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Preparing for an elderly population

Minister Norra Berra is charged with France's response to an ageing demographic. She talks to Connexion.

ONE in five people in France is over 60 - a proportion set to rise to one in three by 2050. Minister Nora Berra is in charge of facing up to this ageing demographic and tackling the fallout from the country’s ageing population.

How will France cope with an ageing population?

It is true that the population is ageing - in France there are 12.6 million people aged 60 or more [one in five] and the population will continue to age. It is estimated that more than one in three will be aged over 60 in 2050; so elderly people are a very important factor in current society and will also be very important in the society of tomorrow.

To respond to this demographic challenge the government is developing resources for elderly people - the creation of my secrétariat d'état dedicated to elderly people is an example of this. To face up to this ageing of our population and to promote the well-being of elderly people the number of healthcare staff in retirement homes has been reinforced with 20,000 extra jobs over 2008 and 2009 [prior to that the 100,000 workforce was increased by 40,000 posts between 2001-2007]. What’s more, the creation of new places in retirement homes has increased in a year from 7,500 to 12,500 and 6,000 new places for home nursing care were created in 2009, thanks to the government’s relaunch plan. Efforts will continue to take up these challenges.

You have said you want to make it easier for elderly people with low means to have access to retirement homes. How will you do that and will the measures help people who are not French? How will you make sure conditions are good in the homes?

There are already means to get access to retirement homes with funding from aide sociale [benefit money from departmental councils].

Where the patient or their family cannot pay, aide sociale pays for their accommodation in those homes which are accredited to accept this method of payment.

In France 450,000 places are available in homes that are either state-run or run by non-profit-making charities and 120,000 people in them can benefit from aide sociale at present. I will be continuing with this aim of helping make places in homes accessible. Aide sociale is aimed at anyone who is a permanent resident in France.

As for our policies for improving living conditions, they are based notably on increasing staffing - hence the extra jobs created in 2008 and 2009 - but it is also important to continue to develop policies such as the plan métiers [a partnership with local authorities on better recruitment and training of staff who work with the elderly], to evaluate services offered and above all to focus on bientraitance (good treatment).

Looking at the big picture we also have to think about how the retirement homes of tomorrow can become real service hubs which can offer both help at home (nurses’ visits, home-delivery of meals, alarm and surveillance systems etc.) and on and off forms of accommodation like day or night care, gardes itinérantes [someone who calls in to check on a person’s well-being and to help with daily tasks] either for the daytime or at night, and temporary accommodation.

What will you do to help people stay in their homes as long as possible? At present, social charges only go towards illness, work accidents, old age and costs of having children. People who need help to remain independent can only get some help from local councils.

Can you explain government plans to bring this under the national social charges regime (the “fifth social security risk”)?

Helping people to stay at home is clearly something most of our elderly people want as only 10% of those aged over 75 and 24% of over-85s live in retirement homes according to the latest figures.

With the development and diversification of home care services we are able to respond in an effective way to the needs of our elderly people and we can give some respite to their families. The government is fully committed to this. In 2009 we are financing more than 3,000 new daycare and temporary shelter places [this will bring the total to more than 9,000]. This is aimed mainly at looking after Alzheimer’s patients for the day or for short periods to give their carers some respite.

By 2012 we plan to triple the number of these places.

As a complement to this I want to continue to develop training for family carers to help them to adapt to the behaviour of their loved-one when they are suffering from Alzheimer’s.

As for the “fifth risk,” this is a pledge by President Sarkozy on which we have been working for a long time and we are still considering it. Nothing in this area will be done without consultation.

Do you have any ideas for how to improve elderly people’s access to healthcare? For example, in the UK OAPs get free medicines.

We are trialling an idea which would mean that from 2011 residents of retirement homes could have all their medicines free.

At the moment the cost of medicine per resident, per day, is an average of €4.12. State health insurance covers 85.4% of this and the rest is paid for by the elderly person or their top-up health insurance.

The idea we are considering would mean that eventually retirement home residents would not have anything left to pay on medicine - which we think is fair.

Don’t forget also that all people who have a recognised affection de longue durée [certain long-term medical conditions], including a lot of elderly people, get their healthcare associated with it free of charge.

You have said we must put the elderly back at the heart of our society and build better links between generations - how will you do this?

You’re right, this is one of my priorities because I am truly convinced that elderly people are the backbone of our society. Putting them back at the centre of our society also means reinforcing solidarity between the generations and favouring social cohesion. This idea of a social bond also brings us back to the need to value the role of elderly people and their dignity.

As a community we must ask ourselves the question - what future and what place do we want for our elderly people? This exchange could take place during a debate that I want to organise before the end of the year.

Let’s ask ourselves the right questions so as to act together and develop initiatives in the heart of the family sphere and the network of associations. Whatever the initiatives, small and larges, they should aim at maintaining the social bond and allowing homes to remain open to their surrounding communities and to show we value the quality of their teams’ work. It’s for all of these reasons that I am very much in favour of communication between the generations.

Connexion has a helpguide on retirement homes in France. Click here to find out more.
Photo: DICOM-DEACG

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