Feedback on the 1st session of the new Aging at Home cycle: Why is it difficult to age at home?




Videoconference and face-to-face event

In creating its Foundation, the French Academy of Medicine wished to put at the service of society as a whole its unique capacity to bring together, on essential health and social issues and around the best French and international experts, all the political, medical, scientific, economic and associative stakeholders.

To fulfill its mission, the Foundation of the French Academy of Medicine (FAM) has chosen to organize debates based on excellent scientific publications or communications, open to the general public (associations, NGOs, companies, patients) and the media, and directly relayed to public authorities, particularly members of parliament. In addition to their level, these debates are distinguished from other events of the same type by the benefit of the institutional status and the guarantees of credibility and ethics that are recognized at the National Academy of Medicine.

After the first cycle of conferences organized by the Foundation of the Academy of Medicine on the theme “Transforming the future of aging”, it seemed important to focus the rest of the debates on “Aging at home”. This theme, linking citizenship and the home, appears to be extremely topical and important.

The recent revelations concerning the elderly in an institutional setting have prompted the Foundation of the French Academy of Medicine to propose a cycle of 4 debates between care professionals and the general public, followed by a synthesis before the decision-making authorities of our country. The aim of these debates is to analyze the difficulties and limits of home care, and then to respond to them in an objective, constructive and ethically correct way in order to build together a better last period of life in a chosen and loved environment.


Session 1: Why is it difficult to age in place?


The limits of home care are above all individual, depending of course on the state of physical, functional and mental health, but also on life history, marital status, family and environmental proximity. All of these interconnected factors play a major role in determining whether or not it is possible to keep one’s home, a built and cherished environment, despite the undeniable emotional, human, technical and financial burdens.


Debate organized under the direction of Pr Jean-Pierre Michel* (Geriatrician, rapporteur of the working group on aging commissioned by SAPEA for the European Union) and moderated by Olivier Mariotte (nile).


14:00 Welcoming remarks
Pr Patrice Tran-Ba-Huy* (President of the National Academy of Medicine), Pr Richard Villet* (FAM General Secretary)


14:10 Overall presentation of the cycle
Prof. Jean-Pierre Michel* (Geriatrician, rapporteur of the working group on aging commissioned by SAPEA for the European Union)


14:25 The different individual pathways of aging and care
Prof. Regis Gonthier* (Geriatrician)

“What is going to be at stake at home is often chronic diseases, with relapse, which makes us vulnerable for daily life and leads to a destabilization of self-esteem, which complicates the maintenance at home.


14:40 The traditional actors of home support
Michel Billé (Sociologist)

“Maintenance or support at home? In the best case, I maintain myself because you support me. By maintaining me, you deprive me of my exercise of autonomy and you do not come to my home with the same intention.


14:55 Discussion with the audience


15:05 Domestic accidents in the home of the elderly
Pr Joël Belmin (Head of the geriatric unit at Charles-Foix Hospital)

“Of the 122,000 accidents of everyday life recorded in 2017, 50% of accidents occurred at home. In the over 70s, 38.9% of accidents are falls, in the garden or bathroom for example.”


15:20 The setbacks of home support for health professionals
Pr Philippe Jaury* (General practitioner)

“The ethics of the doctor: benevolence. Often, an intrusion into the patient’s intimacy is imposed on him/her during a home hospitalization. Our role is to explain the projections related to the doctor, to his health, to his entourage.


15:35 Testimony of a person/family supported at home


15:45 Discussion with the audience


15:55 Home, citizenship and territory
Prof. Jean-Philippe Viriot-Durandal (International Chair for Inclusive Societies and Advancing Age (SIAGE), 2L2S Metz, University of Lorraine)

“The home is an intimate object but becomes public when it is an object of public policy. It is the object of consensus and reflects a refusal of the loss of autonomy, where it is the proof of preserved autonomy. It appears as the only positive alternative.


16:10 Environment, city and society
Pierre-Marie Chapon (President of VAA Conseil)

“The geographical environment around the home has a real impact on aging. Within a 500m radius, in the city center, we must find local shops, health services and exchange spaces.


16:25 Aging and incivilities in public life
Dr. Louise Giaume (Emergency doctor, Paris Fire Brigade)

“Among people over 85 years old, 1/3 of the trauma cases require the intervention of firemen to compensate for the absence of doctors. The lack of medical means forces the transport of elderly people to the hospital, even without serious clinical case.


16:40 Discussion with the audience


16:55 Evaluation for home care
Dr Thierry Lacombe (EMS-APA) and Caroline Kervran (Social worker)

“The APA is about making information accessible while taking into account the capacities and needs of each person. APA is an inalienable right.


17:10 Testimony of a person/family supported at home


17:20 Aging well at home in rural areas
Pr Dominique Vuitton* (Member of the Board of Directors of the Association Santé Education Prévention sur les Territoires (ASEPT) de Bourgogne Franche-Comté), Clément Prévitali (Director of the ASEPT Bourgogne Franche-Comté)

“There is not a “rural” but “rural”: 3/4 of the living areas are rural territories that have their own challenges (mobility, internet access, etc.) and advantages (proximity to nature, coordination, social ties).


17:35 Discussion with the audience


18:00 Conclusion


*Member of the French Academy of Medicine

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Aging well in rural areas