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The elderly after the pandemic


A lesson to be learned

It is time to “find the courage to create spaces where everyone can feel called, and to make possible new forms of hospitality, fraternity and solidarity.”[1] This is what Pope Francis said in his prayer of March 27, 2020 in an empty St. Peter's Square after he reminded everyone that: “greedy for gain, we pay attention only to things, are led astray by our impatience. We did not heed your warnings or come to our senses in the face of wars and global injustices. We were deaf to the cry of the poor and of our gravely ill planet; we carried on undaunted...” [2]

The Pontifical Academy for Life - together with the Dicastery for Integral Human Development - has felt itself obliged to contribute to a reflection on the lessons to be learned from the tragedy of the pandemic, on its consequences for today, and for the immediate future of our societies. In this context, the Academy has previously issued two “Notes” on this subject: “Pandemic and Universal Brotherhood” and “ Humana Communitas in the Age of Pandemic: Untimely Meditations on Life’s Rebirth,”[3] and the Dicastery for the Laity, Family and Life has published “In Loneliness the Coronavirus Kills More.[4]

The pandemic has produced a twofold awareness: on the one hand the interdependence of everyone, and on the other greater attention to inequalities. We are all in the same storm, but it is increasingly evident that we are on different boats, and that the least seaworthy boats are sinking every day. It is essential to rethink the whole planet’s development model. Everyone is called on: politics, the economy, society as a whole, religious organizations, to put in place new societal structure that places the common good of all peoples at its center. There is no longer anything that is “private” that does not also implicate the “public” aspect of the whole community. Love for the “common good” is not a mere Christian dream, its concrete implementation, right now, is a matter of life and death for a life together that is consistent with the personal dignity of each member of the community. For believers, mutually supportive brotherhood is a Gospel-based passion, it reveals without doubt a more meaningful beginning and a loftier destination.

In this difficult context, we look to the latest Encyclical of Pope Francis, Fratelli Tutti, which providentially describes the framework within which to work in order to clarify that “closeness” to the larger world of the elderly that until now has been “trashed” by public opinion. Unfortunately, it is the elderly who have been among the most affected by the pandemic. The number of Covid-19 deaths among people over the age of sixty-five is stunning. In Fratelli Tutti the Holy Father points out, “We have seen what happened with the elderly in certain places in our world as a result of the coronavirus. They did not have to die that way. Yet something similar had long been occurring during heat waves and in other situations: older people found themselves cruelly abandoned. We fail to realize that, by isolating the elderly and leaving them in the care of others without the closeness and concern of family members, we disfigure and impoverish the family itself. We also end up depriving young people of a necessary connection to their roots and to a wisdom that the young cannot achieve on their own.” [5]

The document In Loneliness the Coronavirus Kills More was published by the Dicastery for the Laity, Family and Life on April 7, 2020, a few weeks after the lockdown started in some European countries. It focuses on the difficult situation of the elderly and identifies loneliness and isolation as one of the main reasons why the virus is afflicting this generation. It documented that, “Those living in residential facilities deserve special attention: we hear terrible news about their conditions every day and thousands of people have already lost their lives. The concentration in the same place of so many frail individuals and the difficulty of finding protective equipment devices have created situations that are very difficult to manage notwithstanding the selflessness and, in some cases the sacrifice, of healthcare personnel.” [6]

Covid-19 and the elderly

During the first wave of the pandemic a significant number of Covid-19 deaths has occurred in institutions for the elderly, places that should have protected this “most fragile part of society,” and where instead death struck disproportionately more frequently more than in family homes. The Head of the European Office of the World Health Organization has stated that up to half of the coronavirus deaths in Europe occurred in nursing homes, calling the event an “unimaginable tragedy.”[7] From the comparative analysis of data, it can be seen that the “family”, on the other hand, under the same conditions, protected the elderly much more.

The institutionalization of the elderly, especially of those most vulnerable and most alone, proposed as the only possible solution to look after them, in many social contexts manifests a lack of concern and sensitivity towards the weak, for whom it would rather be necessary to use means and financing to guarantee the best possible care to those who need it most, in a more familiar environment. Isolating the elderly is an obvious manifestation of what Pope Francis has called the “throwaway culture”. The risks that afflict old age, like loneliness, disorientation and consequent confusion, loss of memory and identity, and cognitive decline, often appear even more clearly in these contexts, whereas instead the vocation of these institutions should be the family, social and spiritual accompaniment of the elderly, in full respect of their dignity, on a path often marked by suffering.

