Exploring Representations of Old Age Emerging from the Narratives of Healthcare Professionals Working with Older Adults in Two Italian Cities.

Population ageing is reshaping care systems and cultural meanings of later life. Present explorative qualitative study examined how healthcare professionals working with older adults in two Italian cities (Rome and Bergamo), represent old age. Moreover, we explored whether these representations vary by age, gender, and location. Fifty professionals aged 30-60 years, each residing and practicing professionally in either Rome (n = 25) or Bergamo (n = 25), were interviewed using an open-ended prompt on resources, difficulties, and transitions related to old age. A quali-quantitative approach based on Emotional Text Mining (ETM) was applied to verbatim transcripts. The analysis included text preprocessing, bisecting k-means clustering, and correspondence analysis. Seven clusters emerged: Witnessing ageing, Passing years, Challenging old age, Denial, Awareness, Rethinking services, and Old age as a problem. Correspondence analysis identified six factors; the first three, accounting for 60.24% of total inertia, were interpreted as Time (Present vs. Future), Places (Protected Shelter vs. Exposure to Risk), and Care (Assistance vs. Planning). Together, the factors and clusters outlined a symbolic field ranging from direct observation of ageing and reflection on time, to defensive responses and concerns about decline, and to greater awareness of older adults' needs and calls for more responsive services. No statistically significant differences emerged by age or gender. Conversely, cluster distribution was significantly associated with participants' location (Rome vs. Bergamo; χ2 = 49.84, p < 0.001), suggesting possible differences in the representation of older adults across these two geographical areas. Overall, representations oscillated between proximity and defense, individual responsibility and system-level delegation, supporting reflective training and organizational interventions to strengthen care cultures.