There are several options for services in the home and financial aid to help older people stay living in their own homes.
Services to help with daily tasks such as preparing meals, getting up and housework come under the heading of aide à domicile.
Different organisations provide auxiliaires de vie (carers), depending on where you live, who can be run by the centre communal d’action sociale (CCAS) at the mairie, associations or businesses.
They all have to be accredited by the local departmental council. Local information points can advise on options in your area.
In Vienne (Isère), for example, there is the Aide à Domicile en Milieu Rural, a non-profit making association similar to home help services in the UK. It charges around €25/half-hour.
Such services usually benefit from half the amount off as a tax credit (though you should check if they are accredited for this and are registered as ‘services à la personne’).
The APA benefit (allocation personnalisée d’autonomie), which helps people with dependency needs, can also be applied for from the department to help cover such costs. In this case, it is referred to as APA à domicile (‘at home’, as opposed to the same benefit for those who live in care homes).
Everyone meeting the criteria of age and dependency qualifies in theory for APA but the amount reduces depending on means, and it is also linked to how dependent you are and your specific needs. An assessment will be made to draw up a personal plan.
APA is payable to over-60s to cover some, if not all, costs associated with helping recipients carry out their daily tasks – for example, for home help, day or temporary respite care, special equipment or accommodation adaptations, and transport.
It can go towards paying all or some of the cost of an accredited association d’aide à domicile.
You must be in need of help with daily tasks due to physical and/or mental deterioration, aged 60 or over, and have your main (or only) residence in France.
Aide sociale (social welfare) from the department may also be available, conditional on age and means, towards home help costs, for those who do not have APA because their dependency needs are not deemed serious enough (the CCAS can advise about both of these). A doctor’s prescription is necessary for home nursing services, and care in this case will be paid for via by the Assurance Maladie. A nurse coordinator will visit for an assessment and the care can be short or long term.
Hospitalisation à domicile (hospital at home) services can also be covered, if necessary extending to requirements such as artificial feeding, breathing assistance, intravenous treatments, home dialysis, cancer treatments and end-of-life care.
It is also possible to employ someone directly in your home using the Chèque emploi service universel (Cesu) system, which allows for an income tax credit to refund part of the costs.
For those who struggle with cooking, some communes, associations and businesses offer portage de repas (meals on wheels), or meals in communal dining facilities. Some mairies will finance this, and APA can also go towards this.
If you want to make adaptations to your home to help you cope, you may be able to obtain a grant of up to €3,500 from your French retirement caisse, if you have one.
Anah, a national body for home improvements, also offers aid towards this under its Habiter Facile programme if your income is below certain thresholds (outside Ile-de-France: €19,074 for a single person or €27,896 for a couple).