The family and social environment of the elderly living in an institution and the methods of assistance given by their caregivers are a major political question. This population mainly concerns elderly women (77% of residents of institutions for the elderly are women over 75) in the majority of cases widowed, who more often end their life than men in institutions. The family network of residents is smaller than that of elderly people of the same age who live at home, which may be one of the reasons, along with the worsening state of health, for entering an institution. The death of the spouse is an event that can upset a configuration of assistance and lead to the decision to leave the home. However, the CARE survey by the DREES shows that the frequency of relations between residents and their families, especially children, remains high, even if friendships decline with age and state of health.
Entering an institution does not mean the disappearance of the help provided by family caregivers, but it changes in nature. Help is often multiple: 78% of seniors in an establishment declare at least one caregiver and, on average, residents have 1.4 caregivers.
Non-professional help declared by residents is mainly family help: 73% of declared carers are the children of the elderly. Thus, in comparison with caregivers of elderly people living at home who belong to two distinct generations (that of spouses and that of children), caregivers of elderly people living in institutions are essentially in the age groups of the “generation. pivot ”. They are on average 62 years old. More than half of the children of residential residents are declared caregivers, and this figure rises to 75% for only children. The order of mobilization of relatives firstly involves the spouse – when he is still alive -, the children, then the close relatives and finally non-family caregivers who are part of the neighborhood relations most of the time. .
Aid is more often a matter for women since they constitute 60% of declared caregivers. Women are all the more represented among caregivers as the family relationship with the senior is distant: the less help is framed by family obligations – and therefore the more “chosen” it is – the greater the weight of socialization. gender is felt. Demography undoubtedly also partly explains the higher proportion of women among the oldest caregivers because they represent a larger proportion of the population still alive at old ages, due to a higher life expectancy than men. . The nature of the assistance differs from that provided by caregivers of elderly people living at home, given that the institution takes care of part of the assistance with daily life and domestic tasks (preparation of meals, toilets, etc.) . The help mainly consists of moral support, accompaniment of outings and help with administrative tasks, as well as participation in medical decisions. This day-to-day administrative management and “care manager” work is difficult to estimate quantitatively but may require, depending on the situation, a strong temporal and emotional involvement as well as numerous contacts with the establishment’s professionals and health professionals. Half of the caregivers therefore provide help both during the week and at weekends. This assistance activity, sometimes carried out remotely, can require a complex organization. Indeed, while half of the caregivers live less than 15 km from the establishment, the child caregivers live on average 80 km from their parent’s place of residence. Financial or material assistance, which may include participation in establishment costs, concerns 27% of caregivers and 30% of caregivers. Few caregivers say they receive financial compensation for the assistance provided, despite the possibilities offered by the law.
The help provided therefore has consequences on the daily and professional life of caregivers. Help should not, however, be seen only as a “burden” or “burden”: it is seen as “taken for granted” and rewarding by the majority of caregivers. But more than half of caregivers feel a negative impact on their health as a result of the help provided. For a given person’s GIR, these negative consequences are however less frequent than for home caregivers. The perceived burden of assistance is higher for women, spouses and children of the elderly as well as for single caregivers.
More than a third of caregivers are employed and 80% are full-time. For employed carers, the organization of working time is the preferred method of reconciliation between professional life and the assistance provided. The help provided, by reducing the time available, can also have negative consequences on family life and the leisure activities of family caregivers.
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Reference : Xavier Besnard and Shirine Abdoul-Carime (DREES), 2020, “The entourage of elderly people in institutions: family and social relations, assistance received – Results of the“ CARE-Institutions ”survey (2016)”, Les Dossiers de the DREES n ° 71, December 2020
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