Care homes and alternatives

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, behavioral 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.

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 or American associations) or by asking your local information point for elderly people or the CCAS at the mairie.

Other alternatives to a retirement home

Sheltered accommodation

Known as résidences autonomie in the public or not-for-profit sector or terms like résidences-services séniors in the private sector, sheltered accommodation is designed to be an interim step between a resident’s original home and a traditional retirement home. It may appeal to people, usually over 60, who are independent (level 5 or 6 dependency) 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 a one-bedroom flat which the occupant can furnish. A certain level of security is guaranteed.

Residents maintain their independence while having access to joint facilities and services which remain optional but are charged for, like a restaurant or canteen, services for cleaning and washing, medical assistance and entertainment.

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

To find such accommodation in the public sector, which offers subsidized rents (potentially with added assistance from housing benefits) see the Annuaires on this site, then Je recherche par annuannuaire and then Résidences.

Habitats regroupés

Some towns have accommodation referred to as habitats regroupés, consisting of a small ensemble of grouped independent homes, planned to suit the needs of more independent older people. 

They may have a convenient town-center location, adaptations for mobility problems, low rents and certain additional services such as delivery of meals. A local information point, such as the mairie, can tell you if there are any in your area.

Similar structures where older people may live mostly independently may also have names like petites unités de vie or Marpas (maison d’accueil rurale pour personnes âgées). 

The latter are in rural areas and house residents who live independently in small flats where living areas are communal. The advantage is that the residents remain in their community and retain independence even if they have some dependency needs.

Another similar set-up is the béguinage. These were historically used by religious communities but some historic ones have been opened for ordinary members of the public and some new ones have been built along similar lines. They consist of around 10-20 small individual houses grouped together in an ensemble.

Living with a host family

Another option is to live with a host family (famille d'accueil), generally a cheaper option than living in a retirement home.

These must have an accreditation and training from the departmental council, similar to families that foster children.

They may have one to three older people staying with them. 

The arrangement can be temporary, permanent, or part-time (eg. just in the daytime or just weekends). Meals are shared with the family. The council or a local information point can provide information about this. Beneficiaries can use benefits like APA, aide sociale or housing benefit to help pay the host family.

Sometimes such services or organized via an intermediary such as cettefamille.com, an entreprise sociale et solidaire (ESS), a kind of non-profit-making company in the caring sector.

'Intergenerational' living

Certain cities have schemes, often organized by associations, whereby older people can have a student live with them, for a modest rent, in return for the young person helping them with some of their daily needs. 

You can find out about such schemes from your local information point for elderly people.