Care and support for the elderly in France: Major managerial challenges

Q3 Medicine

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI:10.1016/j.jemep.2025.101161

C. Pascal

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引用次数: 0

Abstract

Background

France, like many other developed countries, is experiencing a significant demographic transition marked by an ageing population. This shift has resulted in a growing demand for care and support services for older people. In response, the French government has implemented several policy measures, including the promotion of home-based care and the development of coordination support systems, in an effort to maintain autonomy and contain costs.

Objectives

This article aims to identify and analyze the main managerial challenges that elderly care institutions and services in France must address to adapt to the changing healthcare and social landscape.

Methods

The analysis is based on a selective review of recent French official reports and peer-reviewed scientific publications related to elderly care policies, service organization, and workforce management.

Findings

Five major managerial challenges are identified:

- Strategic human resources management – The sector faces severe workforce shortages, particularly among nurses and care workers, due to low pay, difficult working conditions, and limited career prospects.

- Operations management and planning – Rising costs associated with increasing care needs, real estate expenses, and regulatory requirements necessitate enhanced efficiency and procurement strategies.

- Organizational memory – High staff turnover risks eroding institutional know-how and calls for procedural reinforcement to sustain quality and safety in care delivery.

- Care pathways – While public authorities seek greater coordination and integration of health and social services, operationalising this ambition remains difficult due to institutional fragmentation, ambiguous responsibilities, and a lack of shared tools and data.

- Transportation and mobility – The limited mobility of frail older adults complicates their access to healthcare and support services. This challenge is exacerbated by rising energy costs and environmental policies aimed at reducing car travel, which constrain traditional models of transportation. While e-health solutions offer promising alternatives to in-person care, their deployment requires a broader reconfiguration of service delivery models and associated economic structures.

Conclusion

Elderly care services in France must navigate multiple structural and operational challenges to adapt to demographic and systemic changes. Addressing these issues requires strategic investment in workforce development, service coordination, and innovation in care delivery mechanisms.

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对法国老年人的照顾和支持：主要的管理挑战

与许多其他发达国家一样，法国正在经历以人口老龄化为标志的重大人口转型。这一转变导致对老年人护理和支助服务的需求日益增长。作为回应，法国政府实施了若干政策措施，包括促进家庭护理和发展协调支持系统，以保持自主权和控制成本。本文旨在确定和分析法国老年护理机构和服务必须解决的主要管理挑战，以适应不断变化的医疗保健和社会景观。方法分析是基于最近法国官方报告和同行评议的科学出版物的选择性审查，涉及老年护理政策，服务组织和劳动力管理。战略人力资源管理-由于低工资、艰苦的工作条件和有限的职业前景，该行业面临严重的劳动力短缺，特别是护士和护理工作者。-运营管理和规划-随着护理需求、房地产费用和监管要求的增加，成本不断上升，需要提高效率和采购策略。-组织记忆-高人员流动率有侵蚀机构知识的风险，需要加强程序，以维持护理服务的质量和安全。-护理途径-虽然公共当局寻求加强卫生和社会服务的协调和整合，但由于机构分散、责任模糊以及缺乏共享的工具和数据，实现这一目标仍然很困难。-交通和流动性-体弱老年人的流动性有限，使他们难以获得保健和支助服务。不断上涨的能源成本和旨在减少汽车出行的环境政策加剧了这一挑战，而汽车出行限制了传统的交通方式。虽然电子保健解决方案为面对面护理提供了有希望的替代方案，但它们的部署需要更广泛地重新配置服务提供模式和相关的经济结构。结论法国的老年护理服务必须应对多种结构和运营挑战，以适应人口和体制的变化。解决这些问题需要在劳动力发展、服务协调和护理提供机制创新方面进行战略投资。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ethics, Medicine and Public Health Medicine-Health Policy

CiteScore

2.20

自引率

0.00%

发文量

107

审稿时长

42 days

期刊介绍： This review aims to compare approaches to medical ethics and bioethics in two forms, Anglo-Saxon (Ethics, Medicine and Public Health) and French (Ethique, Médecine et Politiques Publiques). Thus, in their native languages, the authors will present research on the legitimacy of the practice and appreciation of the consequences of acts towards patients as compared to the limits acceptable by the community, as illustrated by the democratic debate.