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Choosing a care home in France

Moving into a retirement home can be costly but a large choice is available in France. We explain what is on offer

Moving into a retirement can be a costly exercise but with more than 10,000 homes, a large choice is available. We explain the main kinds of home and look at the benefits that can help

A WIDE range of accommodation options, both public and private, can be covered by the general term maison de retraite (retirement home).

In the private sector, homes are run as private businesses or as non-profit-making associations. The majority are approved by the state social services body for the department, the direction départementale des affaires sanitaires et sociales (DDAS). They are managed by insurance companies, hotel chains, associations or foundations.

In the public sector, the homes come under the authority of either the health sector (a hospital for example) or the commune (specifically the centre communal d'action sociale - CCAS).

They are managed by the commune or the departemental council and the latter fixes the prices.

Your mairie can direct you to the CCAS and there you can find a social worker who can talk you through the necessary steps to finding a suitable home.

The medical care offered will vary according to the needs of residents and their degree of dependency. The following examples start with options for the most independent and able-bodied.

Sheltered accommodation is called foyers-logement in the public sector and résidences-services in the private sector.

This is designed to be an interim step between the resident’s original home and a traditional retirement home. It appeals to older people, not necessarily over 60, who are independent and able-bodied but who no longer want or are able to live by themselves.

The accommodation usually takes the form of a studio or two-room flat which the occupant can furnish. A certain level of security is guaranteed.

The residents maintain independence while having access to joint facilities and services which remain optional but are charged for - like a canteen, cleaning and washing services, medical assistance and entertainment.

In the private sector the accommodation can be of a very high standard and can include the 24-hour presence of nursing staff.

Petites unités de vie or PUVs (small residential units) take up to 24 residents within a given local community.

They include community apartment buildings and rural homes for the elderly called marpas (maison d’accueil rurale pour les personnes âgées). These accommodate residents from age 60 onwards who live independently in small flats where the living areas are communal. Residents remain in their local community and retain independence.

Traditional retirement homes are known as établissements d'hébergement pour personnes âgées (EHPA) and retirement homes for dependent elderly people - établissements d'hébergement pour personnes âgées dépendantes (EHPAD).

In these the accommodation offered is usually restricted to a room and all residents are over 60. The difference between the two is that the residents of an EHPAD are no longer able-bodied and autonomous and require regular medical attention.

The EHPAD will have signed a convention with the department and the state requiring them to provide a certain level of quality and to house the residents in the best conditions of hygiene, safety and comfort. The DDAS carries out regular inspections and guarantees good practice.

Some EHPAs do not offer in-house medical services but instead use freelance medical help from district nurses and GPs. Some of them are waiting to sign agreements to become EHPADs.

Unités de soins de longue durée (long-term care units) are for those who need constant medical treatment and supervision. For the most part these units are part of the hospital system.

Cantous (centres d'activités naturelles tirées d'occupations utiles) are small structures which house up to 10 residents suffering from dementia or Alzheimer’s. They deal with the individual care required for residents with special needs as a result of their illness which can result in anxiety, behavioural problems and disorientation.

These units can be independent or within the body of a larger retirement home and offer a secure environment to the residents, who are encouraged to take a part in communal life, including helping with domestic tasks like preparing meals and laying the table.

APA benefit can help with autonomy costs

Social security benefits which can help those elderly people living in some of the homes described above include the aide personnalisée à l'autonomie (APA).

This benefit, towards services needed by people who are not able to be autonomous without help, is granted by departmental councils and so is sometimes called allocation départementale personnalisée d'autonomie (ADPA).

It is payable to people living independently and also to those living in homes, to cover some if not all of the costs associated with helping them live autonomous lives.

It can go towards costs like: home help, day or temporary care, special equipment or accommodation adaptations.

APA is approved by the president of the departmental council after he has taken advice from a commission run by the department and made up of departmental representatives and members of social security organisations.

The relevant forms can be found at your mairie's centre communal d'action sociale (CCAS) or the elderly people’s office (bureau des personnes âgées) at your departmental social services or a centre local d'information et de coordination.

If you are already in a home and wish to apply for APA, the home’s administrative staff should be able to supply you with the necessary documentation and the director of the home can submit the form on your behalf.

In this case the APA benefit money will go directly towards reducing your retirement home costs and is paid to the home.

To be entitled to APA as a non-French national, you must be:

- In need of help with daily tasks due to physical and/or mental deterioration.
- 60 years old or over
- Have your primary residence in France, with a valid resident permit or European passport, and demonstrate that you have spent at least six months during the last year living in France.

The benefit is payable within a month from the date of notification of acceptance of your application by the conseil général.

The amount given depends on the applicant’s level of dependency, income (although all income levels are entitled to a minimum APA) and residential status.

At its top rate the APA benefit is worth more than €1,000 a month.

For the last tax year, if your income exceeded €623.14 a month, you will be asked to contribute proportionately to the dependency charge part of the retirement homes’ bill, with the amount of APA being diminished.

Under this threshold you will receive the maximum amount payable.

Find out more

The Connexion publishes a €5 helpguide on homes for the elderly in France. We explain:

- what to consider when choosing your retirement home
- the costs involved
- financial aid available
- where to find an English-speaking care home

Click here to download our helpguide

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