The question of respect for the fundamental rights of the Aged living in nursing homes is the subject of a report released this week by the Défenseur des Droits (Defender of Rights). This report follows an initial publication in May 2021 of which our web site provided a summary. It included 64 recommendations in order to better care for people living in nursing homes and to ensure the effectivity of their rights.
In January 2022, a book by Victor Castanet “Les Fossoyeurs” (the gravediggers) caused a shockwave in the media and stimulated many reactions, as well as investigations by the public authorities on the situation in certain establishments. The situation in nursing homes throughout France is quite diverse, and many contributions have been made in order to propose new models for nursing homes.
Collective acceptance of the dignity of the aged in nursing homes
The report recently published mentions these facts by referring to the collective acceptance of our society to respect the dignity of the aged. It “welcomes” the announcement by the Ministry of Solidarity and Health for the reinforcement of inspections of the 7500 establishments over the next two years.
However, the report shows that “the results are unfortunately mixed” and the concerns of the “Défenseur des droits“ remain. Since May 2021, 281 new complaints have been received, denouncing in particular the infringement of the right for suitable care and support. The report mentions for example the established times for rising and retiring which are adapted to suit the personnel time-tables. According to the data published, 43% of claims concern ill-treatment by excess or by negligence, 30% limitations on visits, 12% on the freedom to come and go. Physical violence is mentioned in 2% of cases. According to the Défenseur “These claims concern the systemic nature of the problem of ill-treatment in nursing homes. They reveal a strong social demand for the respect of the rights and dignity of the aged.” Claire Héron, in a series of interviews, has expressed the inadequacy of the response by the public authorities. The announcements “are struggling to materialize and must now be translated into concrete terms in the field.”
Proposals to move forward
The report lists five “essential actions to be implemented without delay”:
- Define a minimum ratio of carers and improve the attractiveness of careers in care for the aged.
- Put an end to violations of the freedom to come and go.
- Establish a medico-social supervision device to combat ill-treatment.
- Clarify and reinforce the national policy on inspections.
- Restore the trust of residents and their families.
Concerning the human means in nursing homes for the care and support of the residents, the report calls for the establishment of a standard of 8 carers (full-time equivalent) per 10 residents. These are the people directly involved in providing the care. According to Claire Héron, some states in Germany and Northern European nations achieve such ratios. The difficulties experienced in this sector to attract personnel are widely reported in the media. Official reports have raised this subject, which has been made much worse by the Covid 19 crisis. Unattractive salaries and difficult working conditions are mentioned regularly. This subject adds to the broader difficulty affecting the social and sanitary sector as a whole.
On the delicate subject of the freedom to come and go, the report notes that the abuse persists even after the sanitary crisis. Even if the importance of maintaining links through visits no longer needs stating, in practice the “Défenseur des droits” continues to receive complaints concerning the arbitrary confinement of residents in their rooms, following a unilateral decision of the nursing home manager and outside the framework of protection covered by the regulations.
The complaints received on the help line against ill-treatment of the aged and handicapped (3977) should also be “incorporated in a device for dealing with complaints and monitored by the Agences Régionales de Santé“ (regional health agencies).
Concerning inspections, the lack of human means in the ARS and Department Councils is restricting their effectiveness. The Défenseur is also calling for “unannounced detailed investigations in-situ in order to identify any ill-treatment situations”.
It is time to change our viewpoint and act
In an interview for the La Croix daily, the Défenseur stated that the private bill “to create a society to age well” borne by the government has some positive points but it is “a poor substitute for the great age law which had been promised. Once again, greater action is needed”.
Alliance VITA through its “Priority for humanity” proposals issued prior to the last presidential election, asked for the “great age and dependency law” to be completed.
As recorded in the conclusions of the report, there is a philosophy which must underline the policies, concerning the way we look at vulnerability: The “Défenseur des droits” is calling for a change in the way we look at the situation of the aged and their vulnerability”.
On this theme, the leaflet issued by Alliance VITA “Change our viewpoint to change their life” is a ready-available resource for concrete leads.