There is still life

In Italy there are a total of 14 million 177 thousand people over 65 years of age, 24.1% of the entire population.
Those aged over eighty, in particular, number 4 million and 530 thousand, 7.7% of the population.
In many cases these people are well integrated into the community and continue to make an indispensable contribution to family and social cohesion, thanks to the good health promoted by the Mediterranean diet and by the national health system present in our country and thanks to volunteering and other initiatives for active aging that massively involve the Italian elderly.

Unfortunately - out of the 14 million over 65s - 3.8 million are not self-sufficient and many others live alone.
It is a priority issue for the Public Administration and the Third Sector, because the demographic trend will make this number increasingly larger in the coming years, making preparatory interventions necessary. The sustainability of healthcare and welfare is at stake, as the elderly are the main users of these services, but also the degree of civilization of our democracy, which already today abandons many of these people, even though they are fully entitled to citizenship rights.
Healthcare should be close to these solitudes, making policies for non-self-sufficiency a citizen's right, which concerns not only the elderly but also non-self-sufficient disabled people.
The family cannot be a substitute for the National Health System, yet today the burden of caring for non-self-sufficient people is largely on the shoulders of families.

The insufficiency of public interventions to support non-self-sufficient people is producing dramatic effects on the Italian population:
from the impoverishment of families who have to take care of family care at home or beds in RSAs, to the serious problems that affect family dynamics when the care commitment becomes unsustainable, with the renunciation of the working dimension for those who cannot to do without providing assistance but cannot take advantage of paid leave, up to the very serious risks of loneliness and abandonment for sick people who do not have solid social relationships and family networks. The widespread belief that assistance for non-self-sufficient people is exclusively the responsibility of families, due to the absence or weakness of public support services, constitutes a serious cultural problem, which fuels a painful sense of abandonment in families. The greatest risk is that of a real phenomenon of "euthanasia by abandonment": elderly chronic patients who no longer receive the necessary care.

Today there is an urgency to update care models.
It is necessary to avoid the crystallization of procedures that are no longer adequate to needs and to stop considering the patient as a "client" or as an "object of care", but as a person who must always be recognized with dignity, even when there is no hope of healing. In fact, even those who cannot be cured must be treated with love. For this reason, home and residential care aimed at non-self-sufficient, chronic, psychiatric people and those with neurodegenerative diseases represents the new frontier not only of the social sector, but above all of Italian healthcare.
If on the one hand the supply of residential beds must be adequate to the demand and needs of the population, especially for certain pathologies and for inadequate housing and family situations, on the other hand it is necessary to pay equal attention to the guarantee of care and home care, considering that home care guarantees greater quality of life for users and their families, more personalized interventions, lower costs for the community, reduction of inappropriate hospital admissions and emergency room congestion. These treatments are more appropriate, less expensive and more respectful of emotional and community bonds, which are part of the person's identity and contribute to their well-being, not only relationally, but also health-wise.

The hospital, home and RSA must be put in contact in a fluid manner.
If the National Health System, the greatest achievement of the 1970s, is not reformed to cope with the great Italian demographic change, it will risk withering away or being gradually crumbled.
Alongside health interventions, it is necessary to strengthen social ones: neighborhood networks, co-planning between the Third Sector and the municipalities, intergenerational twinning between oratories and RSAs, RSAs open to the territory, social concierge in every condominium, co-housing for self-sufficient elderly people... Everything that can make older people feel less alone, especially in large cities where the risk of anonymity and isolation is higher. Fraternity must not neglect those who are more invisible and live more secluded, those who have a weaker voice or are forgotten by the media circuits. The logic of efficiency and image cannot prevail. Our elderly are our roots and they are the ones who worked to build our country, we cannot treat them like waste in the most fragile phase of their lives.


By the editorial staff
NPFOCUS
NP February 2024