Pope Francis pointed this out beginning from his years as Archbishop of Buenos Aires: “...the elimination of the elderly from the life of the family and of society represents the expression of a perverse process in which there is no longer gratuitousness, generosity, that wealth of feelings that make life not just a give and take, that is, not just a market.... Eliminating the elderly is a curse that this society of ours often brings down on itself.”[8]

It is therefore very appropriate to begin immediately a careful, far-sighted, and honest reflection about how contemporary society should become “close” to the elderly population, especially the weakest. What happened during Covid-19 prevents the problem of elder care from being settled by, on the one hand, looking right away for scapegoats, or, on the other, by a chorus of praise for excellent results of those who kept an institution free of contagion. What we need is a new vision, a new paradigm that helps society as a whole to care for the elderly.

The Blessing of a Long Life

The need for a new and serious reflection, able of involving society at all levels, is also required following the great demographic changes we are all witnessing.

Statistically and sociologically, men and women in general have a greater life expectancy today. Related to this phenomenon there has also been a drastic reduction in infant mortality. In many countries around the world, this led to the coexistence of four generations. This incredible event, that would have much to tell us about the importance of learning to give value to intergenerational relationships, is definitely the fruit of scientific achievements, of more advanced and broader health care, of a more supportive social structure. The planet is changing face, but the different societies in all the ways they are structured still need to become adequately aware of this development.

This great demographic change represents a great cultural, anthropological and economic challenge. The data reveal that the elderly population is growing faster in urban areas than in rural ones, and that it is in cities that the greatest concentrations are recorded. The phenomenon, inter alia, reveals a second factor of significant import, namely the fact that mortality risks tend to be lower in urban areas than in rural areas.[9] Contrary to what a stereotypical view might be, global cities are places where on average lives are longer and the elderly become more numerous. It is essential, however, to make cities livable for them as well. According to data from the World Health Organization, in 2050 there will be two billion over-60s in the world. Therefore, one in five individuals will be elderly.[10] The question is thus how to make our cities inclusive and welcoming for the elderly, and, in general, for fragility in all its manifestations.

As Pope Francis pointed out, "today old age corresponds to different seasons of life: for many it is the age in which the productive commitment ceases, the forces decline and the signs of illness, the need for help and social isolation appear; but for many it is the beginning of a long period of psychophysical well-being and freedom from work obligations. In both situations, how to live these years? What sense can be given to this phase of life, which for many can be so long?". In our society the idea often prevails that old age is a time when life is unhappy, dominated as it is by illness, understood only as an age needing care, and therefore costly. This is an understanding not dissimilar to that which the Roman playwright Terence expressed more than two millennia ago, writing that “Senectus ipsa est morbus”[11] “Old age is itself a disease.” However, in the Bible, for example, a long life is considered to be the gift of a blessing. “It confronts us with our fragility, with mutual dependence, with our family and community ties, and above all with our divine sonship”. “Old age – as noted by Pope Francis - is not a disease, it is a privilege! Loneliness can be a disease, but with charity, closeness and spiritual comfort we can heal it”.

In any case, being elderly is a gift from God and a huge resource, an achievement to be safeguarded with care, even in case of disabling illnesses when the need emerges for integrated care and high-quality assistance. And it is undeniable that the pandemic has given strength to our awareness that the "wealth of years" is a treasure to be valued and protected.

A new model of care and assistance for the most fragile elderly

At the cultural level and in terms of civil and Christian awareness, a serious and profound rethinking of the welfare models that have existed for the elderly so far is all the more appropriate.

Learning to "honor" the elderly is crucial for the future of our societies and, ultimately, for our future. "There is a very beautiful commandment in the Tables of the Law, beautiful because it corresponds to the truth, able of generating a profound reflection on the meaning of our life: “honor your father and your mother". Honor in Hebrew means "weight", value; to honor means to acknowledge the value of a presence: that of those who have generated us to life and faith. […] The realization of a full life and more just societies for the new generations depends on theacknowledgement of the presence and wealth that grandparents and the elderly constitute for us, in every context and geographical area in the world. The corollary of this acknowledgement is respect, which is such only if it is expressed through welcoming, supporting and enhancing their qualities and their needs.

