As part of the government strategy “Acting for caregivers 2020-2022”, the General Inspectorate of Social Affairs (IGAS) was asked to carry out a mission relating to the evolution of the legal and financial framework of the respite offer. for carers of the elderly, people with disabilities and sick people. It publishes its report, an overview of existing respite solutions for carers and obstacles to their development.
If there are between 8 and 11 million caregivers in France, they still do not all recognize themselves as such. However, they make an essential contribution home support for the elderly, for the inclusion of people with disabilities et supporting sick people, and their role is set to grow in the years to come. Rare are those who know they can benefit from support, while they risk exhaustion and social isolation.
“While the role of caregivers is set to strengthen in the years to come, respite solutions must prevent their risk of exhaustion”
What does the report show?
The mission provides an overview of existing respite solutions for caregivers and obstacles to their development:
– more than 250 support and respite platforms have been put in place by the regional health agencies, mainly for carers of the elderly. They are essential for the orientation of carers towards respite solutions, but not very visible and poorly articulated with the social policies of the departments;
– the development of home relay corresponds to the main request of caregivers. An offer is developing but it remains experimental and financially inaccessible, despite the implementation since 2015 of a respite package for caregivers of beneficiaries of the allowance for autonomy. It is also limited by recruitment difficulties in the sector;
– temporary reception is not always adapted to the expectations of the public in medico-social establishments. It remains non-existent in health facilities, except in emergencies;
– THE vacation-respite stays deserve to be supported, in particular stays in an ordinary environment. Their development is hampered by their high cost.
“In the field of disability and the chronically ill, the needs expressed by the actors relate above all to shortcomings in the supply of medico-social care. For carers of people with disabilities, the offer of home support is still embryonic, subject to specific support for parents of disabled children provided by certain CAFs”.
Furthermore, the mission notes that the funding to support the respite offer, provided for by the Acting for caregivers strategy launched at the end of 2019, have fallen behind the initial ambitions.
Sur le champ du handicap, la notion de répit porte à confusion. L’absence de solution d’accompagnement en établissement ou par un service médico-social de certains publics handicapés conduit à des demandes de répit qui relèvent en réalité d’un besoin de prise en charge adaptée et au long cours des personnes aidées. L’UNAFAM, rencontrée par la mission, a par exemple souligné les insuffisances de l’offre sanitaire et médico-sociale pour les personnes atteintes de troubles psychiques (alors que la reconnaissance en tant que handicap psychique est désormais possible), soulignant l’impératif d’un développement des soins ambulatoires en psychiatrie ainsi que des services d’accompagnement médico-social (SAMSAH et SAVS).
What does the report recommend?
Faced with these findings, the mission sets out a series of recommendations for:
– strengthen support and respite platforms and make them more visible and better integrated;
– facilitate the development of respite at home;
– adapt the offer of temporary reception in medico-social establishments, facilitate its access for people with disabilities, and develop it for the chronically ill;
– encourage the development of respite holiday stays;
– strengthen the funding of respite solutions, through respite supplements within existing allowances and lead a reflection on funding dedicated to caregivers.
“The recommendations of the mission are intended to feed into the new strategy for caregivers announced for the year 2023, which constitutes an opportunity to promote the development of respite solutions on a more significant scale and to support caregivers who play an essential role in national solidarity.
• Support caregivers by removing the obstacles to the development of respite solutions, Report Emilie FAUCHIER-MAGNAN,
Pr. Bertrand FENOLL, Olivier TOCHE, members of the General Inspectorate of Social Affairs, 2022-032R, December 2022 (PDF).