French social care for elderly

Learning of the current proposals in the UK for changes to social care made me realise that I know nothing about it here in France. Know all about medical processes, but what happens if you need looking after in your own home or need to go into a care home.

Who manages social care for the elderly?
What is the eligability criteria and financial parameters?

https://www.pour-les-personnes-agees.gouv.fr/

This is one section about ā€œcare at homeā€
https://www.pour-les-personnes-agees.gouv.fr/vivre-a-domicile/beneficier-daide-a-domicile
give a host of ideas/answers

That is a huge question!

There are several different levels of financial support called APA, ASPA and ASI depending on the personsā€™ state of health and finances. These can pay for home care. There is also an equivalent of meals on wheels. In general policy is geared towards keeping people in their own home. You also get 50% credit impĆ“t for buying in services yourself.

For retirement homes you, and your family, are expected to pay if you can. Only if you canā€™t is financial support available. Unlike in UK children are legally obliged to pay (even if they do not live in France). Retirement homes are of many different levels , and prices. Buy and large you get what you pay for.

A lot of this is channelled through the local Assisantes Sociales.

Lot more complex than that but this is the basics as I know it. The thresholds are roughly similar to other aspects of French life, so below SMIC starts to qualify. EhPADs cost around 2k a month, more if a full on ursing home needed

Interesting that families as an entity are expected to contribute even if not resident in France.
I seems to be quite complicated with lots of differing regulations/standards and my basic French is not up to understanding them if so any links to summary explanations in English?

@strudball
Youā€™ll probably find the subject being discussed in The Connexion any day soonā€¦ that journal seems to follow our threads, quite oftenā€¦ :wink:

In fact it is probably already in their archives (and will be in English) as family-care/responsibilites etc has certainly been mentioned/discussed, on this forum ā€¦ :rofl::+1:

Thanks for the synopsis JJones. very interesting.
so if the children do not live in france and never have, how do the French government enforce that law ? or is it then just down to the person going into the home to pay for ?
I think its a good system that children and family take responsibility for the older ones. long passed unfortunately. mainly due to the fact that everyone has to work until they drop, so its difficult to look after parents etc. or when specific care is needed.

Itā€™s quite logical really, and details may well change before it concerns you directly!

I am making a guess that your income will probably exclude you from the basic aides to keep you in your home, except for things like meals on wheels and any nurse interventions - wound dressings, blood tests and the like. And crƩdit impƓt if you buy these services yourself.

For retirement or nursing home you or your married /PCSā€™d partner have to pay as much as you can - excluding anything you have in an assurance vie. You keep around 100ā‚¬/month, partner will keep enough to live on. House does not have to be sold, but your share of itā€™s value will be taken from your estate.

If thatā€™s not enough your family will be asked to contribute. Not just blood relatives - you could be asked to contribute for your mother in law. But assessed and generally a fair contribution as not aiming to bankrupt people. It is rare that anyone other than children are asked, but they can be.

Amd then if thatā€™s not enough you will get state support. Of course not for a luxury home, but just up to the cost of a ordinary one.

I donā€™t know but would guess in the same way any other law is enforced across borders - international agreements and warrants. The person is asked to provide family details so they would know who they are looking for,

1 Like

Thanks JJones. very interesting.

1 Like

They should also solicit our IT technical support :joy::joy:

2 Likes

This can only be enforced via a court decision, which then requires a request for execution (of the decision) via the channels that govern international recognition and execution of foreign court decisions. Of course, if one were of a mind to challenge such a court order, things could take a very long time to actually be settled. This is why when a care home is faced with such a prospect, it will attempt to pressure the debtors directly by all means possible except via court proceedings. Bear in mind that if the care home files an action with the court and loses, not only will it have to pay its own expenses, but potentially at least part of the defendantā€™s expenses (Article 700 NCPC), and any carehome manager with half a brain would clearly weigh up the potential pros and cons of initiating a suit that it might lose for any number of reasons with regard to a non-French-domiciled defendant.

See here for why I currently feel that no French care home is going to be seeking an enforcible court decision against a UK debtor any time soon, at least not until the UK gets its act together after Brexit.

2nd edit : I forgot to add that if you have asssets in France, then you are exposed nonetheless, as the carehome could seek an order against those assets.

2 Likes

The process of getting someone into a care home can be laborious, as there is a detailed assessment of their assets. I wonder whether many impoverished elderly British people have managed it since January? The simplest solution for a care home faced with a request to house a non-EU foreigner would be to say no, until they have a guarantee from a relative signed or some other form convincing proof they will be paid.

We have a good friend who works at a senior level for one of the big care organisations, I might ask him next time we meetā€¦

3 Likes

Thanks RicePudding. very concise.
hope I never end up in a situation where I need that. but its information to know.

First of all @strudball , thank you for raising this question, just as I was thinking along the same lines myself. You must be psychic. :slightly_smiling_face:

My wife, after her first (of 3) strokes over 5 years ago returned from 10 days in hospital diagnosed with ā€˜demence vasculaireā€™. Since then she has slowly deteriorated but in the last week or so this has been accelerated.

I thus informed those who needed to know that I could no longer do my dog deliveries, being away from home twice recently for 7 hours produced frantic phone calls from her demanding to know where I was, this despite it being clearly explained before I left.

She often spends all day, fully clothed, in bed, and lately all night sitting in a chair facing a blank wall. A lifelong smoker she seems to forget to smoke. She will put a cigarette in her mouth and sit there with it unlit for hours while studying the packet and flicking a lighter on and off. She thinks she is smoking.

She has an appointment with a specialist in Perigueux next January, I suppose the previously excellent French access to such people is affected by covid, like everything else.

Her toenails are very long and curling back towards ingrowing, she wonā€™t let me cut them and a request for a nurse was met with a recommendation to use a specialist (based locally) but I must first take her to our own doctor to get a prescription for that.

We are coping at the moment but the future, especially if I start to go the same way is bleak. As regards resort to children, 2 of hers, in England, are not well off and certainly could not respond to aid demanded, and the only one we think has the means lives in Eire and cut her off for mysterious reasons many years ago.

4 Likes

When I wrote this, I also had in mind the eventuality of a French surviving spouse requiring care home treatment with in-law children in the UK potentially being liable to pay for his/her care. The ā€œobligation alimentaireā€ extends to in-law spouses of children for whom one of the parents is deceased (and vice-versa, as it turns out).

Davidā€¦ why not make an appointment for your wife to see your Doctorā€¦ if her deterioration is accelerating.
There is a lot of care/help available, which the Doc can get started ā€¦

1 Like

Yes, thank you, trying to get a rdv at the moment but the phone at our small surgery arenā€™t always manned and sans rdv disappeared when the previous doc retired.

She already knows of her condition, it was her who booked the January appointment, and I am with her to translate (neither have a common language) and she obviously notes that I have almost as much difficulty in understanding my wifeā€™s speech as she does. But I will emphasise all this when we get a rdv for the nail treatment. :slightly_smiling_face:

1 Like

Letā€™s hope you get an appointment soonā€¦ as I said, there is much which can be done to help
(toenails being only one small part of itā€¦)

good luck.

1 Like

Thanks again, Iā€™ll let you know. :grinning:

1 Like

Ask your doctor about referring her to a gerontologist as well. Having someone who will look at her holistically could help find the best possible option for her. Vascular dementia is such a sad diagnosis, my MIL suffered from this, so I feel for you.

Up in our medical centre is a big notice about care for the elderly, and for those who have lost autonomy many of the options start with contacting the Assistante Sociale so think about doing that as well.

2 Likes

David, thinking of you :hugs: :pray:

2 Likes