The second edition of ICOPE (Integrated Care for Older People), the World Health Organisation’s handbook on the health and care of older people, has been available in Italian since Friday, 2nd October. The Italian edition was produced by UniCamillus University in collaboration with the University of Palermo, with the patronage of the Association of Non-Hospital Geriatricians (AGE) and the Italian Society of Gerontology and Geriatrics (SIGG).
This achievement highlights the University’s expertise: the translation and scientific review were coordinated by UniCamillus lecturers Professor Nicola Veronese and Dr Luisa Solimando, who have made this international reference tool accessible to Italian professionals.
A statement from the project leaders
“The translation makes an internationally validated tool immediately available to colleagues across the region. The aim is to identify functional decline before it becomes disability,” says Professor Nicola Veronese, Lecturer in Geriatrics and Internal Medicine on the degree programmes in Medicine and Surgery, Nursing and Physiotherapy at UniCamillus University, and a physician at ULSS 3 Serenissima.
“ICOPE shifts the focus from the individual disease to the person and their capabilities. It is the change in perspective that Italian geriatrics needs”, adds Dr Luisa Solimando, Lecturer in Internal Medicine at UniCamillus.
A person-centred model
ICOPE proposes a person-centred care model to identify difficulties early and develop a personalised care plan. The handbook addresses key aspects such as memory and cognitive function, mobility, nutrition, vision, hearing and mood, while also involving social services, the family and the community where necessary. The aim is to maintain independence, functional ability and quality of life for as long as possible.
Who it is aimed at
The handbook is primarily intended for primary care professionals: physicians, nurses, community health workers, pharmacists, nutritionists, social workers and physiotherapists.
The language is deliberately simple and accessible, so that it can be used by professionals with varying levels of experience and training in geriatrics. ICOPE may also be useful to those who provide services and support to older people in the community, to those involved in training, and to those who plan and organise healthcare services.
In Italy, almost a quarter of the population is over 65: the Italian version of the text therefore serves as a practical tool for community healthcare, community care centres and social and healthcare services involved in managing frailty.
The four-stage process
At the heart of the handbook is a four‑stage process, developed over time through a series of sessions.
- Initial assessment and support. Any difficulties with memory, mobility, nutrition, vision, hearing and mood are identified. Social needs, support for carers and issues related to incontinence are also assessed, while guidance on healthy lifestyle habits is provided.
- In‑depth assessment. If difficulties are identified, the causes, medical conditions, risk factors and the environmental context in which the person lives are analysed in greater detail.
- Personalised care plan. This is drawn up in consultation with the older person and, where necessary, with family members or carers.
- Implementation and monitoring. The plan is put into action by coordinating health and social care services, with regular follow‑ups and information‑sharing among professionals.
What’s new in the second edition
Compared with the first edition, published in 2019, the new version makes the process simpler, more flexible and more community‑focused.
- From five to four stages: the process has been simplified.
- A more comprehensive first stage: the initial assessment can be followed immediately by advice and interventions, for example on health and lifestyle or through community services. This does not replace the in‑depth assessment and the personalised plan.
- A greater role for the community: the contribution of local associations and organisations is highlighted, as is the role of family members, carers and volunteers.
- Social needs and carers from the outset: these are identified as early as the initial assessment to facilitate timely interventions.
- A new pathway for urinary incontinence: the second edition includes a dedicated chapter on this topic.
Assessment tools
The first stage involves simple questions and quick tests.
- Memory: a question about cognitive difficulties and a three‑word recall test.
- Movement: standing up from a chair five times without using the arms. If the person cannot complete the test or takes more than 14 seconds, a more in‑depth assessment is recommended.
- Nutrition: checks are made for any unintentional weight loss of more than 3 kg over the last three months and for a reduction in appetite.
- Vision: near and distance vision are assessed; the manual also refers to WHOeyes, the WHO’s free app for vision screening.
- Hearing: questions, a whispered voice test or audiometric screening.
For each area, there are dedicated care pathways, guidance on social support and support for carers, and an example of a personalised care plan.
The new pathway on urinary incontinence
Urinary incontinence is still often viewed as an embarrassing problem, which can lead people to avoid seeking help. The handbook emphasises the importance of information and awareness‑raising, including through public campaigns. The pathway includes:
- Lifestyle. Adequate fluid intake, reduced caffeine and alcohol consumption (especially in the evening), a high‑fibre diet, weight management, physical activity and smoking cessation.
- Community support. When an immediate in‑depth assessment is not possible, bladder training using a voiding diary may be recommended for at least six weeks.
- Assessment. The type of incontinence and any reversible causes are investigated in detail.
- Personalised management. Treatment forms part of the care plan and may include, among other things, pelvic floor exercises for women and programmes to regulate urination for people with cognitive difficulties.
The working group
Translation and scientific review: Professor Nicola Veronese and Dr Luisa Solimando (UniCamillus, Rome); Professor Giuseppe Bellelli (University of Milan‑Bicocca); Dr Alberto Cester (President of the Italian Society of Otoneurogeriatrics – SIONG Triveneto); Professor Elisabetta Genovese (University of Modena and Reggio Emilia).
Where to download it
The Italian edition can be viewed and downloaded free of charge from the WHO website: who.int/publications/i/item/9789240103726
The Italian translation was not produced by the WHO, which is not responsible for the content or accuracy of the translation. The original English edition is the authoritative and authentic version.