Shifting the Aging Paradigm

"We are setting up at the national level a “high council” that will allow different individuals from all walks of life (young adults, those in middle age, and elderly people) to exchange between them and to be active contributors to the definition of public policies."


Laurence Rossignol
Minister of State for Family, Childhood, Elderly People and Adult Care, France

An increasing share of the French population is now living longer. In 2020, over a third of the population will be more than 60 years old, and, in 2060, there will be three times as many people who are 85 years old and older as there are now.

Yet France is not an aging society. As the Minister of State for Family, Childhood, Elderly People and Adult Care, I would like to stress this important nuance. France is a society that is built, and that continues to build itself, on the basis of a balance of generations. And indeed, the fertility rate in France is the highest in Europe.

Above all, that an increasing share of the population is growing old signals progress. It is the outcome of a society in which the necessary conditions for everyone to live longer are not only created but also strengthened.

Caring for the most fragile of our citizens calls for comprehensive national solidarity. Every year, France devotes more than 21 billion euros to offer appropriate adult care provision.

And, indeed, declining autonomy is a major challenge for our society— particularly for policy makers. If living longer is important, what we ultimately strive for is living longer in good conditions. This means being in good health and enjoying a way of life that is respectful to both human dignity and to an individual’s goals. The piece of legislation submitted by the government, regarding society’s adaptation to aging, promotes precisely that.

Thus, we act to favor autonomy of elderly people, to enable them to stay active—and this is true even for the most vulnerable of citizens, who likewise need to retain a sense of personal agency. Increased frailty should not entail resignation. I do not mean that we should “decide for them what to do”; rather, we should “make it possible for them to do, enable them, give them the capacities to do.” This is the very basis for a society in which positive treatment is fostered.

Through the legislation mentioned above, the government initiates not only a genuine change in the framework we use to consider aging but also a change in the paradigm, which reflects a strong political commitment. When addressing aging, three main objectives are set: anticipating the decrease of autonomy so as to delay it as much as possible; bringing support to those facing a loss of autonomy; and engaging the whole society into accommodating the changes brought on by  aging.

Individuals who are facing such a loss of independence expect to be supported and to have their needs met. Since 2001, the “individualized benefit for autonomy” (allocation personalisée d’autonomie) helps elderly people ages 60 and older who are suffering from a loss of autonomy to pay for the adult care they receive either at home or in residential care. At a time when most people wish to grow old in their homes, the government has chosen to devote an extra 350 million euros to upgrade this benefit, thereby improving the professional support elderly people receive in their homes.

But we also decided to support informal carers. Indeed, the help brought by families and relatives when providing home-based care, often on a daily basis, is essential. Thus, the legislation will have their status—carer or caregiver—recognized. This is needed, because their strong commitment sometimes has negative impacts on their own health and wellness.

Therefore, carers will be able to enjoy a new right: the right to rest. In practical terms, this means additional financial help that could pay for, say, a temporary day care center or an increase in the professional home-based care provided.

In this field, the government considers everyone older than 60—not just those facing a decreasing autonomy. Indeed, only 20 percent of 85-year-olds have an identifiable loss of independence. This tells us that losing individual autonomy is not inevitable: we can act to prevent, anticipate, and delay it. We should give ourselves the capacities to do so, by identifying and handling the very first indications of frailty.

In order to best meet multiple and changing needs, we need to favor a lateral and cross-divisional approach that also entails a greater coordination of all the stakeholders involved. This is a real challenge, but it is necessary to build platforms for cooperation and exchange so as to get rid of the existing barriers between the different participants.

Hence, from now on, each territory will host a “conference of the funding partners” (conference des financeurs), which puts together all the stakeholders in charge of preventive actions locally. They will agree on a program of actions whose purpose will be to ensure that each and every elderly person, no matter where he or she may live, can benefit from prevention.

These conferences will rely on the Strategy to Prevent the Loss of Autonomy, which includes pieces of advice for both professionals and the elderly people themselves. Topics vary widely from food, planning of care, housing, and so on.

These conferences will also have credits made available so as to make it easier for elderly people to access assistive technologies for their homes. Indeed, sometimes a mere grab-bar in the shower can prevent a fall—and we know that a fall can lead to a decreased autonomy.

We chose to engage all stakeholders and public policy makers to build a society adapted to aging, a society in which elderly people are fully included. Indeed, and because old age should not be a restraint, it is the whole of the culture surrounding elderly people that needs to be rethought.

In order to do this, public mobilization is needed, and elderly people themselves are asked to contribute to the definition of public policies. Locally, elderly people will be able to be members of county committees, thereby contributing to the elaboration of public policies in a wide field of competences: health and social policies, of course, but also housing, transport, culture, and so on.

I aim to open up governance mechanisms of public policies so as to bring different generations to speak to each other. Indeed, different generations often face similar issues: the fight against social isolation, the fight to promote accessibility or to protect informal carers, and so on. Hence, we are setting up at the national level a “high council” that will allow different individuals from all walks of life (young adults, those in middle age, and elderly people) to exchange between them and to be active contributors to the definition of public policies.

We are engaging with the whole of society in order to find socially innovative answers to the challenges brought on by aging.

Aged care professionals are at the heart of the system, and I strongly support, for instance, the development of services that encompass both home-based care and facility-based care. Indeed, they offer a better quality and clearer support service to the users, they overcome isolation from which professional carers suffer, and they enable managers to run their organizations more efficiently. Actors from the “silver economy sector” are also fully engaged in the change of framework described earlier. The aging of individuals entails an evolution of uses and customs, which, in turn, leads to a boost in innovation. The government is therefore proactive in trying to develop the silver economy sector—particularly as it is a source for both improved quality of life for elderly people and creation of jobs for everyone.

Finally, every generation is involved with the challenges brought on by aging and is thus incentivized to act—and to develop new policies. Social isolation has been identified as a determining factor in the process behind declining autonomy. Hence, we support the development of a national mobilization against the isolation of elderly people. This initiative is composed of intergenerational teams that meet with elderly people, particularly those who live in remote areas. Beyond its direct preventive impacts, this action is crucial to enable each and every one of us to feel responsible for the well-being of others.

Population aging is a priority of this government, which works so that France lives up to the challenge. The budgetary context is tight, and yet this government has made a strong and important political choice with 650 million euros devoted to our society’s adaption to aging. The legislation carrying this aim, which was postponed for many years, marks a significant milestone in the collective commitment to meet the needs of those facing a loss of autonomy. I am sure that it will result in improving the daily lives of our older counterparts.

About the author

Laurence Rossignol was appointed Minister of State for Family, Childhood, Elderly People and Adult Care in June 2015. In April 2014 she was nominated by Prime Minister Manuel Valls to be part of his government. She has been fighting since to reform policies designed for the elderly people in France, and a new piece of legislation on the matter she introduced at the National Assembly has just been enacted.


Leave a Comment

Only comments approved by post author will be displayed