Implementing the French Elderly Care Allowance (l'allocation personnalisée d'autonomie)

After years of debates, a specific national allowance for elderly people needing long term care has first been introduced in France in 1997. Facing severe criticism, this allowance was replaced by a new one in 2001, with no more inheritance clause: the allocation personnalisée d’autonomie (APA). The change was not framed with gender arguments, even if care is a highly feminised domain with a majority of women being care receivers, informal helpers or declared and paid care providers. Numerous actors have been in charge of the implementation of this capacity instrument: local authorities and their socio medical teams, a national funding institution, the Caisse Nationale de Solidarité pour l’Autonomie, the different private provider’s organisations, the declared paid care workers. The aim of this paper is to analyse how the implementation of the APA worked in practice, between 2001 and 2016 and if it led to gender transformation. Here it is important to understand how the information of the rights to the APA have been developed, how has the dependency been evaluated and the help plans negotiated with the families, how different needs have been taken into account: the needs of elderly dependant people, the needs of their informal helpers and those of the declared paid providers. In order to answer these questions, we will gather qualitative and quantitative data. We will examine the frames shared by the different actors involved in the implementation, understand how their socialisation and their interactions help them to interpret the APA functioning, to define and take into account the interest of care protagonists and to decide about policy schemes. We will also show how contextual factors like austerity measures and the addition of other policy instruments introduced new constraints during the implementation phase. Finally, we will try to evaluate the final outcomes of the APA.