Among the honors due to them, there is certainly the duty to create the best conditions for the elderly to live this particular stage of life where they have been for a lifetime, at home with one’s family if possible and with life-long friends. Who would not want to continue living at home, surrounded by those who are dearest, even when one becomes more fragile? The family, one’s own home, one’s own neighborhood, is the best choice for every aging man and woman.

Of course, without the support and solutions offered by home care services it will not always be possible to continue living where one lived when autonomous. There are situations where one’s home no longer meets requirements but in these circumstances we should take seriously Pope Francis’ warning not be ensnared by the “throw-away culture” that can result in laziness and lack of imagination in the search for effective solutions for loss of self-sufficiency in old age. Putting the person with his or her needs and rights at center stage is an expression of progress, of civilization and of authentic Christian consciousness.

At the heart of this new and urgent approach is the centrality of the elderly person, knowing that all elderly individuals are different one from the other, as are their stories, and singularity cannot be overlooked. It is always necessary to begin with the person who is standing in front of you, from his or her life story, habitat, and current and past relationships. Any good policy aimed at identifying new housing and welfare possibilities must start from a careful consideration of the life of the individual, his or her personal history and needs. The implementation of this principle implies structured intervention at different levels to establish a continuum of care between one's home and appropriate external services, without traumatic breaks that are inappropriate to the fragility of growing old.

It is obvious that, from this point of view, one of the first concerns is having housing adapted to the needs of the elderly: for example architectural barriers, or the inadequacy of sanitary fixtures, insufficient heating, or confined spaces. When one takes ill, everything becomes an insurmountable obstacle. In addition, a greater number of active policies must be introduced to support integrated home care, including the possibility of skilled home medical care, and the wider distribution of regional services. In short, it is a “taking of responsibility” for the elderly where they live. All this requires social, civil, cultural, and moral conversion. This is the only way to respond adequately to the demand for closeness to the elderly, especially the weakest and most vulnerable.

The role of the caregiver, a profession that has been present in western societies for years, must be given greater importance. Other professions are also to be regulated within precise normative frameworks to enhance skills and support families. Every effort must be made to enable the elderly to live in a "family" environment during this phase of life.

Implementation of new technologies and advances in telemedicine and artificial intelligence, if well used, will increasingly offer to the elderly an opportunity to create in their homes an integrated system of assistance and care capable of making it possible for the elderly to stay in those homes or that of family members. A careful and imaginative alliance in support of our elderly among families, the health and social system, volunteers, and all the other participants in the field, can make it possible to keep the elderly in their homes. It will not, therefore, be enough to simply change paperwork, to construct facilities with few beds rather than many, to lay out a garden or hire an events organizer. Effective reforms should have as their principal goal the personalization of social and health and welfare initiatives. This change would also be consistent with the European Union’s invitation to promote other models of care for the elderly in its proclamation of 2012 as the “European Year of Active Ageing and Solidarity between Generations,” and from the World Health Organization’s dedication of World Health Day 2012 to the theme “Aging and health: good health adds life to years.” In this perspective, independent living, assisted living, co-housing and all those initiatives inspired by the value proposition of mutual assistance must be promoted with creativity and intelligence while still making possible for the elderly a life that is autonomous and independent.

These structures make it possible to live in private accommodations, while enjoying the advantages of community life, thanks to a facility being adequately equipped and having a shared day-to-day administration and certain available services such as neighborhood nurses. Inspired by the traditional neighborhood, these structures make it possible to combat many of the hardships of the contemporary city—loneliness, economic difficulties, the lack of relationships, the simple need for help. These are the fundamental reasons for their success and their widespread acceptance throughout the world. There are several terms used to described these structures and types of residences adopted today: intergenerational, providing for nuclear units with different, but predefined, age groups living in a community setting; those that host only the elderly, but with particular characteristics, or those for older women only; those who welcome young families with children and singles; those that offer certain external services like health care or many other similar ones.[12] In some cases, the need has arisen to offer hospitality to previously institutionalized elderly people, who wish to start “a new life” outside the walls that had welcomed them, perhaps for years.

All these initiatives require a profound change of mentality and approach to the idea of the frail elderly person, who is still able to give and share: we need an alliance between generations that becomes a force in the time of weakness.

