in Cahuzac-sur-Vère, in the Tarn, an innovative shared accommodation to end your days “like at home”

For several months, Patrick Sévègnes has been driving a Porsche. At 61, this former bus driver was forced to swap his walker for an electric chair, which he adorned with the logo of his favorite brand. “I’m missing the steering wheel”, he laments, with a shy smile. He, the road ace, finds himself fighting against a small joystick and hitting the walls of the wide corridors of the Astrolabe House.

Its new racing circuit is a residence for elderly or seriously ill people. Emerging from the ground in the Gaillac vineyard, on the edge of Cahuzac-sur-Vère (Tarn), this single-storey building opened its doors in February 2023. Patrick Sévègnes found refuge there six months later. Suffering from multiple system atrophy, an incurable neurodegenerative disease, he was no longer able to live alone at home in Hérault, but also had no place in the hospital or in a specialized institution. He found there an intermediate level, unique of its kind, between home and a palliative care unit.

Maison Astrolabe is already a model to follow. To generalize the experience and give it a legal framework, Emmanuel Macron announced, Sunday March 10, the creation of “support houses”. These establishments, which are poorly medicalized, will be intended to accommodate “end-of-life patients whose condition is stabilized, but still requiring technical and specialized care”according to a report (PDF) handed over to the executive in December.

A dozen rooms

The project was born in the mind of Delphine Calicis, a palliative care nurse, around fifteen years ago. “On the ground, we saw people isolated or surrounded by exhausted loved ones, who would have needed a place of care at the end of their livesshe describes. I think of a young, sick father, alone, who could not stay at home. He had to leave his child with his ex-partner in Tarn to die far from here in his family.” The trigger came from a meeting with Laure Hubidos, initiator of the first structure of this type in France, the Maison de vie de Besançon, in Doubs. This pioneering place, which operated between 2011 and 2019, inspired the creation of the National Collective of Houses of Life, of which Maison Astrolabe is the only flagship in service to date.

In the Tarn countryside, around sixty kilometers from Toulouse, nine people are welcomed year-round and three others can be accommodated temporarily, for respite stays. A lounge is reserved for families, who can stay there to accompany their loved ones, as was the case in December until the death of a 21-year-old young woman. “Most of our residents are elderly, but we also want to welcome young people”insists Delphine Calicis.

“A retirement home is not a ghetto for the elderly. The richness of the place lies in the cohabitation between generations and the confrontation with other pathologies.”

Delphine Calicis, volunteer president of Maison Astrolabe

at franceinfo

On this Monday in January, the monthly “house council” is held. All the roommates and the entire team are gathered in the large living room, between the piano, the television and the pellet stove. Between two sips of herbal tea, everyone is free to discuss the subject of their choice. We are talking about the upcoming arrival of a 58-year-old woman, suffering from terminal cancer, too young to be accommodated in a nursing home or long-term care unit. She had to vacate her palliative care bed at the hospital, 100 km away, and her loved ones, distraught, turned to Maison Astrolabe. “She is deaf and mute, but it seems that she can make herself understood very well”, Delphine Calicis assures the residents, who wonder how they will be able to integrate her into their gang.

Joe Dassin in the kitchen

Before dinner, everyone is asked to help set the table, get their placemat or cut the bread. A green cabbage in one hand, a knife in the other, a resident is already busy with lunch the next day. Patrick Sévègnes is in charge of the musical ambiance, with his phone connected to the speakers in the dining room. “There was always music on my bus”he smiles.

The week’s menu was decided by the residents in the morning, in consultation with the “mistresses of the house”, two employees responsible for preparing meals, running the place and ensuring everyone’s well-being. Tonight, it’s soup, quiche, Savoyard fondue and compote. And Joe Dassin. “This house is wonderful”enthuses Christine Montels, a nurse from the town. “I worked in a nursing home and the residents are there passive. To go quicklystaff wash people for them, instead of taking the time to help them do it themselves.”

