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Eighteen months after recommendations made to better protect the elderly in nursing homes, a follow-up report published on January 16 points to many persistent shortcomings. Claire Hédon, the Defender of Rights, believes that the Ministry of Solidarity and Health “has not provided the explicit answers” expected.
On May 4, 2021, a report was published containing 64 recommendations to improve the conditions of care for people received in nursing homes, and to ensure the effectiveness of their rights. Thirteen of them concerned the situation of the health crisis. A new follow-up report, this time, was published yesterday, taking stock of what has been applied and what is still missing in the treatment of our seniors. For the defender of rights, this highlights an insufficient implementation and a nuanced assessment.
Assessment: 34 recommendations without response for 18 months
According to Claire Hédon indeed, the Ministry of Solidarity and Health “did not provide an explicit response to 34 recommendations that had been addressed to him”. A situation that weakens a little more the consideration that we have of the elderly.
Thus, it also announces that it is still receiving individual complaints: 281 new complaints have been received since May 2021. More than 46% of these referrals relate to obstacles to private and family life and to residents’ freedom to come and go. .
Five recommendations to be implemented “without delay” according to the Defender of Rights
To overcome this ongoing lack of care and consideration, Claire Hédon asks the Minister of Solidarity and Health to quickly implement five recommendations:
- Define a minimum resident supervision ratio of eight full-time equivalents (FTEs) for ten residents, in order to achieve “an improvement in the care of residents, but also in the working conditions of professionals”;
- Put an end to violations of residents’ freedom to come and go and intervene to restore the maintenance of family ties;
- Set up a medico-social vigilance system to strengthen the identification, reporting and analysis of situations of mistreatment. The defender of rights indeed regrets that a reliable measurement tool shared by all the regulatory and control authorities is still lacking;
- It also wishes to clarify and strengthen the national policy of controls carried out by the Regional Health Agencies (ARS) and the departmental councils, whose controls are very heterogeneous;
- Finally, the Defender of Rights would like a mediation system to be set up in order to restore the confidence of residents and their families.
An unfair report for carers in nursing homes?
David Jacquet, founder and director of Maison de Retraite Sélection consulted on the subject, and who has read the follow-up report, is more bitter on the subject. For him, this does not necessarily reflect the reality of the facts, in Ehpad.
“I’m not saying that everything is wrong in this report, I particularly agree on freedom of movement, nursing homes must more than ever remain places open to families. But I disagree with the overall finding. In life, there is what we would like (and we can, in this case, multiply reports and recommendations…) and what we can have” he reacts.
According to David Jacquet, the reality on the ground is more complex than a wish list, in particular because of the budgets that the listed recommendations would require:
“Why aren’t all the recommendations implemented? You have to ask yourself the question of capacity and budgets. Everything that is recommended here rests on essentially budgetary questions. But going to 8 helpers or caregivers for 10 residents represents an astronomical cost, while the windfall is not permanent, the “whatever it costs” from the State, either”.
Finally, the professional who knows the Ehpad community well criticizes the said observation for giving an image which is not real either, in particular of the actors working in Ehpad:
“With this kind of report, we directly think that as the quota is not assured, then caregivers mistreat people. It is to constantly bring shame to those who work and take care of our elders. 281 complaints out of 700,000 residents in nursing homes, that represents 0.04%. This report, the purpose of which is to put pressure on the government, will not move it further. On the other hand, it dirties those who carry the sector at arm’s length”.