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After the publication of the book by independent journalist Victor Castanet, Les Fossoyeurs, which denounces the treatment of elderly residents of nursing homes, the time has come to question these institutions. What can be done to improve the care of older people? Dr. Christophe Prudhomme, emergency doctor at Samu 93, answers us.
Doctissimo: What is the current state of dependency care in France?
Dr. Christophe Prudhomme: It’s a disaster because there is a shortage of general practitioners and their number will fall until 2030. Those who are settled have an overload of work which means that they no longer have time to make home visits. There are also 600,000 people affected by a long-term illness (ALD) who no longer have a declared attending physician and who are struggling to find one.
These people do not necessarily call for help when things are going badly. We find ourselves in a situation where they arrive at the hospital for things that could have been taken care of well in advance.
It’s the same thing in nursing homes. This system was put in place in the 1990s but is no longer appropriate today. There are 50% of residents who are dependent and the structures have no medical staff either on weekends or on public holidays or even at night! Ehpads lack nurses and coordinating and prescribing doctors. It is a scandalous situation which is the mistreatment of our dependent elderly people.
Much has been said about the private sector, but what about the public sector?
Dr. Christophe Prudhomme: The public sector is unfortunately no better than the private sector but it tries to do the best. A retirement home still has a significant cost: it takes 2000 euros per month in the public sector, 3000 euros for the private sector. However, when we study the staff rates of these establishments, we realize that the public rate is 0.63 when the private rate is 0.55. Paradoxical when you know that it is precisely the staff that costs the most to an establishment!
Dr. Christophe Prudhomme: It’s simple: massive job creation is needed! We must train 200,000 caregivers for nursing homes. It is necessary that all establishments have a nurse 24 hours a day but also a referring coordinating doctor who can move around, come and consult patients if necessary during the day and who can prescribe to these patients the treatments they need. . Health is a major concern of the French. We must now get out of the lucrative public medico-social and health systems but also get out of this logic of investors and private insurance.