“Here, on the contrary, we make them participate in everything, we stimulate them, we make them think. My 98-year-old neighbor has lived here since the death of her husband. In a nursing home, it would have been a collapse. There, I see her get back on your feet.”

Christine Montels, nurse

at franceinfo

At the table, Jeannette Azema, 90 years old, taunts one of her neighbors. In addition to his glass of water and his usual balloon of red, this former wine merchant managed to have rosé served in a third glass. “You’re pumped, you!” she teases him. “And to think that he never worked in the vineyards”adds her neighbor, Odette Dolle, in a burst of laughter.

A well-filled guestbook

A 95-year-old former farmer, Odette Dolle was the first to have had her napkin ring at Maison Astrolabe, which she watched being built with relish from her home. “I was alone for six years, she says. I didn’t want to go to a retirement home. It’s the factory there, I know some who don’t do well there. Here it’s different. It’s family, like home.” This bubbly grandmother has rediscovered the pleasure of cooking, of being surrounded on a daily basis and of helping others, often younger, but less courageous than her. She also likes to support Delphine Calicis, who “gets very tired making it all work”.

“By lending a hand, I feel like I’m participating in the running of the house.”

Odette Dolle, resident, 95 years old

at franceinfo

In the evening, the “big sister” of the household writes down on paper the best jokes and memorable moments shared at the Astrolabe. She was the one who was appointed, in May, during the inauguration of the premises, to speak to Agnès Firmin-Le Bodo, the former Minister Delegate in charge of Territorial Organization and Health Professions. “I explained to him that it was good here, but too expensive for farmers”, raises Odette Dolle. Each month, to supplement her minimum retirement age of 870 euros, she draws from her savings to pay 1 500 euros rent and miscellaneous costs. “I didn’t think I would live this long, she blurted. Maybe I should die soon, because I’m expensive. But, you know, we cling to life.”

Any good news coming?

To finance its structure and lighten the burden of its residents, Delphine Calicis has the impression of “having to fit circles into squares”. Supported at its launch by two charitable organizations, The Works of Father Colombier and The Little Brothers of the Poor, as well as by the Tarn department, Maison Astrolabe now lives off the rent paid by residents. The balance is precarious and the project is struggling to deploy. “There is no legal framework for structures like ours, so we cannot claim any public operating funding”laments the president of the association.

Last year, a man receiving palliative care had his application refused due to a lack of assistance enabling him to pay the requested rent. “He had to turn to a nursing home authorized for social assistance”, deplores Delphine Calicis. A woman welcomed at Maison Astrolabe had to leave her room due to lack of staff. “His cognitive disorders required a permanent presence. However, we do not yet have the means to have professionals on site at nightexplains the founder. It was painful to see her go, for everyone.”

While waiting to have the means to achieve its ambitions, Maison Astrolabe had to broaden its audience. “To be able to live, we had to accept elderly people who were still somewhat independent, for whom there was a strong demand”recognizes the nurse, who works as coordinator of the territorial professional health community of Greater Gaillac.

“If we don’t help us more, we won’t be able to support the people who need us the most.”

Delphine Calicis, president of Maison Astrolabe

at franceinfo

The government’s plans for “support homes” will be clarified at the end of March, during the presentation of the new national strategy for the development of palliative care. The announcements will be followed carefully in Cahuzac-sur-Vère. The report submitted to the executive at the end of the year generated a lot of optimism within the team. Residents were reassured: “The idea is not to put people outside if they are not in palliative care. Perhaps we will even have to ensure that we maintain a form of mixing. It would be a shame to lock people up at the end of their life in one more ghetto.”

The day the good news on the financing of the structure arrives in the mail, it will be Carole Marcandella who will distribute it. At 62, this former postal worker from Castres, followed in psychiatry, became the official postwoman of Maison Astrolabe. Everyone has their own mission in this lively shared accommodation.