Redeveloping the retirement home into a socio-health "continuum"

In the light of these considerations, nursing homes should be redeveloped into a socio-health “continuum”, i.e. offer some of their services directly in the homes of the elderly: hospitalization at home, taking care of the single person with low or high-intensity assistance responses based on personal needs, where integrated social and health care and home care services are the pivot of a new and modern paradigm. On the occasion of the 2020 World Day against elder abuse, Pope Francis stressed: "The Covid-19 pandemic has highlighted that our societies are not organized enough to make room for the elderly, with due respect for their dignity and their fragility. Where there is no care for the elderly, there is no future for the young ". The data that the World Health Organization publishes every year on the same day are painful evidence of the words of the Pope in relation to the presence of abuses that, in institutionalized contexts, occur more frequently.

All this makes even more evident the need to support families who, especially if they are made up of just a few children and grandchildren, cannot bear alone, in a home, the sometimes wearisome responsibility of caring for a loved one with a demanding disease that is burdensome in terms of energy and money. A wider network of solidarity must be reinvented, not necessarily and exclusively based on blood ties, but on affiliations, friendships, common feeling, mutual generosity in responding to the needs of all. The decline in social relationships particularly affects the elderly. As they age and important physical and mental frailties emerge, they are missing points of reference, people to rely on for all the problems of their lives. Some historical and wide-ranging research carried out in the United States, shows for example that between 1985 and 2004 the number of friendship and support networks was drastically reduced.26 In 1985, it was possible to count on about three trusted people, in 2004 this number had fallen to one. The loss affects primarily friends more than relatives. This phenomenon represents a very important driver behind the explosion of the demand for healthcare that is not finding adequate social answers. This question is not inappropriate because the failure of one's network of social relationships is a fact capable of worsening one’s physical and mental health.

That’s the reason why this trend must be reversed, even with careful pastoral plans that highlight the need not to abandon those who are growing old.

In several countries, “retirement homes” have been, in recent decades, the answer to growing demand from a changing world, although many older people live in their own homes and ask to be maintained and supported in this fundamental option. In many cities there was, many years ago, a “place,” a specific structure, well known in the collective imagination, a city institution where many went to live the last years of life, either by choice or because they were forced by their circumstances. Over the years Long Term Care Facilities have multiplied, both in number and type and capacity. With the increase in the elderly population, alternative residential possibilities have also grown. The Catholic Church, through dioceses and various religious institutions, has established and manages homes that house and assist the elderly. The presence of religious in these institutions has been an undoubted advantage for these ancient institutions that are admired by the population for the dedication and love they witness. The reality of Long Term Care Facilities, present everywhere in the world, has represented a solution to complex problem with regard to the ageing of society. There are some examples, beautiful and human, of ancient Christian charity, pious works, and public institutions with a long history of welcoming the older population. There are institutions that continue to reach out to the most deprived and that do not spare energy and effort even if they struggle to meet their monthly expenses.

Many families have turned to these institutions out of necessity, in the hope of being able to offer their loved ones the possibility of quality care in the sunset season of life. There was a time when a large family could organize the care of older family members within the private home, but it is undeniable that todaythe changed situation of families - that are getting “tighter” because their average number of members is decreasing, but are also getting “longer” with three or more generations living together - and complex working needs that keep adults away from home have made taking care of one's elderly into a whole new challenge. In some poor social environments, the institutional solution can be a concrete response to the lack of a home of one's own. And if some elderly persons choose on their own to move, in search of more company, once they are alone, others do so because the dominant culture pushes them to feel they are a burden and a nuisance for their children or family.

In most of these residential facilities, the dignity and respect due to the elderly have been the cornerstones of the care they provide, making more shocking by contrast those episodes of ill-treatment and violation of human rights that have rightly been given media attention. Both public and private social and welfare systems have invested significant economic resources in care for the “third” and “fourth” ages and have integrated Long Term Care Facilities into their structures.

