Starting to have trouble with independent living does not necessarily mean having to move into a retirement home. There are a range of nursing and other home help services available for older people, or people who, for whatever reason, need extra help in the home.
People carrying out the work will typically have taken a two-year training course for a certificat d’aptitude professionnelle (CAP). The government is organising a system of professional cards for people in the home-help sector, which is referred to as aide à domicile or aide ménagère.
Financial help
There are two levels of financial aid for elderly people who need such services. The first involves those who just need someone to come in to help with cleaning, washing and ironing and preparing meals.
The second extends to help getting out of bed, washed and dressed, for elderly people who have lost their autonomy to a significant degree. Both kinds of aid are managed by departmental councils.
Help for people with a temporary loss of autonomy (those recovering from an accident, for example) follows the same principles as for elderly people.
You have the right to ask for aide ménagère financial help if you are over 65, need help around the house and your household revenue is less than €1,012 if you live alone, or €1,571 a month if you are a couple.
If you have French pension rights, then your caisse de retraite may also be able to offer financial help towards an aide à domicile, but the level of help varies depending on the body that pays your pension, your income level and dependency needs.
Read more: Can foreign retirees really claim ‘free pension’ after move to France?
First port of call
In any event, the first step towards getting help is to ask at your mairie; in larger towns it will have a branch called the Centre Communal d’Action Social (CCAS), which is the relevant one. Almost all municipal councils, even in the smallest communes, have one elected member, usually a deputy mayor, in charge of the social work of the mairie.
Municipal secretaries are trained in the form-filling and stamping needed before the mairie sends the request on to the department. Once approved, the money is paid either to the association or business providing the home help, or directly to you if you prefer to hire someone yourself. You may be asked to contribute partially to the funding yourself.
Note also that this funding is officially a loan, to be repaid to the department after your death by your heirs if the accumulated total is over €46,000. Hours worked by an aide à domicile will depend on the department you live in. Most offer 30 hours a month for a single person or 48 hours a month for a couple, which works out at around 90 minutes, five days a week.
Allocation personnalisé d’autonomie is also run by the department, for those with a greater level of needs; it cannot be combined with aide ménagère.
Dependency scale
Recipients must be at least 60 and are assessed by doctors or social workers from levels one (the highest) to four on the six-level Aggir dependency scale (Autonomie Gérontologie Groupe Iso Ressources).
You have to live in France on a stable basis, either in your own home, the home of someone close to you, or in a résidence autonomie (usually flats with a helper on call). Foreigners must have a residency card or a valid titre de séjour.
As well as not being compatible with aide ménagère, Apa cannot be combined with help from your caisse de retraite or certain other benefits, including allocation simple d'aide sociale pour personnes âgées or prestation de compensation du handicap.
You can make a request for Apa either online or on a paper form (Cerfa 16301). You will need copies of your ID, your last income tax statement, bank details (RIB), taxe foncière statement, and, in most departments, a doctor’s certificate.
At the same time as making the Apa application, you can request a Carte Mobilité Inclusion, which gives free public transport in most departments. The department has 10 days to respond, but in urgent cases can make an emergency grant of €971 within this time.
Read more: What are options for older people and ‘wearable’ alarms in France?
A social worker or medical professional from the department will visit to assess you on the Aggir scale, and evaluate your needs. If you are deemed to be Aggir 4 or higher, support can include an aide à domicile visiting your home for help getting dressed and washed, payments to a family member you live with, help with transport and meals, including delivery of meals, financial aid for renovations such as ramps in your home to make living there easier, or a temporary stay in a rest home.
You might be asked to make a contribution to the funding. This is on a sliding scale, from €762 a month maximum for people on Scale 4 and €1,995 for people on Scale 1 (the highest level of dependency). The sums can be increased if there is no one close who can help, or if the helper needs to go on holiday, or is hospitalised.
The government has promised to make accessing help for the elderly easier, with a guichet unique (one-stop-shop) in each department where a trained employee will handle all the form-filling.
In the meantime, there is already a network of information points for elderly people, which you can find by putting in your postcode at this link: tinyurl.com/info-point-pa. Choose Point d’information local and put in your postcode. However, the best point of contact to access help will often be your own local marie.
