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Last Updated: Saturday, 25 September, 2004, 11:32 GMT 12:32 UK
The price of an ageing population

By Caroline Wyatt
BBC correspondent, Paris

With the population across Europe ageing rapidly, governments will have to start taking more notice of the elderly.

A game of boules in France
There are four million people over 75-years-old in France

In France, following the heatwave in 2003 - which killed almost 15,000 vulnerable people - the issue is in its prime.

Madame Beau must be in her mid-80s, though I have never had the courage to ask her exact age nor indeed her first name.

To me, she is simply Madame Beau, my neighbour in the Charente, the region I visit every summer.

She has lived in her tumbledown farmhouse all her life, with her son Alain and now her grandson as well. She is a diminutive figure, with forget-me-not blue eyes twinkling out from beneath the brim of a floppy sunhat.

She is always sharing handy hints on how to trap the moles that dig up the garden - having been a virtuoso mole-killer in her youth - selling their skins to the mole man who used to visit regularly.

She does rather less of that these days. But she still tends her garden lovingly, gathering basketfuls of juicy plums and misshapen, but delicious, vegetables which she donates with pride - and no little sense of competition - to her neighbours.

Madame Beau warned us against the local hospital - full of sick people and germs

This summer, she seemed a little frailer, her steps a little less certain as she came across for a chat. She had been in hospital, she explained, with a leg infection.

Two weeks in a convalescent home were enough for her. She demanded to be allowed back home, to be ministered to by her son and a visiting district nurse.

She warned us against the local hospital; full of sick people and germs.

Madame Beau gave a cheery smile and limped back to her vegetable patch.

'Soul-searching'

She is definitely a survivor - one of those who fought off last summer's heatwave, while nearly 15,000 others did not.

The graves of unclaimed heat wave victims in Thiais cemetery, south of Paris
Unclaimed victims of the heat wave were buried in unmarked graves

They were exhausted by the endless nights of heat in stuffy city flats, or dehydrated in old people's homes, slipping away so quietly that nobody noticed how many had gone until it was too late.

Then came the soul-searching across France. How could this happen here, in a country which prides itself on the strength of its family bonds?

There were few answers, but many promises.

Air conditioning would be installed in the nation's 10,000 retirement homes, nursing staff would no longer all take their holiday in August, and - a very French solution - the over-70s would all receive a free spray of Evian water to cool off with.

The main promise, though, was more funding for care for the aged.

Limited choice?

Last summer, the nation said it would gladly give up a public holiday in solidarity with the elderly, putting that day's national insurance contributions towards their care.

The elderly in France are too reluctant to fight for their rights
Jean-Francois Lacan

But over time, enthusiasm for the idea has diminished, with arguments over exactly which holiday should be sacrificed, and by whom.

This is where France is getting it wrong, says Jean-Francois Lacan, a gerontologist who has written an angry book called Scandal about what he sees as his country's neglect of its senior citizens.

He says the real problem is that none of us can imagine ever getting old.

Sure, we can see ourselves sailing happily on a cruise ship in our 60s or 70s, or pottering around enjoying sunny days with the grandchildren. Yet, he insists, no one can face the reality beyond that age, when living independently may not be an option.

British pensioners demonstrate outside the House of Commons
British pensioners have been demonstrating in London for an increase in the state pension

He is fiercely critical of the French system, of the state-run retirement homes mostly used by those in their 80s and 90s.

He says no-one is allowed to choose which one they go to, nor have a say in which doctor they see.

Private care homes are few and far between. He thinks competition would drive up standards.

"The elderly in France are too reluctant to fight for their rights," he says, unlike senior citizens in Germany, who have formed their own political party, the Grey Panthers; or states such as Florida, where there are so many old people that their votes count a lot.

Rising cost

Yet I think France still organises care in old age rather well.

At least, if the worst comes to the worst for Madame Beau, her son Alain will not be forced to sell the family home to pay for her care.

Care home for the elderly
There are 650,000 people in 10,000 retirement homes in France

Under France's inheritance laws, it will pass to Alain and his sister, and after them to their children.

If Madame Beau cannot afford it, her nursing care will be paid for through her pension, with any shortfall made up by the local authority.

France also manages to keep people independent for as long as possible. Of the over-75s, almost 90% live either on their own, or with their family.

In Paris, just 5% of the over-75s are in retirement homes, and the ones I have seen are not bad; mainly purpose-built, with light and space and gardens, and even wine served with lunch and supper.

So I am not sure Mr Lacan is right. I do not think France neglects its elderly.

But it does face a huge challenge: accustomed to relatively generous care now, the bill for that will be increasingly unmanageable as the population gets older.

Madame Beau's may be the last generation in France for whom some comfort in old age is assured.

From Our Own Correspondent was broadcast on Saturday, 25 September, 2004 at 1130 BST on BBC Radio 4. Please check the programme schedules for World Service transmission times.

SEE ALSO:
France seeks funds for elderly
27 Aug 03  |  Europe
French heat toll almost 15,000
25 Sep 03  |  Europe
'We were not at all prepared'
14 Aug 03  |  Europe


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