Retirement homes in France

With more people living at home into old age, the average age for entering a retirement home is around 85.

There is plenty of choice as there are more than 10,000 homes in France, most of them with medical care. They can be in the private or the public sector.

In the private sector, establishments are either 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 (DDASS). They may be managed by bodies such as insurance companies, hotel chains, associations or foundations.

In the public sector, homes come under the authority of the health service (a hospital for example) or the part of the local mairie called the Centre communal d’action sociale (CCAS). They are managed by the commune or the departmental 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 steps to finding a home which suits your needs.

Medical care offered will vary according to the needs of residents in each home and their degree of dependency.

Traditional retirement homes

These are officially called établissements d'hébergement pour personnes âgées (Ehpa) and nursing homes for dependent elderly people are établissements d’hébergement pour personnes âgées dépendantes (Ehpad). The latter are the most common (about 70%) kind of homes, and have the most places (about 81 on average, compared to 25 for Ehpas).

In an Ehpa or an Ehpad the accommodation available is usually restricted to a room and all residents are aged over 60.

The difference between them is that the residents of an Ehpad have dependency needs, so they are no longer able-bodied and autonomous and require regular medical attention.

An Ehpad will have signed an agreement with the departmental council and the state requiring them to provide a certain level of quality and to house the residents in the best possible conditions of hygiene, safety and comfort. The DDASS undertakes regular inspections and guarantees good practice within these homes.

Some Ehpas do not offer in-house medical services but use freelance medical help from district nurses and GPs.

Unités de soins de longue durée (long-term care units)

Unités de soins de longue durée (USLDs) are for the most dependent elderly people, who are totally reliant on medical care and need constant supervision. Typically they are part of the hospital system.

Cantous

Cantous are small structures which house up to ten residents suffering from dementia (for example 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 they may be located within the body of a larger retirement home (in the latter case they are now often called Unité de vie protégée spécialisée Alzheimer). 

They offer a secure environment to the residents who are encouraged to take a part in the communal life, including helping with domestic tasks such as preparing meals and laying the table.

Rights of residents

Laws covering social security and the family guarantee that people living in retirement homes retain their rights and freedoms. They are assured of respect for their dignity, integrity, private life, intimacy and safety.

They also have freedom to choose between different suitable options offered to them, whether extra support to stay in their home or a place in a home. (However with the proviso that judges have certain powers to decide in cases involving elderly people under legal protection measures.)

They have a right to good quality care and support favouring their personal development and integration, suited to their age and needs and respecting their consent where they are able to express it (and where that is not possible, consent of their legal representative should be sought).

Information about them should remain confidential and they should be allowed freedom of access to information concerning their care, unless there is a legal ruling opposing this, as well as information about their fundamental rights, legal and contractual protection and rights of redress. They should also be directly involved – or with help from their legal representative – in planning accommodation and their support programme.

English-speaking care homes

While there is no nationwide retirement home service in English there are individual homes which pride themselves on their welcome to English-speakers.

On the Riviera, for example, the Sunnybank association in Mouans-Sartoux near Cannes helps English-speakers with care needs, in close association with the English-speaking Victoria Residential Care Home and the Albert Retirement Apartments.

You may find a suitable home in your local areas by word of mouth among the expatriate community (such as British associations) or by asking your local information point for elderly people or the CCAS at the mairie.

What to consider when choosing a residence in France

Location

A simple way to find homes in your area is to visit pagesjaunes.fr and search under the town or department number for maison de retraite. You will obtain a list and a clickable map showing locations.

Your mairie should also be able to advise, especially with regard to state-run homes.

The directory (annuaire) of pour-les-personnes-agees.gouv.fr is also a good resource. Click établissement and put in your postcode and how far away from your current home you are willing to go.

It is possible to see the accommodation and dependency costs of individual homes listed on this site and compare a selection of those in a given area.

There is also another helpful online resource set up by the regional health agencies, at trajectoire.sante-ra.fr. 

You can consult a directory (annuaire) as well as actually submit an application for a retirement home place (click Créer votre dossier).

