Foster families for the elderly might represent an interesting strategy to meet the unmet clinical and social needs of the elderly. This model remains little developed and explored. A subject that the Vinatier Hospital Center shares with readers of Mental Health.
A neglected strategy
With the aging of the population, the development of coherent strategies for caring for the elderly has become a crucial issue. Within this population, which has a high dependency rate, staying at home is sometimes difficult or even impossible. This situation opens the door to alternative accommodation arrangements. This is the case of nursing homes, which remain the most developed and successful model for these dependent people. However, there is another type of accommodation reserved for dependent elderly people: host families. In 2022, in France, around 4,000 elderly people would be cared for by these families (according to IFREP). This model is particularly developed in the West Indies. There, each host family is responsible for one to three people, providing a room for each of them in the house. The latter ensure the meals and the activities of the residents. The links forged between carers and the elderly are strong. Thus, the participation of residents in family life and close contact with a single reference person might have a concrete impact on their well-being and fight once morest their isolation.
Host families, outstanding questions
However, foster families for dependent elderly people have been little studied in the scientific literature for 30 years and this type of model remains underdeveloped. Indeed, several questions remain as to its viability. Firstly, the medical profile of the elderly people accommodated, adapted to foster families, needs to be studied, particularly in terms of psychiatric pathologies (Alzheimer’s, etc.) and dependency. Second, for patients with similar characteristics, the effectiveness of this model must be compared to these existing alternatives, in terms of hospitalization, mortality, mental health and the evolution of geriatric syndromes. Thirdly, the overall cost of this care must be evaluated by including the direct cost of housing, as well as medical and paramedical visits, the need for transport to the care structures and the cost of care by these structures. Last point, the training of caregivers of dependent elderly people needs to be solid.
Research insights
Foster families, as an alternative or transition to nursing homes, therefore deserve to be studied scientifically. This care model might have its place in the organization of care in many countries if robust data demonstrate its usefulness. On the other hand, it responds to societal issues of intergenerational solidarity and potential job creation, particularly in areas of rural or medical desertification. This is the subject of research carried out in the West Indies (KASAF/KASEHPAD projects, financed by the Departmental Council of Guadeloupe, ARS of Guadeloupe and ARS of Martinique) by Dr Boucaud-Maitre, director of research in public health and epidemiology at the Center Hospitalier Le Vinatier and Pr. Tabué-Teguo, Head of the Geriatrics/Gerontology Unit at the Martinique University Hospital, Deputy Director of the UR EpiCliV, University of the West Indies, as well as of the ACTIVE Team of the Inserm U1219 center, University of Bordeaux ).
Find the full correspondence on The Lancet