The state of assisted living/ nursing home facilities in France

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The state of assisted living/ nursing home facilities in France


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Old 10th July 2020, 02:53 PM
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Default The state of assisted living/ nursing home facilities in France

Hello all,
I’ve been learning a great deal about a potential move to France and hope to get some light shed on a question I have been giving some thought to currently. Dejw has often brought up to prospective expats the question of “are you prepared to, do you want to grow old and die in France”. It’s an important question and one that deserves some of my attention. I have a close French friend here in the US who has been here for 25 years, she is around 50. She has recently had both of her parents pass away in the Rennes area where she grew up. When I was going over some issues regarding a potential move to France and we briefly discussed the “do you want to die in France” issue she made a comment to the effect of “my parents experience of spending time in a French nursing/assisted living facilty was not very good”. I did not press her for details and certainly can but I thought I would throw the topic out for discussion here.

So, my question is, what is the state of French assisted living/nursing facilities in France? Clearly, no one anywhere looks forward to the prospect of spending their last years in one of these facilities. I’m just looking for some reactions based on peoples personal experience or tales you have heard of others experiences, family members,friends etc.. Are they all state run or are there private options? I should think so. Are they decently run and well managed or run down and poorly managed? I would imagine there are more opportunities in more urban areas. What are costs like? Certainly there is a wide range depending on your care needs. I wouldn’t imagine that any of this would be covered but the French government for a US expat retiree as you have never paid into their social welfare system.

That’s it for now, any response will be greatly appreciated.

Best,
wvdthree

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Old 10th July 2020, 03:29 PM
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That's actually a very good question for a forum like ours.

I was just recently talking to a friend who is discussing with her siblings about "what to do about Mom" and in this case, the family (siblings) are French, but Mom is Italian (with acquired US citizenship). And to complicate things, Mom hasn't had all the best of experiences in her years here in France, but has tended to stay here (except for the summers, which she spends in Italy in the house she inherited from her family) to be closer to her kids and grandchildren.

It's a tough decision and not unlike the situation in the US - except that the range of options is perhaps a bit more limited. There are private "senior residences" that resemble what's called "assisted living" in the States - but the definitions and regulations can be vastly different. The State run homes vary from really awful to pretty good, depending on the management (though all are underfunded, which seems to be the main problem).

There are also a number of annuaires of Ehpads and maisons de retraite. There are also the facilities for "rehabilitation" (what we might call nursing homes in the US) that are more for people coming out of hospital who need supervised care before they can be allowed to return home.

This site has a good description of what is considered an "Ehpad" and the various types and levels: https://www.ehpad.fr/ehpad-definition/

But, there are also a wider range of resources available for seniors in some areas. The towns may provide delivered meals on a subscription basis. And now the Post Office is setting up regular visits to elderly people to check on their well being (which are free of charge), plus a variety of other services (for which you pay). https://www.laposte.fr/senior/conseils-et-actualites

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Old 10th July 2020, 03:56 PM
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A French friend of mine and her sister were looking for solutions last year for their elderly mother, who needs constant care and it was becoming difficult for the daughters to cope. With their Mum's agreement, they got in a place in a aged care home for her (not an Ehpad). They were so horrified after regularly visiting for a couple of weeks, that they moved her back to my friend's sister's home and again are sharing caring for her (though the sister does most of it as she lives with the mother). They have of course arranged for some assistance, but it has meant that the sisters can never go out together. I cannot even begin to tell you how releived they are that their mother has not been in the facility during and after the Covid-19 crisis.

That aside, aged care facilities can be very expensive and waiting lists can be very long.

As for me, I sincerely hope I never end up in one.

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Old 10th July 2020, 04:19 PM
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As for me, I sincerely hope I never end up in one.
Which raises the question of looking into the local services available to allow you to remain in your home as long as possible. I notice that many of the sites that offer such services more or less assume that family members are the ones who arrange for such services.

For expats - or others living here without family in the area or in France - the question arises of being able to make arrangements for in-home care or other services for yourself.

As we were discussing the issues of her Mom, my friend was saying that she should really start making a list of things she should do (or not do) as she gets older so that she doesn't put her children in the same situation her mother is putting her in. Got me thinking that I need to prepare a list of all my financial accounts, pensions and other official business that would need to be contacted in the event of my demise. And ask DH to do the same for his affairs. Because we don't have any joint accounts, we tend to keep our financial affairs to ourselves - but having to paw through papers and old receipts to find all that sort of thing after the other is gone would be a real horror show.

