(For English-speakers living in France and others who are interested to know what’s available to dementia sufferers and carers in this country)
We’re so often told to ‘follow the dream’. Go for it, take the risk, don’t just talk about it – feel the fear and do it anyway*.
Here we are living in France and most of us have no regrets. If we do decide to go back to our country, what are likely to be our main reasons? (in no particular order)
- financial
- cultural
- grandchildren
- disillusionment
- divorce
- another family member needing our support
- problems with the language
- some form of dementia
How many of us think about the future when we set out on our new adventure? If we’re in forties, as I was, becoming old and infirm is the last thing on our minds and even those of us who retire to France may well find it difficult to imagine we might get seriously ill one day. If we do think about it, we’re confident the French medical system will look after us brilliantly. And, for the most part, they will. But have we thought about dementia?
To find out what help France will provide, we need to get into the French dementia care system. Sounds straightforward, but only if we speak good French! I cannot see how we can fully benefit, either as a sufferer or carer, if we can’t speak the language.
For the moment, let’s assume we have a carer and will be able to manage, and take a look at the process in stages:
(I’m writing from personal experience, the procedure may vary in other departments – we live on the Gers/Hautes Pyrénées border)
- we know something is wrong with one of us so we go to our doctor.
- he or she will refer us to a team of experts in cognitive problems, particularly memory.
- we’ll spend several hours with the team, usually at a local hospital – seeing specialists such as a psychologist, social worker, dietician, memory therapist and finally a gerontologist – by the way, we were allocated a private room and given a free lunch! During the session, the person with the memory problems will see the psychologist, the memory therapist and the gerontologist. The carer gets to see the social worker and the dietician too.ENDLESS FORMS TO FILL IN
NOTE: even for those who speak good French, one of the memory tests, judged on speed – counting backwards from a hundred in groups of seven – is difficult (those wretched 60’s, 70’s, 80’s and 90’s – phew!)
- at the end of the sessions, the assessments of the team are passed to the gerontologist who will decide whether further tests are necessary. (In our case, he took a sample of Leaf’s spinal fluid to check for Alzheimer markers). The wait for a result can be as long as six weeks.
- if a form of dementia is diagnosed, we’re referred to our local Assistante Sociale (social worker) who will interview the carer to discuss what help may be available.
- the social worker will then home-visit us to talk to the sufferer, see how and where we live, and determine our particular needs. We will have to fill in forms and produce various documents – our Carte Vitale (medical card) Mutuelle or Complimentaire card (top-up medical), Carte de Sejour (residence permit) or at least our Passport, our latest Avis des Impôts (tax assessment) and so on.
- we’re home-visited and interviewed over the next few weeks by a team of specialist helpers. We can expect representatives from several different departments, all of which have complicated names and, of course, acronyms.
From there, the help will be tailored accordingly. In our case, Leaf was entitled to fifteen two-hour weekly sessions with a memory specialist. We were also allocated an Auxiliaire de Vie (additional carer) who comes for two, two-hour sessions a week; once to work with Leaf on memory exercises and once to clean the house to give me a break. I have a back problem which is also taken into account.
Further help will be available if our income is below a certain level; usually below the tax threshold. This help may include a reduction in our electricity bills, cheaper top-up insurance and small grants towards equipment such as personal alarm systems for emergencies and memory aids. I’m also entitled to five free sessions with a psychologist and Leaf can attend free art therapy once a month.
Beyond all this, there are services offered to those who wish to partake, such as:
- Café Memoire get-togethers with carers and sufferers – informal coffee mornings
- free courses for carers (you have to join FRANCE ALZHEIMER to qualify)
- other events such as walks, talks and animation days
I can almost hear the ‘Oh my Gods’ from those whose French is either very basic or non-existent. We cannot and should not expect the care teams to speak English. Our ability to learn the language, if we can’t already speak it, is therefore of paramount importance. However it’s unlikely to be something we can master in a few months, particularly if we haven’t learned French at school. And if we’re over, say 40, it can be very difficult indeed.
On the other hand, there are carers who speak some English and English people, mainly women, who are employed here, usually as Aide à Domicile (Home Help) and, maybe, if trained in France, as Auziliaires de Vie. They may be few and far between, but they do exist.
Those of us who speak very good French but live alone, should also think about how we will eventually cope if diagnosed with AD or another form of dementia.
We may have followed our dream, but we don’t want it to turn into a nightmare. It’s therefore clear that we would be well advised to envisage the worst scenario and ask ourselves:
Could we manage in France or might we eventually have to return to our home country?
Comments
doodahtwo.home.blog 
adrienne says
Hello Sue
You have worked hard to get the help that is available for Leaf and it’s good to read that their is some help available for you to.
Your article really does bring home the fact that to live “comfortably” here in France one must have a good command of the language and that achieving a good level should be a priority to those that choose to live here.
Thanks, Adrienne. Yes, I try to do something every day towards stabilising the situation as far as I can and learning how to be an effective and loving carer. I do have to bite my tongue sometimes though.
It is indeed important to have a reasonable command of the language – we can’t expect to always be able rely on others when problems arise.
What an astonishing difference in the level of help and concessions to over here!!! (in UK)
Most normal people do not fit into the little Governmental and Council boxes required for assistance and are simply unable to jump through the various hoops to any be offered any help at all, so therefore just have to get on with it. (unless they’re in social housing and on benefits then they get the lot)
Thanks for this info. Hugh. I am aware that help in the UK is hard to come by unless you’re really strapped for cash and know how to jump through all the hoops. The social services there seem to make it deliberately hard for people who are already suffering hugely. Here they’re keen to offer all the help they can. It is extraordinary and we’re very lucky. But, we have to make an effort ourselves.
One point I didn’t make is that Leaf is doing all his memory work, including keeping a daily diary, in French. I’m full of admiration.
I am an avid reader of your posts/blogs. Thank you. CPAM is discontinuing reimboursements for Alzeimers meds. Maybe you know about this already.
Thanks – it’s great do know one’s efforts are appreciated!!
Yes, I was aware of this news and it’s interesting to note they do not mention the undesirable side-effects that I believe are another reason they are discontinuing reimbursement. The main medicament for AD here is Memantine, allied to Aricept and others. Although, in some cases, it can alleviate the symptoms a little, it does no more than that and the risks are, in my opinion, too many to be acceptable.