Homecare solutions

Adapted housing

If the person's state of health allows them to remain in their own home, it will certainly be necessary to provide adapted adaptations on a case-by-case basis. In most cases, these will involve aids for communication (hearing aids, etc.), mobility (canes, walkers, wheelchairs, elevators or stair lifts, etc.), or enabling the person to stand up or sit down (grab bars, etc.). (grab bars, electric bed, lift...), for toileting (bathtubs with doors, bathroom furniture suspended to allow the passage of a wheelchair...).

Weighing up the pros and cons

A number of criteria need to be taken into account when deciding whether or not to remain at home: health, the possibility of home improvements, and the resources of the elderly person. Indeed, while it's tempting to stay at home, the person's level of dependence must allow it without jeopardizing their health and safety. Whether or not this solution is possible will depend on the person's state of health. If the person's state of health deteriorates, or leads to excessive difficulties and medical constraints, the cost of adapting the home and the equipment will be reduced.If the health of the person concerned deteriorates or leads to excessive difficulties and medical constraints, the cost of adapting the home and providing the appropriate home help services could prove too expensive for the senior to afford.
After health, the family environment will be the second decisive criterion: will relatives be able to visit the elderly person easily and regularly? Do they live nearby in case of need? If not, can you count on your neighbors to take over?

Tailor-made services

Alongside home improvements and technical aids, staying at home can sometimes involve more "day-to-day", personalized assistance:

- remote assistance. For elderly people living alone, this is an effective way of reassuring them and alerting relatives or emergency services in the event of an emergency (fall, illness...), 24 hours a day, 7 days a week. Teleassistance requires a minimum of equipment: a medallion or watch to trigger the alarm and put the elderly person in touch with a monitoring center. To take advantage of this service, you are advised to contact your local town hall or departmental council, which will provide you with information on the conditions for benefiting from teleassistance.They can tell you about the conditions for remote assistance, its cost and whether your local council will cover installation or subscription fees, for example;
- household help: it is possible to benefit from household help if the elderly person has difficulty performing certain daily tasks, and meets certain age and income criteria. The nature of the tasks taken on is determined on a case-by-case basis according to need. For example, housework, linen care, on-site meal preparation...
- Meal delivery enables the elderly to continue eating complete, balanced meals without having to do the shopping or cooking. Several types of organization are likely to offer this service (your local council, home help services, personal services organizations, etc.). The cost varies from organization to organization. In some cases, depending on the beneficiary's resources, local authorities may contribute to financing the service. The APA (allocation personnalisée d'autonomie) may also help finance part of the cost of meal delivery;
- nursing care. Home nursing services (SSIAD) are only available on medical prescription for people over 60 who are ill, losing their independence, disabled or suffering from a chronic illness. Care is paid for by the health insurance scheme. They help delay placement in a specialized facility, or facilitate the return home following hospitalization.

Home automation
Home automation can be a great help to elderly people living at home. For example, it can be used to automatically switch on lights using presence detectors to prevent falls at night, open and close shutters, program heating, etc.
In addition to these "domestic" applications, home automation can also be used to geolocate a person and enable them to move around in complete safety.

Financial assistance

- Personalized autonomy allowance (APA). This aid is designed to cover the costs associated with loss of autonomy for people over 60 living at home or in a nursing home. Depending on the degree of loss of autonomy and resources, its monthly amount may not exceed 1,719.93 euros (GIR 1), 1,381.04 euros (GIR 2), 997.85 euros (GIR 3) or 665.60 euros (GIR 4);
- Allocation de solidarité aux personnes âgées (ASPA). This is granted to people aged 60 and over with a monthly income of less than 833.20 euros for a single person, or less than 1,293.54 euros for a couple;
- Anah assistance for home improvements (up to 35%, or even 50% of the cost of the work excluding VAT);
- tax credit for the installation of special equipment. Worth 25% of the purchase and installation costs, up to a limit of 5,000 euros for 1 single person and 10,000 euros for a couple, this tax credit can be granted to the owner, tenant or free occupant of your home. However, this tax credit applies only to a limited list of equipment, including expenditure on the installation or replacement of equipment specially designed for accessibility to of homes for the elderly or disabled, and equipment to adapt homes to loss of autonomy or disability, subject to certain conditions (loss of autonomy, disability, etc.)...). The work must be carried out by the company supplying the equipment;
- assistance from pension funds. Whether under the general or supplementary scheme, pension funds can finance (on request and subject to conditions) household help, home support staff or home improvement work;
- assistance from local authorities. Regional, departmental or local authorities can provide various forms of assistance, depending on the applicant's place of residence.

The advantages of home care
- it's more economical. Keeping a dependent person at home is often less expensive than placing them in a retirement home or EHPAD, which is often prohibitively expensive;
- it's more comfortable. Elderly people like to stay in their own neighborhoods, to keep their landmarks, their neighbors and their habits. Psychologically, this makes them less aware of their loss of autonomy. For the elderly, retirement homes are synonymous with the loss of some of their freedom and autonomy, due to time constraints and a certain form of isolation. What's more, not being able to take their furniture or cherished possessions with them is a complete uprooting, and one that they often find hard to cope with.

Marie-Christine MENOIRE