MANY expats move to France with the intention of making it their permanent home so the issue of care homes in later life often arise and Connexion frequently receives queries on the subject. Fortunately permanent residents in France have good rights in this regard as we explain below.
What are the main kinds of French retirement home and where do I find one?
As you would expect there are both private sector homes, run as businesses or by non-profit-making associations, and council or health-service ones. Most private sector ones are approved by the social services body for the department, the DDAS.
Your mairie should have information as should the nearest centre local d’information et de coordination(Clic) which advises on services for the elderly.
See http://clic-info.personnes-agees.gouv.fr (click on “Clic”, then on your department, then put in your postcode).
Listings can also be found in the yellow pages and at www.lesmaisonsderetraite.fr
The general term for a home without onsite medical care, is an EHPA (établissement d’hébergement pour personnes âgées). The resident may just have a bedroom, the rest of the home being communual, or it may involve renting a fully-equipped flat while also having some communal facilities, such as dining, laundry or leisure activities.
The latter are sometimes called logements-foyers or résidence pour personnes âgées. One kind, with flats to rent, situated in rural areas and relatively small, are called marpas (www.marpa.fr).
Homes for people aged over 60 who are dependent and need onsite medical care are établissements d’hébergement pour personnes âgées dépendantes (EHPAD).
Accommodation is a room and help with daily life is on hand from staff who are there 24-hours a day as well as continual medical help. EHPADs are required to sign an agreement with the departmental council guaranteeing standards and are inspected.
Applications are on form Cerfa n°14732*01 submitted to the home (www.tinyurl.com/ehpad-form). On becoming a resident a person signs a contract with the home detailing services offered and how the resident will pay for them. More specialised facilities also exist such as Unités de soins de longue durée - USLD (long-term care units) for elderly people who need constant medical treatment and supervision. Typically these are part of the hospital system but still involve individual rooms. A version specialised in dementia is a Unité de soins spécifiques Alzheimer.
There are also so-called cantous - small facilities for up to ten residents, which may be independent or located in a larger home. Residents are encouraged to take part in communal life, including helping with domestic tasks.
What do they cost?
Homes split the bill into three sections; accommodation costs, which include board and lodging and leisure activities; medical care costs, which are covered by social security (Cpam), and dependency costs which cover assistance for day-to-day care and are assigned after a medical examination.
www.lesmaisonsderetraite.fr estimates the average monthly cost of an EHPAD to be €2,780 in Paris and from €1,591 elsewhere in France.
What financial help is available?
Several kinds of help may assist, firstly allocation personnalisée à l’autonomie (APA), which is towards services needed by people who are not able to be autonomous without help and is granted by departmental councils. This is for people in their own homes or in care homes where it covers the dependency costs. The relevant forms can be found at your mairie, CLIC or departmental council.
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; be aged 60 or over; have your primary residence in France and demonstrate that you have spent at least six months of the last year living here.
APA is paid monthly at amounts depending on the level of dependency and the individual’s income, ranging from €28.59 to €1,304.84.
Aide sociale à l’hébergement (ASH) may be granted by the departmental council towards accommodation costs in many homes that are state-run or run by non-profit-making associations.
It is means-tested and is available to those who: are 65 or over, or over 60 but unfit for work; and do not have sufficient income to pay the fees.
You should be willing to use 90% of your income from all sources, though you must be left at least €94 per month. Aide sociale can be recuperated from a person’s estate after death or during their lifetime if they should come into money. The request for the benefit is made by the home to the council.
Residents who live in accredited sheltered accommodation may be entitled to aide personnalisée au logement from the caisse d’allocations familiales to reduce rent payments (it can also help reduce mortgage ones). In some cases it is also relevant to people who live in retirement homes but is not usually combined with aide sociale. The amount depends on where the accommodation is, the cost and the resident’s level of income.
Income tax reductions can also help, especially for those who live in an EHPAD. These are based on the dependency and accommodation costs after deduction of benefits and are equal to 25% of the expenses, with a fixed upper limit of expenses of €10,000, meaning a maximum annual reduction of €2,500 per person is available.
By moving permanently into a retirement home or into accommodation offering long-term care, and dependent on your level of income, you are totally or partially exempt from local property taxes on your former main residence if you do not let it out. The resident is exempt from taxe d’habitation for their stay within a home apart from in the case of autonomous flats.
Are EU expats on equal footing with the French?
Yes, permanent French residents of EU nationality qualify for the same help and the financial conditions are the same.
Are residents expected to sell any home they may own to pay the bills, if necessary?
Honorary avocat Gérard Barron from Boulogne-sur-Mer said: “There is no lifetime requirement on pensioners to dispose of their home in order to qualify for assistance.
“Ordinary APA is often intended to keep them at home in order to avoid them being institutionalised at even greater cost to the community.”
He added: “APA is not clawed back from family or from the estate after death under current rules; however where an OAP needs to go into a home, the cost, particularly if it is a medicalised facility, often exceeds their pension income. In that case, they will in the case of publicly-run facilities be kept on but the cost of care unfunded by their pension or other cash savings, will be a charge on their estate; so if the estate still comprises real property on death, it will usually be sold to cover that charge.
“The charge on the estate does not however apply to privately-run old age facilities and if the resident in a private home is unable to cover the cost of care they may be evicted, which will usually encourage them to sell their home or other assets. A viager sale may be a solution and I have heard of cases where the retirement home has put the resident or their family directly in touch with a specialist companyn in order to arrange such a sale.”
Can a person’s family be required to contribute?
Yes, children (and even grand-children) may be required to contribute in proportion to their ability to pay and the parent’s needs. Payment can either be agreed amicably or councils can sue in the family courts, in which case a judge may fix the amount.
If the children live in France enforcement would be relatively simple. If they live in the UK then theoretically a French court could seek to enforce the obligation but this has not so far been tested (to our knowledge) and would be complex. Some councils have asked children living in the UK to give details of their means, or have indeed asked for contributions from them.
Are there English-speaking homes in France?
Individual homes do exist that specialise in catering for English-speakers.
Naturally they are more likely to be found in areas to which English-speakers typically retire.
On the Riviera there is Sunny Bank at Mouans-Sartoux near Cannes, which is a bilingual home (www.sunny-bank.org). In the Dordogne, Résidence Yvan Roque in Issigeac provides an Englishspeaking service (www.tinyurl.com/yvanroque).