Over the years, though, legislation has been passed that has limited the size of these structures to smaller and more contained modules, more responsive to the needs of those who live there. It is also true that a Long Term Care Facility is structured more like a hospital than a house, but without the most important element of a hospital: you enter a hospital with the hope of getting out of it once you have recovered. This discomfort is emerging, in the collective consciousness, both medically and culturally. Therefore, it is important to preserve a human fabric [13] and a habitat where everyone can look after them, serve them and spend time with them. As Pope Francis reminds us: “The elder is not an alien, the elder is us—soon, in a shorter or longer time, inevitably anyway, even if we do not think about it. And if we do not learn to treat the elderly well, that’s how we will be treated.” [14]

The elderly and the strength of frailty

In this new horizon, the dioceses, parishes, and all ecclesial communities are also invited to reflect more attentively about the great world of the elderly. In recent decades, the Popes have intervened several times to promote a more caring pastoral relationship with the elderly.

The very presence of the elderly is actually a great resource. Just think of the decisive role they played in the preservation and transmission of the faith to young people in countries under atheist and authoritarian regimes, without forgetting what so many grandparents continue to do to transmit the faith to their grandchildren. “In the secularized societies of many countries - Pope Francis remarked - the current generations of parents do not have, for the most part, that Christian formation and that living faith, which grandparents can pass on to their grandchildren. They are the indispensable link for educating children and young people to the faith. We must get used to including them in our pastoral horizons and to consider them, not only sporadically, as one of the vital components of our communities. They are not only people we are called to assist and protect in order to safeguard their life, but they can be actors in an evangelizing pastoral care, privileged witnesses of God's faithful love”.

Certainly the elderly, for their part, must try to live old age with wisdom. “These years of our last journey are a gift and a mission: a true vocation from of the Lord.... For this reason, “the pastoral care of the elderly, like every pastoral, must be inserted in the new missionary season inaugurated by Pope Francis with Evangelii Gaudium. This means: announcing the presence of Christ [also] to the elderly. Evangelization must aim at the spiritual growth of every age, since the call to holiness is for everyone, even for grandparents. Not all elderly people have already encountered Christ and even if the encounter did take place, it is essential to help them rediscover the meaning of their own Baptism, in a special stage of life, [...]: to rediscover the amazement before the mystery of love of God and eternity; [...] to discover the relationship with the God of merciful love; to ask the elderly who are part of our communities to be actors in the new evangelization to transmit the Gospel themselves. They are called to be missionaries”, like every other age of life.

In this sense, "the Church [can be] a place where generations are called to share God's plan of love, in a relationship of mutual exchange of the gifts of the Holy Spirit. This intergenerational sharing forces us to change our gaze towards the elderly, to learn to look to the future with them. […] The Lord can and will write new pages also with them, pages of holiness, of service, of prayer”.

If the two generations, that of young people and that of the elderly, can manage to meet, they can bring into the body of society that new sap of humanism that would make society more supportive. Pope Francis has repeatedly urged young people to stay close to their grandparents. On July 26, 2020, in the midst of the pandemic, addressing young people, he said, “I would like to invite young people to make a gesture of tenderness towards the elderly, especially the most alone, in homes and residences, those who have not seen their loved ones for many months. Dear young people, each of these elders is your grandfather! Do not leave them alone! Use the imagination of love, make phone calls, video calls, send messages, listen to them […]. Send them a hug.” Pope Emeritus Benedict XVI said, in 2012, “There can be no real human growth and education without fruitful contact with the elderly, because their very existence is like an open book in which the younger generations can find valuable advice for their path in life.”

Old age makes us aware of the ultimate destination of human life. St. John Paul II reminded the elderly of this perspective in 1999: “There is an urgent need to recover a correct perspective on life as a whole. The correct perspective is that of eternity, for which life at every phase is a meaningful preparation. Old age too has a proper role to play in this process of gradual maturing along the path to eternity.”[15] If life is a pilgrimage to the mystery of God, old age is the time when most naturally one looks to the threshold of this mystery. The aging man is not approaching the end, but the mystery of eternity; to understand it he needs to get close to God and to live in relationship with Him. Taking care of the spirituality of the elderly, of their need for intimacy with Christ and sharing of faith is a task of charity in the Church.

