If retirement is an opportunity to jump on opportunities that have so far eluded us for lack of time or energy, and if the third age therefore no longer represents a slow twilight but the beginning of a new life in in its own right, we have to admit that health declines little by little — and we are not all equal in this respect, whether it is due to a more or less trying life, to sometimes harmful habits, or quite simply to a different luck in the genetic lottery or in the face of the vagaries of life. Some therefore still frolic in full possession of their mental faculties at the age of 90, while others see their autonomy severely tested from the age of sixty (even earlier of course:accidents and illnesses do not wait until the end of our professional life to appear ). However, when autonomy becomes too impacted for solitary living to remain a safe option, and the burden becomes too heavy for the spouse or loved ones, it is necessary to act accordingly.
In this case, there are two options, which depend on our means and the degree of disability:the heaviest is that of placement in an EHPAD or other medical establishment, the other that of the choice of home support accompanied by assistance with home, for people who need a simple boost on a daily basis more than full support, which can be perceived as degrading and represents a certain obstacle to their desires and their autonomy - or at least to this what remains of the latter. In 2014, 1.4 million people in France received social assistance to compensate for their loss of autonomy:this is the personalized autonomy allowance (APA), the amount of which will depend on the level of dependence of the person and therefore of the latter's needs on the one hand, and on the other hand of the resources already present at his disposal — an amount that can be made available to caregivers, but also be used to join the home help services, a professional service that can greatly relieve caregivers. Without replacing them completely:a professional does not have the same relationship or the same intimacy with his patient as a loved one – these are ultimately two completely different types of support. And the fact that the most difficult tasks are carried out by the latter precisely frees up more qualitative time to share together for loved ones. When this option therefore seems to be the most suited to the desires and needs of the person concerned, there is still the question of choosing the home help that will suit them best.
Home help should not be seen as the vestibule of the EHPAD, before assured degradation. Some need only light assistance, and their situation may remain stable for a long time. There are also different types of services offered, which depend precisely on the level of autonomy of the person being cared for. This is the first criterion to be determined. While some only need the help of a student, for example, for whom this activity is somewhat the equivalent of a small job, others will have to call on real professionals, as capable as the latter to help in the races and the small steps of everyday life, that trained in the assistance in the toilet or in the follow-up in the administration of a possible medical treatment. In this case, there are two methods, called provider and agent, each with their own advantages and disadvantages.
In the case of the service provider, the person cared for calls upon an organization which itself employs the person who performs the role of home help. This means that the person being helped is relieved of any obligation, since they rely on their service provider to ensure all the logistics. This type of home help performs daily tasks, but also has a real medico-social status, which makes it more suitable for fragile people who need real daily monitoring. Please note that these are not home nursing services (SSIAD), for their part authorized to provide real medical care, although some providers offer both formulas! On the other hand, this service has a higher hourly cost, and does not ensure that you always have to deal with the same home helpers.
In the case of the proxy service, this only acts as a relay between the worker and the person being helped, who therefore has the role of employer himself - and therefore all the obligations that go with it, starting with respect labor law! On the other hand, the person who uses this service has a certain flexibility here — in the choice of the person who will help him, for example, who generally remains the same, which makes it possible to establish a certain relationship of complicity — and a lower hourly cost of intervention. The organization is only there to help and simplify the legal obligations incumbent on any employer – a bit like how an accountant relieves companies in the management of their accounts and their taxes. In short, depending on the specific needs of your loved one, it will be better to call on one or the other.
Then, to obtain more information on the variety of the offer present around you - which can moreover come from the public sector as well as from the associative private sector - you can turn, among other places, to your municipal center for social action ( CCAS), the CNAV or even the supplementary pension funds.
So much for the legal framework. But it is obvious that the most important thing in the choice of a personal assistant remains its ability to meet the specific needs of the person being cared for, and the affinity between the two. In other words, will the current flow on a professional level first - is this person concretely able to meet the particular needs of the person being helped? — and then on a more personal level elsewhere?
The first aspect therefore looks rather at the skills of the carer with regard to the needs expressed by the person:does the latter require simple accompaniment for shopping, cleaning or even assistance with DIY and gardening? Does she have real problems getting around or bathing? Does it require follow-up in taking medication or regular support from health professionals? Some carers, for example, are better trained to work with people suffering from certain disabilities - a patient with Alzheimer's, for example. Other questions arise regarding availability (early morning, late evening, night call, 24/7 availability? weekends and public holidays? etc.) or the geographical proximity between the two partners.
Then comes the question of the agreement between the two. For this, a preliminary presentation is welcome. Some services also offer a trial period to determine if there is chemistry. Of course, these are more proxy services, where the link is more personal and long-term. In the case of service providers, it will then be a question of trying to find out about the recruitment process of the mandated company. As everywhere, not everyone has the same level of hiring requirements.
To ensure that the service offered is in line with the needs of the person being cared for once these have been determined, do not hesitate to ask as many questions as possible of the service provider or agent. Ask if the service has an approval (a quality aggregation is compulsory to take care of people over 60) or a certification, which ensure a better quality service, but also if the service provider envisaged is holder or not of a diploma:there are several, but these are not necessarily compulsory in order to practice this profession.
As explained above, find out about the other options offered by this service, such as nursing care (or if this is not the case directly, about a possible partnership with an SSIAD organization); on the extent to which the person being followed and his relatives are involved in the development of the follow-up plan; on the follow-up by the body of the work carried out by its contributor; on the question of replacements for the latter in the event of illness or vacation; or on the ability of this organization to explain and possibly guide you in obtaining financial aid.
Finally, mention all the characteristics specific to your particular situation:certain illnesses or infirmities, a preference for a speaker who masters a foreign language, and so on. Finally, remember that this is a person who will have to share an extraordinary intimacy with your loved one, and that as such, it is never possible to be too demanding!
