Nothing to do with a CHSLD

You don’t arrive at Roxane Acloque Ittah by chance. In front of a wood in Louargat, in Brittany, between two country lanes, a white house appears. Goats graze on the grass to avoid mowing. Four dogs play in the wind. In the distance, the chickens are clucking. A handful of cats, including one on three legs, watch with their big eyes as the visitor parks. Maria Catarino’s room faces this improvised menagerie. This is the last arrival in the house. She turned 91 on September 15.


The nonagenarian is the first elderly person to be welcomed into the small back room of Acloque Ittah. Roxane obtained approval from the French government to become a host family a few months earlier.

Next to her bedroom door, Maria Catarino wrote the first names of the five people with whom she now lives. She still has a little difficulty remembering the names of Roxane, Kévin and their three children, Sharon, Gabriel and Salomé. It must be said that she only met them on July 24, the day she moved in. Before, Maria Catarino lived in a residence owned by the municipality. “My daughter was afraid I would fall,” she explains, after having the question repeated a few times – her hearing aids will soon run out of batteries. In fact, the fears were a little more fleshed out. “She forgot to take her medication, to drink and sometimes even to eat,” confides Roxane Acloque Ittah.

“They are nice here,” says Maria Catarino. Before adding, a hint of Portuguese accent in his voice: “but what I would like is to be with my children”. An impossible request for his daughter and sons who, in addition to not all living in Brittany, have a job and a family life.

So, Maria agreed to live in this home which is not hers. She gets manicures there, helps cut vegetables for dinner and drinks, as she always has, her glass of rosé at the table.

Host family has nothing to do with an EHPAD [établissement d’hébergement pour personnes âgées dépendantes, équivalent des CHSLD]. We take our time, we’re not in a hurry. There is no set time for washing, eating lunch or going to bed.

Roxane Acloque Ittah, family host

The family caregiver is there to support Maria Catarino in her daily life, while integrating her full-time into hers and that of her blood family. To take care of Maria at home, the 32-year-old mother receives remuneration of 1,062 euros per month (approximately $1,535 CAN) – an amount that varies depending on the resident’s level of autonomy. Added to this is compensation of 625 euros ($900 CAN) for the provision of the room and some 200 euros ($290 CAN) for current charges. It’s up to the receptionist to settle the bill.

But Roxane Acloque Ittah did not choose this path for the money. After years spent in sales and a furtive experience as a home help – “I hated the concept, we are limited in time, we visit people one after the other, without having time to build relationships » –, she took the necessary steps to obtain family foster approval. This is obvious for someone who was raised by her grandmother and who, on several occasions, welcomed members of her family into her home to accompany them in their final years.

“To obtain approval, it was complicated. Every time we think it’s over, there are new challenges! “, she says. She had to have a physical and psychological health check-up. His house was inspected three times. An official came to visit the house. Then, she was forced to return to school, in particular to obtain her compulsory first aid diploma. Then, 44 hours of additional training imposed by the departmental councils.

In Côtes-d’Armor – the region of Brittany where Roxane is based – 108 people are approved to accommodate up to three tenants maximum. In fact, only around thirty seniors are welcomed through this system. “It’s an interesting alternative, but our hosts are getting older, so we would like to have new ones,” explains Véronique Cadudal, departmental vice-president in charge of Autonomy. At the national level, the Ministry of Solidarity assures that it wants to work on promoting family reception.

We aim to allow people to choose where they want to age. Family care is a gentler option than EHPAD when you leave your home.

Véronique Cadudal, departmental vice-president responsible for Autonomy

“Death is part of the game”

At the Acloque Ittah family, the presence of children makes the host family experience even more enriching. Aged 12, 7 and 5, they quickly got used to the presence of a nonagenarian in their house. “I like having Maria because we have good times. We’re playing dominoes,” Gabriel breathes, sitting against the nonagenarian on the sofa.

Roxane prepared them for the arrival of an elderly person in their home, and all that entails. “Death is part of the game, but it’s hard. I don’t hide anything from my children. They know very well that it can happen and that you have to be ready,” she says, without filter. Little by little, bonds are formed between all the members of the house. However, there is no question of leaving the children alone with Maria. The thirty-year-old must personally watch over her welcome. The commitment and responsibilities of a lifetime.

Accommodation for seniors in France in figures

17,000

Number of places in family care distributed among 8,000 people approved by the State

770,000

Approximate number of places in EHPAD type accommodation structures distributed among 11,000 establishments

21%

of the French population is over 65, which roughly equates to 14 million people likely to require one or other of these services

Family welcome analyzed

Jean-Claude Cébula, clinical psychologist and director of the Institute for Training, Research and Evaluation of Medical-Social Practices (IFREP), sets out for us the framework of family reception in France.

What governs family care for the elderly in France?

The activity was regulated in 1989 following press articles which denounced abuses by pseudo-host families. The law concerns approval, given by the departmental councils. Financial exchanges between hosts and hosts are also regulated. On the other hand, this regulation leaves complete initiative in organizing the reception to the hosts themselves. Since 2002, the law has been improved. Approvals are now valid for five years and each family carer can care for a maximum of three elderly people in their home.

What inventory can we draw up on family care for the elderly today?

We are witnessing a gradual decline in the number of foster families in France. There were 8,400 in 2022, for 13,000 welcomed. And the first figures for 2023 show that the decline continues, even if there are territorial disparities. Certain regions are historically welcoming lands. Others, like Réunion, have politically promoted family foster care because there were not enough retirement homes and this provides resources for caregivers.

What do you think explains this gradual decline?

This activity is little recognized, poorly paid and increasingly difficult to carry out as the level of autonomy of the host decreases. There is also no government ambition on the subject. For our part, we are calling for better remuneration for family carers and for the organization of care by law.


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