Long-Term Care Policy in France

Traditionally characterized by a familialist approach to long-term care (LTC), with the legal obligation for families to care for their relatives, France has developed several policy measures and evolved toward a mixed model, combining public measures and family care. The chapter investigates LTC policy in France by exploring the balance between formal and informal care and its evolution during the last decades. Building on the scholarly debate on familialization versus defamilialization policies, the chapter argues that different policy measures have contributed to a turn toward “optional familialism,” according to which families are encouraged to provide family care and are (directly or indirectly) given alternatives through the provision of public and market care. Based on qualitative empirical research conducted in several research projects since the 2000s and an updated literature review, it explores the impact of the development of a cash-for-care scheme which can support both familialism or defamilialism depending on the context, and which, in France, facilitated the externalization of care. It also investigates the introduction, since the 2000s, of direct policy interventions toward informal caregivers, which question the defamilialization process. It identifies three types of policy intervention – compensation measures (means to reward caregivers’ time financially or via social security rights), conciliation measures (interventions to help caregivers who have a job to combine work and care), and supportive measures (to assist caregivers in their role and enable them to carry out their caring activities) – and concludes with the importance of supportive measures in France and the trend taken toward optional familialism.