In this framework, we must understand the precious witness that the elderly bear with their frailty as a “magisterium,” that is, a real teaching. This is well exemplified by the encounter of the Risen Jesus with Peter on the shores of Lake Tiberias. Addressing the apostle, he says to him, “...when you were younger, you used to dress yourself and go where you wanted, but when you grow old, you will stretch out your hands, and someone else will dress you and lead you where you do not want to go.” (Jn 21:28). These words sum up all the magisterium about the person who weakens in old age, who “stretches out” his or her hands for help. The elderly remind us of the radical weakness of every human being, even when they are healthy, they remind us of the need to be loved and supported. In old age, losing all self-sufficiency, we beg for help. “When I am weak, then I am strong" (2Cor 12:10), writes the Apostle Paul. In weakness it is God himself who first extends His hand towards man.

Old age must also be understood in this spiritual framework. It is the ideal age for abandonment to God. As the body weakens, psychic vitality, memory and mind grow dim, the human person's dependence on God becomes increasingly evident. The elderly thus teach everyone —with their frailty and dependence—to reset their relationship with God. Of course, there are those who feel old age as a condemnation, but also those who feel it as an opportune moment to rediscover the meaning of faith in a Saving God. After the human props have fallen, the fundamental virtue is faith lived not only as adherence to revealed truths, but as a certainty about God's love who never abandons.

The weakness of the elderly is also a challenge. It invites younger people to accept dependence on others as a lifestyle, as a way of life. Only a youthful culture makes the term “old” seem disparaging. A society that is able to accept the weakness of the elderly is capable of offering everyone hope for the future. Taking away the right to life of those who are frail means stealing hope for the future from everyone, especially the youngest. That is why discarding the old—even with expressions—is a serious problem for everyone. It implies a clear message that lies at the heart of so much rejection—from the person just conceived to the person with disabilities, from the emigrant to the homeless person. Life is not welcomed if it is too weak and in need of care, unloved in its differentness, not accepted in its frailty. Unfortunately, this is not a remote possibility. It is something that happens frequently where abandonment, as the Pope repeats, becomes a genuine hidden euthanasia and sends out a message that puts the whole of society at risk.[16] That is a dangerous attitude, which clearly manifests that the opposite of weakness is not strength, but hybris, as the Greeks called the presumptuousness that knows no limits. Hybris, which is widespread in our societies, actually generates giants with feet of clay. Presumption, pride, arrogance, contempt for the weak are the marks of those who believe they are strong. But this attitude has always been stigmatized in Scripture—God's weakness is stronger than men (1Cor 1:25). And, what is weak for the world, God uses to confound the strong (1Cor 1:27). Christianity not only neither expels nor hides weakness, from the baby just conceived to man on the threshold of death, but also gives weakness honor, meaning and even strength. Of course, it shouldn’t be said, with superficiality, that as you get older you automatically become better. Defects and rough edges already present in adulthood can be accentuated, and the encounter with one's old age and its weaknesses can represent a time of inner discomfort, closing off to others or rejection of frailty.

Christians—in particular—must question themselves with the intelligence that springs from love in order to identify new perspectives and ways to respond adequately to the challenge, not only of aging, but more, of the weakness of old age. Undeniably, as you get older, taking sick and losing autonomy, a problem exists and the need for support becomes legitimate and pressing.

A Gospel account, in particular, highlights the value and the surprising potential of old age. That is the episode of the Presentation of the Lord in the Temple, an event that is called the "Feast of the Encounter" in the Eastern Christian tradition. On that occasion, in fact, two elderly people, Simeon and Anna, meet the Child Jesus: two frail elderly reveal him to the world as the light of the people and speak of him to those who were waiting for the fulfillment of the divine promises (cf Lk 2: 32.38). Simeon takes Jesus in his arms: the Child and the elderly mutually support each other as if to symbolize the beginning and the end of earthly existence: in fact, as some liturgical hymns proclaim, "the old man carried the Child, but the Child supported the elderly person». Hope thus springs from the encounter between two fragile people, a child and an elderly person, to remind us, in our times that exalt the culture of performance and strength, that the Lord loves to reveal greatness in smallness and strength in tenderness. This episode, as repeatedly emphasized by the Holy Father, also marks the meeting between the young people, represented by Mary and Joseph who carry the Child to the Temple, and the elderly Simeon and Anna, who welcome and instruct them. In the meeting, however, the roles are reversed: the biblical text highlights, through several repetitions, how young people seek faithful adherence to tradition, abiding by what "the law of the Lord" prescribed (cf. vv. 22-24.27), while the elderly reveal the newness of the Spirit (cf. vv. 25-27), prophesying the future.