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Old 10th July 2020, 05:54 PM
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A French friend of mine and her sister were looking for solutions last year for their elderly mother, who needs constant care and it was becoming difficult for the daughters to cope. With their Mum's agreement, they got in a place in a aged care home for her (not an Ehpad). They were so horrified after regularly visiting for a couple of weeks, that they moved her back to my friend's sister's home and again are sharing caring for her (though the sister does most of it as she lives with the mother). They have of course arranged for some assistance, but it has meant that the sisters can never go out together. I cannot even begin to tell you how releived they are that their mother has not been in the facility during and after the Covid-19 crisis.

That aside, aged care facilities can be very expensive and waiting lists can be very long.

As for me, I sincerely hope I never end up in one.
I should just mention that there are by all accounts a couple of good nursing homes here, both private but one does take an occasional very needy person (they have a small number of rooms for that purpose).

I also have no doubt that there are some genuinely good facilities in France, the issue is (a) finding them and (b) being able to afford the fees.

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Old 10th July 2020, 05:59 PM
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Which raises the question of looking into the local services available to allow you to remain in your home as long as possible. I notice that many of the sites that offer such services more or less assume that family members are the ones who arrange for such services.

For expats - or others living here without family in the area or in France - the question arises of being able to make arrangements for in-home care or other services for yourself.
There are services here that I already know of (not overnight care, though you can get one of those alarm thingies that are monitored) and I know some infirm people who have been able to make those arrangements themselves - but this is always where it helps to know your neighbours, to be well integrated, and to speak French (bearing in mind though that people with dementia or Alzheimer's often lose their second language, even if they spoke it really well, regressing to their native tongue).

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Old 10th July 2020, 07:11 PM
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Thanks for the replies EH and Bev. So, as an expat can one apply for, get into and pay for a assisted/nursing home within the state run facilities or are you obliged to go to a private one?

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Old 10th July 2020, 07:26 PM
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Quote:
Originally Posted by Bevdeforges View Post
Got me thinking that I need to prepare a list of all my financial accounts, pensions and other official business that would need to be contacted in the event of my demise. And ask DH to do the same for his affairs. Because we don't have any joint accounts, we tend to keep our financial affairs to ourselves - but having to paw through papers and old receipts to find all that sort of thing after the other is gone would be a real horror show.
Which brought to my mind an issue for all expats in France who are married, and definitely expats who arrive as an expat married couple.

What happens to the remaining partner after you die? Will that person have an escape route, or have sufficient funds to carry on and eventually seek their own aged care? What would that person prefer? Remembering that it is very often not the partner that you expect to die first who actually does, sometimes and perhaps against the odds they live long after you. But what if they are already on the verge of needing care, or the partner who actually dies first is the primary carer?

Don't ask me how you deal with that, because I have no idea and, of course, everyone's circumstances differ.

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Old 10th July 2020, 07:32 PM
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Thanks for the replies EH and Bev. So, as an expat can one apply for, get into and pay for a assisted/nursing home within the state run facilities or are you obliged to go to a private one?
Well, if you are legally resident, I don't see why you could not go into a state run facility. More so if you are paying taxes in France and in the French healthcare system. The state run facilities charge you anyway - if they can't verify your worldwide resources, chances are they will charge the maxiul fee. And if you own a home in France, they can have access to that to offset fees (which would have to be paid from your estate). It is not free and it is not covered by the French health system (though some medical costs charged are currently covered by the French health system).

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Old 10th July 2020, 07:46 PM
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Thanks for the replies EH and Bev. So, as an expat can one apply for, get into and pay for a assisted/nursing home within the state run facilities or are you obliged to go to a private one?
Good question .. and I don't know the answer. But would like to hear from someone who does.
But what I do know is that our excellently run EHPAD .. state run .. has not had a single case of Covid. Unfortunately there is a long waiting list as inmates here seem to go on forever.
The fees are approx. €2600 - €2800 inclusive but before such luxuries as a visiting chiropodist or a visiting hairdresser.
On the private side there is such a home here, belonging to a Group, and the basic inclusive costs start at around €3000 and rise exponentially, depending on the room and the available facilities. It is not as highly regarded as the EHPAD .. but some people just cannot see their way to being anywhere but in a private Home.

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