In many parts of the world, the management of loss of autonomy is at the heart of the reforms. Commissioned by the Prime Minister, the report from which the present position paper is to consider the French system in this changing international context, offering a comparative analysis of systems of care dependency in six countries of the European Union (Germany, Denmark, Italy, Netherlands, United Kingdom, Sweden), and the United States and Japan.
The weight of public effort devoted to the dependence is quite similar in the OECD countries, where they account for 1.2% of GDP. In France, it is thus about 23 billion euros have been spent in 2010, mostly by the state and Medicare. Although each country is characterized by an own pace and pattern of aging, finding none the less the same everywhere: we live more and more old and, if the individual risk of becoming dependent on one day remains relatively low, the financial risk is very important and the problem of loss of autonomy will arise more acutely in the coming years due to the many generations that come with old age.
Two major challenges facing the whole country.
The first is financial: it is to reconcile the objective of controlling public spending with the protection requirements which suck the elderly frail. The second challenge is organizational: to enable better coverage of the care needs of frail elderly, by providing them with quality care, according to their wishes either at home or in a suitable structure, including support to the various stakeholders ( professional or family caregivers).
Following the work of international comparison, several trends emerge: in most countries,
- benefits are gradually becoming universal, but targeted at those with the highest needs;
- Priority is given to home care, through the political structuring of the offer of home services, home adaptation, diversification of living space and support to family caregivers;
- actor coordination remains a major issue of political support in old age;
- the importance of policies to prevent the loss of autonomy is recognized everywhere. However, despite positive results, these programs are still underdeveloped.
Contents:
- Framing the Debate: dependency, loss of independence, long-term care
- A demographic challenge globally common
- Main features of care dependency
- Fund services related to dependence in OECD countries
- Evaluate, compensate and prevent the loss of autonomy
- Organize support for home and institutional
- Support family caregivers
- Authors: Virginie Gimbert and Guillaume Malochet , Social Issues Department
Press Contact:
Jean-Michel Roullé, Head of Communications
Tel. +33 (0)1 42 75 61 37 - jean-michel.roulle@strategie.gouv.fr
Les ressources
- Report "Challenges accompaniment of old age"