France | When Elder Abuse Becomes Systemic

(Paris) In his investigative book The gravediggers published in January, the French journalist Victor Castanet recounts how the French group Orpea, world leader in the housing sector for the elderly, set up a “system” to increase its profits to the detriment of the well-being of its residents and employees.

Myriam Boulianne
special cooperation

Rental, prices, services and, above all, a night nurse. In front of her Excel table, Delphine* lists the criteria on which she relied when she placed her 90-year-old mother in an accommodation establishment for dependent elderly people (EHPAD), a type of establishment similar to CHSLD in Quebec. Public or private, it didn’t matter to her, she says. But Delphine had the impression that the financial means, the controls and the quality were superior in the private establishments.

Following her research, she opted for a private establishment of the Orpea group, located in the Paris suburbs, in October 2021. Four months later, revelations about the system of abuse within this group broke out in France. “It took me to the guts, remembers the fifties. I wanted to find the best thing for my mother, but maybe I was naive. »

In his 400-page investigative book, Victor Castanet describes the way in which the French group Orpea “rations” hygiene care, medical care, even care products and meals for residents to optimize its profitability. Revelations that quickly interested the media and the French political world.

Orpea manages retirement homes and care clinics in 23 countries and generates several billion euros in profits every year. The multinational nevertheless receives 300 million euros from the French government each year, to manage its 220 nursing homes in the country.

As the journalist found during his investigation, which lasted three years, the group is reducing certain essential services, such as the number of employees assigned to care, in order to enrich itself.

The survey also shows that the control mechanisms – regional, departmental and national – are failing. “The system cannot work this way”, laments Victor Castanet, met in a Parisian café. “This is what has allowed the drifts for 15, 20 years. »

“Electroshock”

Following the revelations published by the journalist, the French government announced the opening of two administrative investigations into Orpea. The French Ministers of Health, Olivier Véran, and Autonomy, Brigitte Bourguignon, also announced the implementation of around fifteen measures intended to strengthen the control of EHPADs.

“We hoped it would create an electric shock, but we did not expect it to go to this level,” says Victor Castanet, who will speak to the French Senate this week. He claims to have received thousands of emails, including testimonials, since the publication of his book. In other newsrooms too, and even in the Ministry of Health, email boxes exploded. A kind of “liberation of speech”, sums up the thirty-something.

As for Delphine, she refuses to read the book, for “fear of [se] add worries. Since the scandal, the lady has redoubled her vigilance, even if her mother assures her that she is well treated in the establishment where she lives. What if something serious happened to him?

And in Quebec?

“The Orpea affair” comes as no surprise to the holder of the Research Chair in Elder Abuse in Quebec, Marie Beaulieu, who has been studying this issue for 35 years. Since the objective of companies listed on the stock exchange is profit, it could be that “some companies in the sector have less at heart than others the living conditions of seniors”, she supposes.

In Quebec, the portrait is less gloomy than in France, she says. The problem is not systemic in the province, but rather concerns certain targeted establishments. We saw this in the case of the private CHSLD Herron, which was accused of serious organizational negligence during the first wave of COVID-19.

In private residences for seniors, M^me Beaulieu admits that there are four to five major players, but warns us that “we must be careful not to attach the qualifier of abuse to all private establishments”.

The professor from the University of Sherbrooke hopes that the monitoring mechanisms will soon be the same in the public and private sectors, particularly in terms of standards and accreditations, in order to avoid abuse.

In the coming months, Victor Castanet will continue to devote himself to promoting his book, determined that “the subject does not go under the carpet”. His wish has already been granted: in March, the Korian group, number 1 in the sector of accommodation for the elderly in France, faced similar accusations following an investigation broadcast by the French public affairs program Cash Investigation.

* Delphine asked to be identified only by her first name for fear of reprisals.