The home visit in the framework of APA: what effect does the initial training of staff have on their practices?

Summary Entrusted to the departmental councils in 2002, the procedure for allocating the personalized autonomy allowance (APA) provides that elderly people who apply for the APA receive a visit at their home from a departmental council medical-social team. The purpose of this visit is to assess the degree of loss of autonomy of the person based on a legal grid (AGGIR grid) and to develop a personalized assistance plan financed in part by the APA. The law sets out the overall composition of the medico-social teams: they must include at least one doctor and one social worker. However, it does not specify the type of professional training required for the other members of the team who are also responsible for home visits. In practice, although they occupy similar positions, the members of the medical-social teams may have undergone different initial professional training, which is mainly either paramedical (nursing diploma) or social work (social service assistant, family social economy counsellor or educator diploma). Does this difference in initial training have any effect on their professional practices in terms of assessing the degree of loss of autonomy and drawing up assistance plans? This note presents the main elements of an answer to this question obtained following a sociological research study conducted in four departments.