Violence Against Older Adults and Healthcare Workers' Reporting Obligations in Italy

Abstract: Violence against older adults is a public health problem often underestimated by healthcare workers and not yet included on the international political agenda. Numerous statistical data confirm its increasing frequency and its effects on morbidity, mortality, and rising healthcare costs. Despite the complexity of this phenomenon, violence against older adults is something that can be contained with concrete actions, public awareness campaigns, and training for healthcare workers, including regarding their reporting obligations. Starting from the international context, the authors analyze how Italy has developed its own regulatory framework that, without compromising the duty of confidentiality, regulates the obligation to report to judicial authorities. Exploring the complex set of laws governing this legal obligation, the recent changes introduced by the Cartabia Reform and its practical implications for healthcare professionals, the authors clarify the meaning of those conceptual categories (fragility, vulnerability, incapacity, and impaired defense) that, in Italy, assume specific relevance in cases of violence against older individuals. Finally, they report a clinical case they observed and formulate a series of final recommendations, implementable at the local level, which the Italian Association of Psychogeriatrics (AIP) will disseminate to the professional community to raise awareness of this complex social emergency.