While all eyes are riveted on a possible pension reform which will certainly fuel economic and political debates, the question of the future of our elders is of little interest. However, we are convinced that the reform of autonomy must be carried out before the reform of pensions!
“Our first mission: to give the elderly the ability to age peacefully at home. (…) we will achieve this by improving the quality of home services”. These were the words of the Prime Minister during her general policy speech. Of which act. But that means not hiding the face.
For aging in place to finally become the rule in France and for the EHPAD to be no more than a last resort, it would already take an additional 6.2 billion euros per year by 2024. Then find 10 to 16 billion per year from 2030.
It is well known that the elderly have time and therefore can wait. In any case, this is what our public authorities seem to think as the “Great Law on Autonomy” promised, affirmed, confirmed and reaffirmed hand on heart has already been repeatedly rejected. Not knowing how to approach this question, we will probably ask for a new “flash mission” (as the new fashionable term wants it) at the start of the school year and a new report will then be added to the dusty pile of its predecessors, which has been increasing since years on the desks of successive health ministers. Perhaps the Avenue de Ségur is planning to compete with the column in the Place Vendôme by piling up conclusions that follow each other and resemble each other?
Admittedly, the floor rate was recently raised to 22 euros per hour of intervention (for home help) but this is well below what is necessary to make the sector truly attractive.
The state must take its share of the responsibility
Home help and support services (Saad), and in particular our companies, the “private” Saads, are underfunded and therefore face a shortage of recruitment in jobs perceived as difficult and insufficiently remunerated. To recruit, it would be necessary to be able to increase the salaries of home helpers, in particular in a difficult context (inflation, rising fuel prices, etc.) and when this itinerant trade is particularly suffering from the rise in fuel prices. In Germany and Switzerland, a home help earns 2,200 euros gross per month! As a result, the situation is even more complex elsewhere in the east of France where aid crosses the border to work with our neighbours.
And the situation is not going to get better, quite the contrary. In 2030, the number of elderly people with severe loss of autonomy will double, reaching 1.4 million people. In 2050, according to INSEE, France will have 4 million people over the age of 60 with a loss of autonomy, compared to 2.5 million today. The Saads now employ 400,000 professionals. By 2030, we should therefore create at least 305,000 additional jobs for home help, according to a study by Dares published in March 2022.
Companies are ready to take their share of responsibility but the State must also take its own. This system on the brink of failure means that some older people are also victims of abuse at home, such as in institutions. Yes, despite the professionalism and dedication of home helpers, to whom we must pay tribute, some elderly people are not lifted, not washed, not changed or poorly fed… Faced with a busy schedule, where home visits one after the other, many carers carry out their work in a hurry and not systematically when the elderly person needs it.
Home support professionals have been calling for a “home shift” for the care of our seniors for a very long time. This residential shift has been in the mouths of ministers and elected officials since 2005, but without a financial commitment truly commensurate with the challenges ever being made. As such, the adoption of a 5th branch of social security underfunded by tricks of budgetary piping of which only Bercy has the secret will not be enough for a long time to create illusions.
This debate, which smells of mothballs and bores the public authorities, is socially, societally and economically inevitable. Because it is the daily life of millions of people in our country including caregivers, families, professionals… While a first episode of heat wave hit the country in June, the worst is to be feared for the summer incoming.
The law on pension reform carries certain risks of political divisions, the great law on autonomy will on the contrary be unifying for families and their elders, by giving priority to home support that all are calling for. She can’t wait any longer, otherwise it won’t be the prospect of growing old with a small retirement that will scare our fellow citizens, but the prospect of growing old.