Dependence in France: houses must be adapted

One French person in three will be aged 60 or over in 2050 and 9 out of 10 would like to grow old in their own home. It is therefore essential for these homes to be adapted to senior citizens and their needs. Though telecare is already in use in France, telemedicine has yet to establish itself. But housing design can also be optimised to accommodate the needs and abilities of elderly or dependent persons.

300,000 French people currently use telecare services

An intelligent house can provide several types of telecare services such as incident detection for flooding, gas, movement, intrusions, or falls. These sensors are not very intrusive, since the elderly person does not need to interact with them.

According to a study commissioned by the French National Solidarity Fund for Autonomy (CNSA) entitled “Telecare to maintain the elderly and dependent in their homes: how to move beyond telephone services and set up pertinent solutions”, some 300,000 elderly or disabled French people have already subscribed to these types of services. Their average age is 84 years old and 80% of them are women.

Adapting houses appears to be one of the most pressing solutions

Housing design can be adapted to suit the abilities and needs of dependent people, by including automated systems to limit difficult movements such as opening shutters, implementing automatic or portable light switches, or installing night lights to avoid falls when moving around the house during the night.

To better understand these needs and cater to the older population in the Limousin region where one third are over 60, Limousin Expansion, the regional agency for economic development, created Autonom’lab. This organisation is inspired by the Living Labs model, a new approach to research and innovation in which “the user” is involved throughout the innovation process (observation and understanding of needs, validation of functionalities, tests, assessment of solutions, etc.). Autonom’Lab is a network of businesses, such as the Legrand group; researchers (the Odyssée 2023 centre for home automation and health); establishments from the health and social services sector (Limoges Hospital); and health system users. In 2009, for example, Autonom’Lab rewarded an ergonomic object design project aimed at people with hemiplegia, and the Link Care Services project which involves rolling out computerised monitoring systems to people suffering from diseases such as Alzheimer’s.

Telemedicine is in the project phase

An ever-increasing incidence of chronic illnesses and an ageing population have both contributed to telecare services being adopted by healthcare providers. According to French decree n° 2010-1229 of 19 October 2010, telemedicine encompasses “medical services provided remotely via electronic communications technologies”. At least two practices could be developed in the home. Teleconsultation allows healthcare providers to conduct patient consultations from a distance, through a video system and a network of sensors.  Intelligent houses are also well suited to remote patient monitoring, which allows medical professionals to remotely interpret any data necessary for patient management and decide on the best course of action.

According to the French Institute for Information and Research in Health Economics (IRDES) in 2007, “creating 10,000 at-home hospitalisation (AHH) places, for example, would represent a long-term saving of nearly 350 million euros per year for public funding organisations.” Furthermore, telemedicine addresses the shortage of healthcare providers, particularly in rural areas.

Nevertheless, telemedicine has yet to gain a firm foothold. According to a survey conducted by Pasteur Mutualité, “with only 17% of the people interviewed declaring themselves willing to use the Internet to consult a doctor (2% chose not to express an opinion), telemedicine appeals to few patients. This means that 81% of French people are not prepared to consult a doctor over the Internet. There are several reasons for this reluctance: fear of a wrong diagnosis, need for face-to-face contact with the physician, absence of regulations, unknown procedure, etc.” For the time being, the main services on the market are advice hotlines like those launched by Wengo and Médecin Direct, or assistance providers such as Mondial Assistance.

Developing ways for older people to continue “living at home” is no doubt the best solution to allow them to maintain their independence and quality of life. Home design will have to adapt and innovate to keep up with the growing need for assistance solutions.

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