The Vatican called on Tuesday for a rethinking of elder care in a document arguing that the elderly are best cared for in an environment more like a family home than a hospital.

The Pontifical Academy for Life published the 6,000-word document Feb. 9 on the need to improve social and pastoral care for the elderly, particularly after the devastating effect of the coronavirus pandemic on retirement homes across the world.

"During the first wave of the pandemic, a considerable part of the deaths from COVID-19 occurred in institutions for the elderly, places that should have protected the 'most fragile part of society' and where instead death has struck disproportionately more than the home and family environment," the document said.

The pontifical academy called for a "profound change of mentality and approach" to care for the elderly, pointing to the disproportionate number of coronavirus-related deaths as an example of a failure of the widespread "institutionalization of the elderly" and calling it a manifestation of "throwaway culture."  

"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,'" it said.

The pontifical academy highlighted the family home as the best environment to respect the "full dignity of the elderly," whose lives are often marked by suffering. 

"Already in the years when he was Archbishop of Buenos Aires, Pope Francis stressed that '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 any gratuitousness, generosity, that wealth of feelings that make life not just a give and take, that is a market… Eliminating the elderly is a curse that our society often inflicts on itself,'" the document said, quoting a 2013 statement from Cardinal Jorge Mario Bergoglio before he became pope.

The document also acknowledged that there are many people who lack the support of the ideal family environment and therefore it called for another framework connecting different generations.

"Nursing homes should be redeveloped …  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," it said.

The document also called for changes to cities to make them more habitable for the elderly.

It said: "The data tell us that the elderly population is growing faster in urban areas than in rural areas and that the concentration of older people in them is higher … According to data from the World Health Organization, in 2050 there will be two billion over-60s in the world: therefore, one in five people will be elderly. It is therefore essential to make our cities inclusive and welcoming places for the elderly and, in general, for all forms of fragility."

The Pontifical Academy for Life asked dioceses, parishes, and religious communities to reflect more attentively on pastoral care for the elderly.

"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," it said.

The document quoted St. John Paul II's 1999 "Letter to the Elderly": "It is urgent to recover the right perspective from which to consider life as a whole. And the right perspective is eternity, for which life is a significant preparation in every phase. Old age also has its role to play in this process of progressive maturation of the human being on his way to eternity. If life is a pilgrimage towards the mystery of God, old age is the time in which we most naturally look at the threshold of this mystery."

Pope Francis recently proclaimed the World Day of Grandparents and the Elderly, to take place each year in July.

Archbishop Vincenzo Paglia, the president of the Pontifical Academy for Life, said that the pope's institution of the new annual day in the Church was "an invitation to believers to grow in them and around them a new sensitivity and care towards grandparents and the elderly."

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"It is the Church's responsibility," Paglia said at a Vatican press conference on Feb. 9.

"We owe it to our elders, to all those who will become so in the years to come. The level of civilization of an era ... is measured by the way we treat those who are weaker and more fragile."