Locomotion
Walking, balance, transfers, risk of falling and adaptation of the home.
Supporting an older person well does not mean doing things for them. It means preserving for as long as possible what they can still do alone, and stepping in precisely where they no longer can.
Our framework draws on the World Health Organization’s ICOPE approach — Integrated Care for Older People. Its principle is simple and it changes everything: rather than starting from diagnoses, you observe the person’s intrinsic capacities and act where they decline, as early as possible.
Every care worker trained at Les 3A learns to observe these domains visit after visit, to record what they see and to raise concerns through a clear procedure. Observation is not administrative overhead: it is the heart of the job.
Walking, balance, transfers, risk of falling and adaptation of the home.
Memory, orientation, capacity to decide; early detection of behavioural change.
Nutritional status, weight, hydration, activity levels and fatigue.
Mood, anxiety, withdrawal, quality of social contact and sense of usefulness.
Sensory function, whose decline isolates more surely than loss of mobility.
Housing, social network, resources, access to care: what holds up or undermines everything else.
Every person supported has a single, revisable document bringing together four elements.
Every service rests on professionals trained at the centre, working under contract, supervised, and replaceable in case of absence.
Washing, dressing, help at mealtimes, mobility, accompanying to appointments. The foundation of staying at home.
Conversation, adapted activities, accompanied outings. Isolation damages as surely as illness.
Detection of falls, undernutrition and cognitive impairment. Structured reporting to the family and escalation by protocol.
A few hours of respite, practical advice, short training. An exhausted carer eventually becomes a second patient.
A named care worker, regular documented reports, a single point of contact. For families arranging care from abroad.
Presence, comfort, respect for the person’s wishes, support for those around them. Our specialist workers are prepared for it, and supported through it.
Institutions attract attention and resources. But the great majority of people losing independence live at home, often with moderate dependency — and that is where most of the care work is done.
65.6 % of dependent older people live at home with moderate dependency, yet account for only 32.1 % of the sector’s jobs. Conversely, severe dependency in institutions concerns 11.6 % of people and absorbs 29.5 % of the jobs.
This imbalance is not an anomaly: supporting someone with heavy dependency requires more resources. But it does signal a blind spot — moderate dependency at home, the most common situation, is also the least covered.
That is exactly the segment where a well-trained social care worker makes the difference, and the one the Les 3A model targets first.
| Indicator | Urban | Rural |
|---|---|---|
| Older people at home losing independence | 7.7 % | 6.7 % |
| Share of women among older people at home | 56.6 % | 52.9 % |
| Poverty rate of the population | 17.0 % | 11.2 % |
Source: Drees, Vie quotidienne et santé survey 2021; Insee-DGFiP-Cnaf-Cnav-CCMSA. French data, cited for comparison.
In September 2023 Cameroon ratified the African Union Protocol on the Rights of Older Persons, in force since 4 November 2024. That text gives an international legal basis to what we do every day: supporting an older person with dignity is a matter of their rights, not of their family’s charity.
It also binds professionals. A care worker is not a servant to whom a relative is handed over: they are a trained third party, answerable for their actions, whose presence protects as much as it relieves.
Our respectful care charter turns that principle into verifiable rules, enforceable against our own teams.
The first step is a home assessment, with no commitment: understanding the situation, listening to the person and their family, and proposing a realistic plan.