The lesmaisonsderetraite.fr is another (non-official) information source.

'Local information points' exist to advise older people: visit the official personnes âgées help site (see above), click for the Annuaires, then Je recherche par annuaire and then under point 1. click Point d'information local dédié aux personnes âgées.

Selection criteria

It is strongly advisable to visit a variety of establishments before making a decision so that you can be in a position to choose which home best suits your needs.

Try to spend at least a day in the home to get a feel for how it is run and to meet the staff and residents.

For a future resident, it might be helpful to spend longer than a day there and some homes offer ad hoc residential care.

This way you can avoid the stress of having to look at a retirement home as an option of last resort in the case of emergency. In all cases, it is advisable to ask to see the home’s official accreditation and any satisfaction questionnaires filled out by the residents or their families.

Costs 

Typically, private retirement homes charge up to 50% more than public sector ones but have shorter waiting lists.

Factors affecting price include staff-to-patient ratio, services, and location (homes in cities usually cost more).

The average (mean) cost of an Ehpad care home, including accommodation and dependency needs costs, was just under €55,000 a year per month in 2023, according to analysis by Cnsa, an official body involved in aid to the elderly.

However, costs vary widely, from under €10,000 a year to almost €100,000.

Costs are the highest in Paris, less in the provinces, especially in rural areas and do not include the price of medical care.

In publicly-run homes costs within a certain geographical area will be similar.

Sheltered accommodation is often charged for on a monthly basis with a separate bill issued for any catering costs.

Three parts to Ehpads costs

1. Accommodation

Board and lodging and leisure activities. This is at the resident’s expense but means-tested aid is available. This tarif hébergement is fixed by the departmental council if it is a public sector home which is habilité à l'aide sociale (accredited to accept people who are eligible for means-tested state aid) otherwise it can be set freely but annual increases are subject to limits.

This cost is cited per day and includes meals, utilities, cleaning and laundry of sheets and towels etc.

2. Medical care

The social security system (Cpam) covers the costs of this, which amount to over €1,000/month for the typical resident. It is paid directly by your health caisse.

3. Dependency care

The tarif dépendance is variable depending on the type of home and levels of dependency of the person, starting at a few euros a day.

It covers day-to-day non-medical assistance and special equipment and adaptations, depending on a person’s needs.

This includes, for example, help with washing and getting around.

It rises depending on how major the needs are: from six (the least serious) to one (the most serious).

Optional charges are made for clothes laundry, visitors’ meals, television or telephone, hairdressing or pedicures etc.

In the event of absence due to hospitalisation, the daily rate is usually refunded.

The accommodation and dependency costs part of the fees will usually be paid by the resident from incomes like their pension and part may be paid via various benefits and state aid.

You can compare home costs in a given area of France at pour-les-personnes-agees.gouv.fr. 

Points to check:

1. Accommodation, setting and facilities

Are there safety features like smoke alarms, panic buttons and a secure environment for residents with, for example, Alzheimer’s? How many residents are there and what is their average age? How dependent are they? How good are the facilities for disabled people – lifts, ramps, electric beds etc.? What facilities are residents expected to share? Can you bring your own furnishings?

2. Catering

When are meals served and what is the typical menu? Are they prepared on site? Are meals adapted to dietary and medical requirements?

3. Staff

What is the ratio of staff to patients? What does the mission statement (projet de vie) of the home say?

4. Visitors

What are the visiting times and where do visits take place? Do visitors have access to specific areas of the home only? Can they stay overnight?

5. Medical services

If it is a nursing home, what qualified medical staff such as doctors, nurses, physiotherapists or psychologists work there, both in the day and at night? Some homes offer 24-hour nursing care and have a resident GP.

6. Leisure

What kind of leisure facilities are on offer? They might include gentle gymnastics, music, card games or talks. Are any outings organised?

7. Religion

Are services organised within the home? Can religious ministers visit?

8. Pets

In sheltered accommodation you can usually keep a pet with you; this is rarely possible in communal homes.

9. Waiting lists

How long do potential residents have to wait on average? How many names are on the waiting list?