The second chapter, in its first two articles, also outlines rights and duties for responsible assistance by stating that «2.1 The elderly person has the right to participate in the definition of care paths, types of treatment and to choose the methods of providing care health and social care. Health and social care institutions and workers have the duty to present to the elderly person all the options available for the provision of health and social care".

There is a right to knowledge of the possible alternatives, the pros and cons of each, in the modern complexity of therapeutic paths. It could be said that even in the field of assistance it is necessary to formulate an informed consent, an indispensable safeguard against the risk of incorrect information when not openly counterfeit, or simply the lack of it. It is exactly in this direction that the following articles move by providing that «2.3 The elderly person must be guaranteed the right to informed consent in relation to health treatments as provided for by current legislation. 2.4 It is the duty of doctors and healthcare professionals to provide the elderly person with all the necessary information and professional skills in relation to their physical and cognitive conditions. 2.5 The institutions have the duty to adopt adequate and effective measures to prevent abuse."

The examples reported in the relevant comment are illuminating in this regard: «there are frequent cases in which the support administrator's consent is improperly requested for the provision of healthcare treatment even where the elderly person is capable of expressing it, as are the cases in which information on the state of health is provided only to relatives and not to the elderly people concerned or to other subjects indicated by them".

The following articles aim to guarantee the elderly care of the same quality offered to younger people; that care settings do not paradoxically produce disability or loss of self-sufficiency; that therapies and assistance always also have the objectives of recovery and return to previous health and life conditions. Providing home care represents a guarantee in itself: we know well how institutionalization represents an intrinsic factor of physical and mental disability: the so-called bed rest, the states of confusion that inevitably accompany separation from home, the immobility to which one is forced, the change in diet, the different sleep rhythms, the poverty of the activities that can be carried out, the objective social isolation, just to mention the most significant variables. This is the rationale of the following articles: «2.6 The elderly person has the right to high quality care and treatments suited to their personal needs and desires. 2.7 The elderly person has the right to appropriate and effective access to any healthcare service deemed necessary in relation to his or her state of health. 2.8 The elderly person has the right to be looked after and cared for in the environment that best guarantees the recovery of the damaged function. 2.9 It is the duty of the institutions to combat any form of age-selective healthcare and assistance."

Unfortunately, the trend, widespread in other European countries, of denying quality care to the elderly is also gaining ground in Italy. The pandemic has revealed worrying trends in this sense: from the "contract" that Dutch doctors propose to their elderly patients - long ventilation or euthanasia in the case of COVID - to the limitations on access to intensive care put in black and white in Switzerland and Spain for patients over 75. The gallery of horrors would be very long. An eCancer Medical Science study reveals that only half of older people in Europe receive the excellent cancer care reserved for younger people. And paradoxically, neoplasms are much more common in old age! However, it is not even necessary to bother about the pandemic and the choices that accompanied it or the forms of cancer. Unfortunately just consider the ordinary, at least in English hospitals, based on data from the Parliamentary Service Ombudsman and the Daily Telegraph: Elderly patients are left without food or water, their wounds remain open and dressings are not changed, patients are not washed, there is a woefully inadequate way of cleaning them, leaving people soaked in urine or lying in bed in their feces, in the absence of pain medications, with incorrect therapies, or people left on the floor after falling, and so on.

The Daily Telegraph article describes such abuse as the norm in English hospitals and confirms what many families have known and complained about for years. The data reported is from 2010, well before the pandemic, and certainly not in an emergency regime. There is an embankment to be rebuilt for example

r avoid falling into similar horrors and losses of humanity. The paper tries to draw guarantees for everyone: that there is no shortage of treatments, that they have the aim of healing, when possible, that care is always taken to alleviate all forms of suffering and pain. This last point was considered so important by the Commission that it was actually included in the first chapter, where we find the following text: «The elderly person has the right to access palliative care, in compliance with the principles of preservation of dignity, control of pain and suffering whether physical, mental or psychological, until the end of life. No one should be abandoned on the threshold of the last passage."

It is accompanied by the following comment: «The growing aging of the population, the evolution of the epidemiological picture and the progress of medical science make the need to guarantee older people adequate access to palliative care and renewed human, social and spiritual. As highlighted by the international reference literature, alongside the general elements on which palliative care is based (early identification, multidimensionality of assessment and treatment, continuity of care and individualized planning of treatment and assistance pathways), it is necessary to consider the specificity of needs expressed by elderly patients and the ways in which these needs manifest themselves. In this sense, it must be considered that loneliness is always a harsh condition, but in moments of weakness and illness it is even more so. With pain it is unbearable; we prefer death to suffering alone. The request for euthanasia often starts here. Family members, social bodies, the community, have the duty not to delegate the needs of the dying person to the medical dimension alone, but to accompany him worthily and affectionately in the final stages of life."

The fight against pain runs through all three chapters of our text: it is at the same time a right, protection of assistance and care, human and social accompaniment in the awareness that pain cannot and must not be experienced in solitude. From this desire that belongs to everyone, simply to be cared for in the best possible way, and accompanied in the various difficulties of life, comes the Commission's proposal for a new model of care, close to homes, attentive to social issues, concerned with prevention, search for synergies. We understand it better by examining what is reported in the third section of the Charter.