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Hi there, I think the most important thing is to have at least a rudimentary understanding of Italian. I did not, and I felt very isolated until a got some language skills. My partner(now my husband) was very skilled and sweet about translating and trying to keep me in the loop, but it really isnt fair to totally depend on him. I love Italy and I love Italian people. Now I have a good working relationship with lots of Italian friends. My Italian is probably on the level of a 6 year old(my grammar is terrible) but I can participate and keep up with most conversations. Of course if more than 3 people are talking at once, forget it. They over-lap and change subjects so fast it makes my head spin.
When I went to get my permesso di sogiorno, I had to take either my husband or my sister-in law with me. The first two times I tried to do it alone and ended in tears. People in bureaucratic positions tend to not have much patience. People in shops, however are wonderful. I think I learned a lot of my Italian buying food and ordering in restaurants.
I dont work in Italy, so it was very important to keep busy while my husband was at work. I could now probably do a  fabulous guided tour of Genova. I wandered everywhere, went into every museum, saw every tiny village with in that region. I also learned to drive Italian style. It ended in tears many times, I got lost constantly and people were always honking and yelling at me, but I survived and now my stepsons say I drive just like an Italian.
Another thing it took a while to sort out was getting my USA mail in Italy. I still pay US taxes and we keep a small apartment in Los Angeles because I come back once a year for work. The US postal service is not very efficient about out of the ordinary circumstances. I tried having it forwarded to another address or having somone pick it up for me and non of that worked very well. What I am going to try this time is a mailbox at a postal service. They will empty it and send it to me fedex once a month. I think this will work
Anyway, life in Italy is at a different pace, things get done slower, but they get done.
Right now our beloved Italy is being devastated  by corona. We happened to be in US when in broke, but we are in close touch with our family and for now everyone is in lock down and is safe. We are doing the same here. Please everyone stay safe follow the guidelines and hopefully we will all be in a healthy restored Italy in the near future. Thanks  Brooks and Maurizio