“Like at home”, it is in these terms that Arpavie, associative manager of residences for the elderly, describes its offer of independent residences. These structures, much less known than nursing homes (accommodation establishments for dependent elderly people), accommodate people aged over 60 which are still quite independent. They live in adapted apartments, with their own kitchen and bathroom, and can benefit from common services such as catering, laundry and even entertainment.
In the mapping of housing solutions offered to seniors, independent residences are at the same level as service residences. Except that, unlike the latter, managed mainly by the private commercial sector and whose costs are high, independent residences essentially depend on public or associative actors and offer affordable prices. The rent to live there is on average around 700 euros per month.
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An often forgotten possibility
However, and despite all these advantages on paper, this type of structure does not succeed in finding its audience. According to a study by the Department of Research, Studies, Evaluation and Statistics (Drees) published this Thursday, November 16, at the end of 2019, 2,260 independent residences were identified, for an offer of 114,120 places. Compared to the more than 7,000 nursing homes which accommodate more than 700,000 people, the place of independent residences in the world of accommodation for the elderly seems insignificant.
While nursing homes are increasingly turning to welcoming very dependent seniors, independent residences would have their place, for a population requiring less medical care. But nothing works. The Drees thus notes that between 2015 and 2019, the number of residents welcomed in these structures decreased by 2.2%. “The reduction in their number (of residents, Editor’s note) coupled with an increase in installed places (open in independent residences, Editor’s note) mechanically translates into a sharp drop in the occupancy rate: 87 places occupied for every 100 available in 2019, compared to 93 in 2015”notes the organization attached to the Ministry of Health.
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A significant lack of resources
To understand this lack of appeal, we have to go back several decades. Before they were called independent residences, we were talking about residential homes. Built in the 1960s and 1970s and managed mainly by the municipalities, they accommodated aging people lacking resources. Unfortunately, these accommodations have aged poorly and, in the face of major renovation work to carry out, the communities put them aside. “These buildings were not easy to recondition to add additional comfort elementsrecalls Yann Reboulleau, president of the Philogeris group of nursing homes and independent residences. Transforming small studios of 9 m2 into housing of around twenty square meters can be expensive and when it was necessary to do so, the investment priorities of local authorities were moving towards other subjects., he explains. So new buildings were built but the already existing park was not completely renovated.
Convinced that independent residences are one of the solutions to deal with the aging of the population, the Arpavie group, through its general director Jean-François Vitoux, is requesting the construction of 60,000 additional places. Main obstacle to this deployment: financing. “Cities do not have enough resources to manage these structures and departments are putting less and less money into their pockets, notes Joachim Tavares, founder of papyhappy.fr, an online housing comparator for seniors. It is the departments which give construction authorizations and which regulate the opening of the number of beds.he recalls.
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But their economic model is fragile. With rents that rarely exceed 1,000 euros per month, structures struggle to be profitable and cannot live without subsidies from local authorities. “If you have a very social vocation with very low rent levels, you never achieve balance. There needs to be a balancing subsidy paid by the local authority which developed the product., judge Yann Reboulleau. To make the model more economically viable, he proposes reintroducing social diversity within these establishments, seeking to attract more of the middle and wealthy classes.
A desire to reinvent oneself
To establish their place as an alternative, halfway between nursing homes and home care, independent residences must review their operation, according to professionals. And especially emphasize prevention against loss of autonomy. Today, most of these structures have maintenance workers, cooks and entertainers on their staff. Few have hired nursing assistants or home helpers. This staff could, however, reassure future residents who are starting to lose their autonomy but who do not want to go to a nursing home.
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But like the others, independent residences, if they were to take this turn, would risk being faced with a shortage of staff. To anticipate this problem, the Arpavie group launched an experiment with the start-up Epoca, specializing in medical innovations. In three of its 78 independent residences, Arpavie offered residents telemedicine or artificial intelligence solutions to detect, as early as possible, signs of loss of autonomy. In-depth medical monitoring, the price of which – 110 euros per month per resident – was entirely financed by the care package and therefore Social Security.
However, this system promises to be complicated to generalize given that few independent residences have this care package. These assignments were made years ago, when these structures were residential homes. “This is why in the future, all independent residences must have a care package”, encouraged Arpavie boss Jean-François Vitoux, during a press conference organized last October. An opinion shared by Joachim Tavares. “There would be a real interest in offering care in these structures, for example via platforms that would be managed by nursing homes”estimates the founder of papyhappy.com. A virtuous mechanism which would allow residents to stay longer in the premises. “With a little more logistics and staff, we could support more people at the start of losing their autonomy and therefore make referral to nursing homes less essential”concludes Yann Reboulleau.
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