"We are still seeing violations of the rights of residents in nursing homes (...). The response of the public authorities is not up to the denounced violations, nor the urgency", regrets in an interview with JDD Claire Hédon, which on Monday presents a follow-up report to 64 recommendations issued in May 2021 during the Covid crisis.

The May 2021 document and Victor Castanet's book "Les Fossoyeurs" - an updated version of which is expected for the end of January - "have raised awareness, not just of the public authorities, but of the whole of society. “, emphasizes Claire Hédon.

But much remains to be done.

She cites "an increase in reports" to the Defender of Rights organization, which had investigated some 900 complaints during the six years preceding the 2021 report, and 181 in just 18 months.

The follow-up detailed in the report was drawn up from the complaints and "responses given by the ministries and public bodies to the recommendations that we had sent to them", specifies the Defender of Rights.

These are "abuse" (43% of cases), "limitation of visits" (30%), "restrictions on the freedom to come and go" (12%).

These shortcomings concern both the private and the public.

But "eighteen months after the first report, the results are extremely worrying: 9% of our recommendations have resulted in action, 55% have been announced but are struggling to materialize, and 36% remain unanswered", laments Claire Hédon.

Its main recommendation is to set "a minimum ratio of supervision", including "at least eight caregivers and facilitators for ten residents in nursing homes".

"In France, the ratio is 6 to 10, where the northern countries are at 10," she told JDD.

And "if you restore a normal supervision rate, the caregivers will come back to work there".

"Arbitrary isolation"

According to the report presented Monday, "certain care", such as the toilet, are "organized in an accounting logic to reduce the number of staff".

He evokes the residents of an nursing home who had "at best a shower every fortnight" and remained for some "most of the time in hospital gowns or pajamas".

To compensate for the lack of staff, the establishment imposed "two days of bed rest per week per resident".

Another black spot, the untimely confinements in establishments following some Covid contaminations.

The Defender of Rights asks to "put an end to violations of the freedom to come and go" and to "restore the right to maintain family ties for residents in Ehpad" (this question constitutes 46% of the complaints received).

Defender of Rights Claire Hénon, July 20, 2020 in Paris © JOEL SAGET / AFP/Archives

She cites "cases of arbitrary isolation of residents in their rooms" or "restrictions on visits", details examples of "prohibition of the presence of a loved one during meals; obligation to keep the doors of the rooms open in order to check compliance with maintaining a distance between people; prohibition of physical contact, such as taking hands".

Thirdly, the report highlights the weaknesses in the fight against abuse, in particular the absence of a "reliable measurement tool shared by all supervisory authorities".

It calls for a "medico-social vigilance system to strengthen the identification, reporting and analysis of situations of abuse".

A project in progress since the government launched three administrative missions in September to develop ways to better identify, quantify and prevent abuse against the elderly or disabled and children.

Welcoming the government's decision to inspect all 7,500 Ehpads in the wake of the Orpea scandal, she notes "the lack of human resources" to carry out "the required inspections".

Announced in March 2022 by the government, the publication of 10 key indicators on each establishment to help families make their choice is still pending.

© 2023 AFP