President

appropriate performance, guaranteeing a unified system. The Government and
the Regions have identified the strategic sectors in which to operate in order to
improve regional healthcare services and guarantee the satisfaction of the
citizens’ needs and at the same time more control over expenses. With regards
to the elderly, the focus has been placed especially on gradual disability over
the years. The main cause of the marginalisation and then isolation of the
elderly is not however due only to their possible disability, but it must be
identified, as we have seen, in the loss of their social and productive role, which
causes a decrease in their financial potential, a feeling of loneliness and finally,
not uncommonly, a strong sense of uselessness accompanied by a loss of selfesteem.
Moreover, the Pact highlights a need to know these factors, which then
affect the regulations, recognising that the need of elderly people are also by
and large not only “material”. Consequently, the Guideline for the realisation of
an integrated system of interventions and social services (Law of the 8 th of
November 2000, No.328) expressed the clear intention of intervening on the
different sectors of social life, integrating – through the implementation of a
system of local networks – the services to the person and to the family,
anticipating financial incentives aimed at optimising the resources and avoiding
clashes of authority and the sectorialisation of the responses. This overall
vision has been taken on by the three-year Plans of the National Healthcare
Service agreed upon so far, which have never failed in highlighting how the
needs of the elderly must be at the centre of an healthcare service that is
varied in its methods and ways of care (unfortunately not always carried out or
made possible): this is the so-called “third economy”, aimed at making sure that
“the elderly who are not supported by a family can, with their own economic
activity, express their freedom and at the same time contribute to the individual
and collective well-being” 294 . As already highlighted by the National Bioethics
Committee (NBC, 2006), when we talk about the elderly we cannot reduce the
discussion merely to demographic and economic data without taking into
account their equal dignity in comparison to other citizens, regardless of their
age, their health conditions and the contribution they are able to make,
because their presence in itself contributes to the well-being of society. And
more, alongside the Report “World Population Ageing 2007” by the United
Nations – which states that “there are numerous ways in which the elderly can
express themselves and feel fulfilled: continuing to participate to family life,
practising voluntary work, acquiring new knowledge, enrolling in courses,
expressing themselves through arts and crafts activities, participating in
community organisations and associations of the elderly or religious,
recreational, touristic activities, working part-time or being part of the political
life as informed citizens…” 295 – a variety of ways to participate to activities,
courses or other have been planned, and in some cases realised locally,
suggested by the various local Administrations (Attachment II).
According to the White Book on the future of the social model by the
Ministry of Labour, Health and Social Politicies, published in 2009, which
register the data of the “the level of generational separation of the elderly who,
more and more often, live only with other elderly people, in particular in rural
areas that are going through a depopulation”, this new situation “imposes
294 M. Trabucchi, Perché Terza Economia, in: Fondazione onlus socialità e ricerche – La
Scienza dell’assistenza. Terza Economia sempre più valore dalla terza età. Quaderno No. 2,
The European House Ambrosetti, 22 nd of January 2008, p. 4.
295 www.unpopulation.org.
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