This happens in the fecund sphere of the open and welcoming encounter between young and old, which allows the fulfillment of an ancient promise: "This episode fulfills the prophecy of Joel: “Your elders will dream, your young people will have visions"(Gl 3.1). In that meeting, young people see their mission and the elderly realize their dreams". This prophecy seems to tell us that the future opens up surprising possibilities only if we cultivate it together. It is only thanks to the elderly that young people can rediscover their roots and it is only thanks to young people that the elderly regain the ability to dream. Pope Francis has repeatedly stressed this need, both for the Church and for society, proposing to encourage grandparents to dream with boldness: not only to revive hope in them, but also to give the younger generations the lifeblood, which springs from the dreams of the elderly, irreplaceable vehicles for memory to wisely guide the future. This is why depriving the elderly of their "prophetic role", setting them aside for purely productive reasons, causes an incalculable impoverishment, an unforgivable loss of wisdom and humanity. By discarding the elderly, the roots are cut off that allow society to grow upwards and not flatten itself on the momentary needs of the present.

This vision is not an abstract utopian or naïve pretense. It can instead bring to life and nourish new and wiser public health policies and original proposals for a welfare system for the elderly. More effective, as well as more human. This requires an ethic of the public good and the principle of respect for the dignity of every individual, without distinction, not even that of age. The whole of civil society, the Church and the different religious traditions, the world of culture, school, volunteering, entertainment, the manufacturing classes and classical and modern social communications, must feel the responsibility to suggest and support—in this Copernican revolution—new and targeted measures that make it possible for the elderly to remain in the homes they know and in any case in familiar environments that look more like a home than a hospital. We are dealing with the implementation of a truly new cultural orientation. The Pontifical Academy for Life will always be attentive in pointing out that this is the most authentic practical way to witness to the profound truth of the human being—the image and likeness of the God who begs and who teaches love.


+ Vincenzo Paglia

Msgr. Renzo Pegoraro




Vatican City, February 2, 2021



[1]Francis, Special Moment of Prayer during the Pandemic, March 27, 2020

[2] Francis, Ibid.

[3] Humana Communitas is the title of the Letter that Pope Francis sent to the Pontifical Academy for Life on January 6, 2019, for its Twenty-fifth Anniversary. Its title reveals its intent: reflection on the relationships that unite the human community and generate shared values, objectives, and reciprocity.

[4] Dicastery for the Laity, Family and Life, In Loneliness the Coronavirus Kills More, 7 April 2020, in

[5] Francis, Fratelli tutti, 19

[6] Dicastery for the Laity, Family and Life, In Loneliness the Coronavirus Kills More, April 7, 2020, in

[7] Associated Press, April 23, 2020. In a press conference, WHO's director for Europe, Dr. Hans Kluge, said a “deeply worrying” picture is emerging of the impact of COVID-19 on residences for the elderly, where care is “often notoriously neglected.” Kluge he said healthcare workers at such facilities were often overworked and underpaid and asked that they receive more protective equipment and support...".

[8] J.M. Bergoglio, Only love can save us, LEV Vatican City 2013, p. 83.

[9] See for Example: Singh and Siahpush Municipality, Widening Rural–Urban Disparities in All-Cause Mortality and Mortality from Major Causes of Death in the USA, 1969–2009, 2014 in Zimmer, Kaneda and Spess, 19, An Examination of Urban Versus Rural Mortality in China Using Community and Individual Data, 2007 in:

[10] World Health Organization (2011), Global Health and Aging, Available In

[11] P. Terentius Afer (Terence), Phormio, or The Scheming Parasite, Act 4, Scene 1, 160 B.C.

[12] For an overview cfr. C. Durret, Senior Cohousing, A Community approach to Independent LivingThe Handbook, 2019, Gabriola Island BC, Canada

[13] Marco Trabucchi, Geriatra and President of the Italian Society of Psychogeriatrics, wrote: "How many elderly people die in the first three months of hospitalization in a residence... and most often not for precise clinical factors, but for the loss of hope!". (M. Trabucchi, The faces of aging, Saint Paul, Cinisello Balsamo 2016, p. 174).

[14] Francis, General Audience, March 4, 2015.

[15] St. John Paul II, Letter to the Elderly, 10.

[16] See. Meeting the Pope with the elders, September 28th, 2014