IPP Policy Brief n°77 - January 2022

Mapping loss of autonomy among the elderly

IPP Policy Brief n°77

January 2022

Author : Amélie Carrère

Contacts : amelie.carrere@ipp.eu

 

logo-pdf-minMapping loss of autonomy among the elderly

 

Summary:

Understanding the differences in loss of autonomy between French departments is essential since they are the leading providers of social services to the elderly. For the first time, thanks to the combination of several data sources, it is possible to obtain a snapshot of the care needs of the elderly in each French department. This study sheds light on the differences in care that can be observed between departments from the perspective of the needs of their citizens, and can help to orient local policies to meet these needs. Unlike previous studies on the subject, it is not restricted to the population receiving benefits related to loss of autonomy (Abassi et al., 2020), it includes both the at-home and institutionalized populations (Brunel and Carrère, 2017), and it compares several measures of disability (Larbi and Roy, 2019). Moreover, it allows us to question the implications of departmental policy via two channels: (1) the way departments mobilize the criteria for assessing loss of autonomy; and (2) the supply of institutional places and the residential mobilities that may induce.

Key points:

  • The analysis of several measures of loss of autonomy highlights differences between French departments in terms of prevalence, type of disability, and its appearance at an early age.
  • Pas-de-Calais is particularly affected by physical disabilities (24% of people aged 60 or more), Guadeloupe by cognitive disorders (17%), and Lozère by difficulties in washing (13%). Northern France and Seine-Saint-Denis stand out for early onset of difficulties (before 75 years of age).
  • These differences in needs are not entirely consistent with the loss of autonomy assessed by the departmental councils.
  • Departmental differences in needs change little when considering the department of residence before entering a nursing home, with the exception of a few departments. Paris is the department for which the prevalence of loss of autonomy decreases the most due to an “institutional” exodus.