The heavy burden of health spending on elderly care is common-place in the preoccupations of policy makers and politicians, and is constantly the focus of media attention. The attention on this subject is however rather ambivalent: stress is not placed on the «physiology» of growth in investments for a part of society that «obviously» expresses several needs and is entitled to corresponding rights; the objective complexity of the problem is presented in such a way as to make the solutions appear increasingly more difficult and not due, with the consequent rise in cultural, political and cognitive marginalisation. Analysing four model scenarios, operative solutions, feasible through a participatory way, are indicated at both the local and general levels.