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Ages et Vie: Personalised care and a richer social life for the elderly in rural France

Change management

Nicolas Perrette and Simon Vdouillot developed the innovative Ages&Vie concept with the support of the mayors of a number of small villages in the East of France. One key feature of Ages&Vie homes is the tailored architecture to balance personal autonomy with communal social life. Each home accomodates six elderly residents and three support staff. The design of the projects also ensures the financial viability of the concept and ensures that the rent is no higher than the average rent in institutionalised care homes. The project sponsors, particularly the mayors, were also keen to create full-time posts for support staff. The Ages&Vie homes are based on the philosophy of living together rather than joint living – so there are no spaces in the homes that are meant for joint use by the residents and the support staff (a feature built into an earlier version of the concept but which proved to be unsustainable).

All residents of an Ages&Vie house – the elderly, the professional support staff and their families – have the same status as tenants. In addition to the rent, the elderly residents also pay a salary to the professional support staff. With the creation of an Ages&Vie house, an association is set up which includes the mayor, the GP of the village, the professional support staff and their families and the elderly residents or their families. In this governance structure, the elderly residents are regarded as the employers of the professional staff members. The mayor has the power to nominate the President of the assocation (who in most cases will be himself or the GP of the village). The secretary is always one of the elderly residents representing his/her peers. The presence of the secretary at the meetings of the association gives the elderly residents decison-making powers in staffing and building issues.

The professional staff are female in 95% of cases. Typically, they have a state diploma as a social support worker (called AVS in French). Alternatively, they may demonstrate professional experience in gerontology as a nursing auxiliary, either in medical institutions or in homes for the elderly. Many of the support staff prefer to work in an Ages&Vie house because it allows them to combine a highly responsible job at an attractive salary (typically € 1700 per month, 25% over the average salary in this field). Moreover, their flat and living space in the house is big enough to suit a young couple with children, and both the children and the elderly benefit from being in touch with other generations. Consequently, there are lots of applicants for these jobs.

The professional support staff in Ages&Vie homes also get extra training which helps them to focus on the overall quality of life of the residents, so that they can help and support them much more effectively. Their role is to allow the elderly residents to continue to live their life with a maximum of autonomy. As Nicolas Perrette emphasises, traditional training of care staff in France focuses on how to help dependent persons. However, in Ages&Vie homes the professionals have to work WITH the elderly residents and not just simply provide a service FOR them. For example, they try to help elderly residents to eat their meals without any external help. The training also helps the professionals to deal with bereavement issues – the death of elderly residents affects staff and other residents strongly, as they live close to each other and often develop very close relationships. The financing of this training comes from contributions by the elderly residents. Other specific training programmes, e.g. on pain management, is often subsidised by the regional government.

As far as social issues are concerned, the professional support staff are monitored and regulated by the public sector. Three public authorities are involved: central government, the département, and the local authority. Central government fixes salary levels of support care staff, and the level of allowances for food and daily care. The staff are registered and monitored by the respective département, which checks their level of competence and the suitability of their household, and also provides training courses. The local authority plays the role of a mediator through its role in the association – but the association only intervenes in cases of a conflict, it does not otherwise interfere in the management of the Ages&Vie homes. For instance, when an elderly person becoms so severely ill that they are themselves in danger or become a danger to the others, the association is entitled to decide to transfer them to an appropriate specialised institution. Furthermore, through this association, other members of the community – and, of course, relatives of the elderly – can be kept in touch of what is going on in the house.

In summary, the concept of Ages&Vie is based on the idea of multiple actors working with each other, all using their own capabilities and personal assets to contribute to the overall functioning of the home.


About this case study
Main Contact

Nicolas Perrette
Tel: 00 33 (0) 3 81 25 08 23

Laurine Artus

Marcel Guenoun

Laurine Artus and Marcel Guenoun, our Associates in France, wrote this case study for Governance International on 12 March 2012.

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