If you have looked into retirement home options in France, you will have come across the term Ehpad.
This stands for établissement d’hébergement pour personnes âgées dépendantes and refers to care or nursing homes, strictly regulated by the regional health agency ARS, and DGAS, part of the departmental council.
There are four main types of Ehpad, depending on how they are run:
- Etablissement privé à but lucratif: Private profit-making homes, usually part of a national group
- Etablissement privé à but non-lucratif: Non-profit-making home, usually managed by an association, and often cheaper
- Etablissement hospitalier public: State-run homes, attached to a local hospital for administration purposes
- Etablissement public territorial: State-owned homes run by the mairie or intercommunal body.
Other kinds of home you will come across include an Ehpa, which is a home for elderly people who do not need on-site nursing care, and unités de soins de longue durée (USLD), which are for the most dependent people, needing constant care, and often attached to a hospital.
Options for those able to live independently include résidences autonomie, similar to sheltered housing in the UK, where residents rent an apartment and there are shared facilities such as a restaurant but usually no on-site medical care. They are run by public bodies or non-profit-making associations. Résidences services are similar but run by private companies.
Financing of homes
The ARS and DGAS share certain responsibilities for the financing of homes, with the costs faced by residents being for their own accommodation plus their care needs, depending on their level of dependency (graded from 1 to 6).
These costs combined will typically range from €60 to €95 a day, or a monthly fee of around €1,800-€3,000.
Medical costs are covered directly by the state under the Assurance Maladie.
Several kinds of financial help are available, depending on means, with allocation personnalisée d’autonomie (Apa) from the departmental council being the most common form of help.
Apa goes towards the dependency part of the fees, and residents with income under €2,487/month will only, after Apa, be eligible to pay the home’s lowest level of these fees, corresponding to the charge for those with few or no needs.
For those with higher incomes, the amount left payable increases depending on income and level of needs.
Aide sociale à l’hébergement (ASH) is money from the department towards accommodation costs for those unable to afford these and it is available to those living in many state-run and non-profit-making homes.
If you also receive means-tested housing benefit (allocation de logement sociale), from Caf, this will be factored in.
An income tax credit is also available to help reduce nursing home costs.
How do French retirement homes work?
Joanne Cain, nurse manager for Association Les Ages and responsible for 220 residents and 170 staff in three Ehpads in Vienne, said: “It is difficult to compare the French and British systems, but I am very proud of the quality of care provided by our homes, largely thanks to the French system, regulation and financing.”
She said their residents have varied needs, from those who are independent but can no longer manage certain tasks, such as shopping or cooking, to others who are dependent for all their needs.
“Many homes have specialist units for the care of disorientated or confused residents, called unités de vie protégée (protected living units) or de vie sécurisée (secure living).
“We have units at two of our homes, Saint-Pierre de Maillé and La Puye. They are usually small, for 14-16 residents, cared for by specially-trained staff who allow them to live at their own pace. Breakfast can be served at any hour and if the resident refuses to wash or dress, we simply try later so as not to distress them.”
She said most care homes have temporary places for respite care and can often offer end-of-life care.
'My mother was very well cared for in France'
Julia Arkell, who moved to France in 2005, brought her mother over from the UK when she could no longer cope alone, to live in a new Alzheimer’s unit at the La Puye home run by Ms Cain.
She said: “She was very well cared for. My biggest worry had been language, but the staff made a huge effort.
“I gave them a dictionary, and if they had any problems, they would telephone me.
“I took her out regularly and we saw more of each other than would have been possible if she had been in the UK. It cost around €1,800 a month, a lot of money, but friends in the UK said that is much lower than they have paid.”
Ms Cain advises choosing carefully: “Visit more than one and don’t automatically choose the closest to home, as quality of care is key. Ask to visit, and aim to get a feel for the atmosphere. See how friendly the staff are as you pass them in the corridor and whether the residents look content.
“These are all indicators of the conditions of work and care.”
She said you will usually be asked for a chèque de caution – one month’s fee – in advance as a deposit, which will be refunded at the end of the stay.
“Most homes will expect you to reserve the room, and begin paying for it, generally at a reduced rate, until the resident actually arrives.”
She added that for those seeking work, retirement homes are short of carers and it is a good way to improve your French.
She has had British residents working in her homes, who have gone on to study for qualifications and made it their career.
To find a home, you can search on the government’s website for older people.
Our main image was drawn for Connexion by artist Perry Taylor.