-ulcer dressings, catheter management, feeding tubes, stoma care.
- Physiotherapist: home-based motor and respiratory rehabilitation.
- OSS care worker: personal hygiene, mobilisation, help at mealtimes.
- Palliative-care physician: chronic pain management, primarily for cancer or terminal patients.
- Psychologist: emotional support for the patient and their family carer.
- Social worker: link to the Comune's social-care services for non-medical needs.
The intensity depends on the level of need: from 1–2 visits per week for low-complexity situations up to daily visits for those with high-level needs.
If Your Relative Has Just Left Hospital: Protected Discharge
If a family member is in hospital and is expected to need home care after discharge, do not wait until they are home to start the paperwork. All major Roman hospitals — Policlinico Umberto I, Gemelli, San Camillo, and others — have a protected discharge unit that contacts the ASL district before the patient leaves.
The UVMD assessment can take place directly in the hospital, cutting waiting times significantly. In this case care can start within 72 hours of discharge, sometimes the same day.
Palliative Home Care
For patients in the terminal phase of illness — oncological, neurological, or advanced cardiac disease — there is a dedicated pathway: Cure Palliative Domiciliari (UCP-Dom) — home-based palliative care. It is activated by a referral from the GP or the oncologist to the district Palliative Care Centre. Assessment is fast-tracked (48–72 hours). The palliative team provides 24/7 telephone availability, with on-demand home visits.
If managing the patient at home becomes unworkable, transfer to a hospice can be arranged.
Mistakes to Avoid
- Waiting for a crisis or emergency hospitalisation. ADI works best when activated early. By the time the situation is critical, the waiting period becomes much harder to manage.
- Paying anyone to "activate ADI." The health service is free and is activated only through your GP and the PUA. If someone asks for money to act as an intermediary, that is improper.
- Refusing the UVMD home visit. Without the assessment the care plan cannot start. The commission is not a gatekeeping exercise — it is there to figure out exactly what the patient needs.
Special Cases
You live alone with no family carer: ADI can be activated even without a family caregiver. In this case the Comune can simultaneously activate the SAD (Servizio di Assistenza Domiciliare — the municipality's social home-care service), a telesoccorso (personal alarm button service), and, in the most serious cases, placement in an RSA (Residenza Sanitaria Assistenziale — a residential care home).
The patient holds Legge 104/92 status: ADI complements — rather than replaces — the rights already granted under that law. The family caregiver who is also an employee retains their paid leave entitlement; the patient with full disability can apply to INPS (Italy's social-security agency) for the indennità di accompagnamento (attendance allowance — roughly €530 per month).
You need equipment (adjustable bed, wheelchair, pressure-relief mattress): supply is free through the ASL on a specialist prescription. Allow 15–45 days. Contact the Protesica (prosthetics and aids) desk at your district.
You are the carer and want to learn how to manage at home: the ASL districts and the Comune's Municipi (local councils) run free carer training courses covering moving and handling, pressure-ulcer prevention, and feeding a bedridden patient. Ask at your district PUA.
Where to Go in Rome: PUA One-Stop Intake Desks
| ASL | Main area | PUA address | Phone |
|---|---|---|---|
| Roma 1 — District 1 | Historic centre, Municipio I | Via Luzzatti 6/8 | 06 77302610 |
| Roma 2 — District 4 | Tiburtina, Municipio IV | Via dei Crispolti 142 | 06 51005240 |
| Roma 2 — District 7 | Appio/Tuscolano, Municipio VII | Via Monza 2 | 06 51005203 |
| Roma 2 — District 9 | EUR, Municipio IX | Via Cardano 135 | 06 51008300 |
| Roma 3 — District 10 | Ostia, Municipio X | Via D. Baffigo 39 | 06 56487291 |
| Roma 3 — District 11 | Portuense, Municipio XI | Via Portuense 332 | 06 56486591 |
To find the exact district responsible for your home address, call Roma Capitale on 060606 or visit comune.roma.it. For urgent social-care situations call the Sala Operativa Sociale freephone 800 440022, available 24 hours a day.
Official Sources
- Ministry of Health — LEA Care
- Ministry of Health — ADI
- Salute Lazio
- ASL Roma 1 — Home care
- ASL Roma 2 — Home care
- ASL Roma 3 — Home care
- Roma Capitale — Elderly social services
- Roma Capitale — Social emergency line
- INPS — Attendance allowance
- PNRR Mission 6 — Health
- Italian Palliative Care Federation
Legal references: L. 833/1978, DLgs 502/1992, L. 104/1992, DPR 14/1/1997, DPCM 12/1/2017 (LEA), L. 38/2010, DGR Lazio 223/2019, L. 33/2023, DLgs 29/2024.