The text supported by the presidential majority, which aims to respond to the challenge of aging and dependency in France, notably proposes better reporting of cases of mistreatment.
Emmanuel Macron had promised a “old age” law during his first five-year term, in 2018. It is ultimately the “aging well” bill which is examined on Monday November 20 in the National Assembly. Examination of the text, tabled in December 2022 by Renaissance and Horizons deputies, was postponed to July, after a first reading interrupted in April by the parliamentary recess.
At the time, the text was castigated by the opposition, who considered it insufficient: “An empty shell”, according to LR MP for Saône-et-Loire Josiane Corneloup; a “tiny little thing” according to rebellious MP François Ruffin. The socialist deputy Jérôme Guedj had expressed his “giant frustration” while a text on the subject could have been “unifying”. On the majority side, Renaissance MP Monique Iborra even gave up being the rapporteur, to denounce her lack of ambition. “Reforms that will not address the substance but only the form. The symptom, but not the disease”, deplored Monique Iborra on X (ex-Twitter) in April, whilen 2030, one in three French people will be over 60, according to INSEE. And those over 65 will then be more numerous than those under 15, for the first time.
One-stop shop for families facing dependency situations, system for reporting cases of abuse, professional card for home help… Franceinfo details the main measures of the text, which includes 14 articles.
A plan to prevent and combat social isolation
The first part of the bill aims to prevent the loss of autonomy of elderly people, with the creation of the National Conference on Autonomy. This new state body has the mission of piloting this prevention policy and detailing its missions. It is based on a “national evidence center for prevention of loss of autonomy and gerontological resources”, which must identify technical aids or new technologies favoring in particular “home support”. The Renaissance rapporteur Laurence Cristol defended in April this “tool which will allow us to set strategic axes” faced with the diversity of local initiatives.
An article is also devoted to the fight against the isolation of people in vulnerable situations. According to the text, “it allows social and health services to more easily have access to data facilitating the identification of elderly people or people with disabilities who are isolated”. This involves organizing periodic contact with people at risk.
According to a study (PDF) from the Department of Research, Studies, Evaluation and Statistics (Drees) of 2022, around 1.5 million people aged 75 and over in France suffered from severe or moderate social isolation. Another study from the same organization, published in February, specifies that isolation particularly affects the youngest and most socially disadvantaged residents in establishments.
A system for reporting mistreatment
The text provides for an alert system for situations of mistreatment. A territorial authority will be responsible, in each department, for ensuring the collection, processing and evaluation of alerts. At the end of its investigation, it may give rise to a report to the judicial authority. It concerns any adult in a vulnerable situation based on their age, illness, disability, or any protected adult and victim of mistreatment.
In 2022, the Orpéa scandal broke out with the publication of the book The Gravediggers by Victor Castanet, denouncing institutionalized mistreatment and a system of embezzlement of public money within the nursing home group. Residents were deprived of basic care or even mistreated, while diapers or meals were rationed in order to maximize profits. In 2022, 1,400 establishments were subject to inspection out of nearly 7,500, according to the Ministry of Solidarity, Autonomy and People with Disabilities (PDF).
A right of visitation and a right to maintain social ties
The bill also mentions “a right to visit loved ones and a right to maintain social ties and a normal family life”. If the person is partially or totally unable to express themselves, they may be assisted or represented by the person exercising a measure of legal protection over them. This may be a guardian or designated support person.
“It’s a victory after three years of fighting”rejoiced Laurent Frémont, head of the Tenir ta main association, with Franceinfo. In a report from this association, submitted to the government on Tuesday, it was recommended to include in law this right of visiting families in nursing homes, and to‘”ensure openness in principle, whatever the time”. The text denounces the measures taken during the Covid-19 pandemic, aimed at isolating nursing home residents from their families to prevent the spread of the virus. “Even today, people suffer from this hidden mourning, because they were unable to say their last goodbyes”lamented Laurent Frémont.
Support from professionals and families
The text provides for the experimentation of a professional card intended for workers in the home autonomy services sector. The idea is to make their daily work easier. This experiment, which should last three years, will be evaluated by the government. These workers could receive financial assistance for mobility from their department, financed by the National Solidarity Fund for Autonomy.
To relieve the financial burden on the descendants of seniors, the bill provides for the elimination of the maintenance obligation paid by grandchildren, compulsory financial assistance towards their ancestors who are not able to ensure their basic needs (eating , clothing, housing, healthcare).
In April, the Assembly also declared itself in favor of a “one-stop shop” for autonomy at department level, with the aim of simplifying the journey for elderly people. “Today the user is sent from counter to counter, tomorrow the user will have an answer to their requests regardless of where they go”said the Minister of Solidarity and Families Jean-Christophe Combe, defending a government amendment to the bill.