Chapter 4, which looked at healthcare as a rationale for hostel residents’ mobility, showed that the va-et-vient can continue for a long time, even in situations of advanced frailty. Sooner or later, however, ageing hostel residents begin to experience loss of autonomy. This term refers to those individuals “who, in addition to the medical care which they are susceptible to receive, require help to accomplish essential daily tasks, or whose situation necessitates regular monitoring” (Bachelay 2013: 66). Once loss of autonomy intervenes, a decision about where to live out the rest of one’s days has to be made. In this final chapter before the Conclusion, the focus will be on hostel residents’ mobility and residential strategies to manage their impending frailty, loss of autonomy, and ultimately, the end of life.

That older hostel residents show their determination to continue in the va-et-vient for as long as possible should come as no surprise given how engrained it has become in their lives. This is elucidated in a 2007 report from Sonacotra-Adoma, which shows that 10% of all externally-contracted care services in Sonacotra-Adoma hostels are suspended due to return trips home (Adoma 2007). The report continues: “The non-negligible number of suspended care actions shows clearly that the migrants continue with the system of back-and-forth trips as long as possible, despite illness or a certain dependency” (Adoma 2007: 13). The same tendency is seen in the records of certain ‘at risk’ residents (experiencing more advanced loss of autonomy) that I was able to consult in Marseille at Adoma-Sonacotra’s South-East regional headquarters.Footnote 1 I have reproduced some of the casefiles here in tabular form, taking care to anonymise the records as completely as possible. The case shown in Table 7.1 is indicative of the phenomenon of va-et-vient in a situation of ill-health and loss of autonomy.

Table 7.1 Casefile n° FVA 2006-04
Full size table

The incorporation of mobile methods in my research design (see Sect. 2.4) also helped me appreciate the sometimes precarious nature of the va-et-vient. In the course of a gruelling three-day journey by bus and ferry from Paris to Tiznit in Southern Morocco, I gained an insight into the fragile state in which some older hostel residents are prepared to travel. Between the cramped coach seating which made sleep difficult, the infrequent stops for meals and comfort breaks, and the steep gangways and stairs on board the ferry, I could only empathise with my travelling companions. A health advisor at Sonacotra-Adoma recounted similar experiences:

If you go to the airports, it’s quite funny to see – they do the va-et-vient as long as possible. They leave in conditions sometimes which neither you nor I would accept our parents travelling in: one would think they wouldn’t survive the journey (...) They continue to do the va-et-vient as long as possible even in states of health or mobility which are really degraded, that’s for sure.

Nonetheless there comes a point when the va-et-vient becomes unsustainable due to loss of autonomy. While the timing varies according to each individual’s circumstances, in general hostel companies observe this juncture around the age of 75. According to a Sonacotra-Adoma study of 2005, “The more the residents advance in age, the more they are engaged in the back-and-forth trips, up until the age of 75. The percentage of people going back-and-forth falls after 75” (Sonacotra 2005b: 6).

Several options are open to hostel residents regarding place of residence once loss of autonomy intervenes, as Vivianne (geriatric doctor) elaborated: “Afterwards it’s very variable: there are those who stay over there [with their families]; there are those who come back here [to stay in France]; and then there are those who remain here but go back home, but really at the very last minute, those who return to die. It’s what we observe, but we don’t know too much about it: there haven’t been many studies which have appeared on that topic.” One study by the association Migrations Santé does give some indications at least: at the ADEF hostel in L’Haÿ-les-Roses, only 15% of residents envisaged moving to a French care home in a situation of reduced autonomy, against 60% who foresaw a return home to their families (Migrations Santé 2007).

The mobility options outlined by Vivianne in the preceding paragraph structure the remainder of this chapter. I will firstly consider the possibility of returning home (Sect. 7.1). While some returns in a situation of reduced autonomy are voluntary, it will be shown that others are occasioned by elements of constraint. I will then turn to the various options available for those who would remain in France: receiving care and assistance for everyday tasks in the hostel itself (Sect 7.2); arrival in France of a relative (usually the spouse) to care for an individual with reduced autonomy (Sect. 7.3); or the possibility of moving to a nursing home (Sect. 7.4). Finally, I will consider return mobility at the very end of life, encompassing not only the ‘last-minute’ returns alluded to by Vivianne, but also the widespread practice of posthumous repatriation (Sect. 7.5).

7.1 Returning Home: The Penultimate Voyage

Previous scholarship has highlighted that reaching retirement age is a key moment when the question of a possible return is posed (see Chap. 1). However my research shows that this question also becomes pertinent once older migrants start to require more intensive support (see also Karl et al. 2017). Many residents envisage returning home definitively when loss of autonomy becomes unmanageable in the hostel. Such a move enables ailing hostel residents to receive care from family members back home, which, as noted in Chap. 1, is a strong rationale behind late-in-life migration in other contexts (Findley 1988; Longino 1992).

By way of example, Walid (72, Oujda, Morocco) mentioned that he was hoping to quit the hostel soon, to go back to Oujda to “live out his days.” Brahim (60s, Agadir, Morocco) spoke of his serious gastric and mental health problems several years previously. By his own admission he had returned to Morocco “to die” but following a three year-long recovery he has come back to France. Most residents however remain in their countries of origin, according to healthcare professionals who intervene regularly in hostels. Béatrice (health advisor, migrant welfare association) commented: “When they are too ill, too old, they return home, and they never come back here. That’s for sure.” Hadyatou in Dembancané put it this way:

When I’m too beat-up, when I can no longer move, well I’ll stay here [in the village] and re-direct my pension money here. But for the time being, I’m in good health, I can move just fine. (Hadyatou, Dembancané, Senegal)

I use the term ‘penultimate voyage’ as a shorthand for this option of returning definitively once loss of autonomy intervenes. This choice of words is sensitive to the religiosity which hostel residents evinced when discussing their own mortality and their wishes at the end of life. Indeed, nowhere did this religious identity express itself more than when discussing death and dying. Being Muslim, my respondents in the hostels drew a very clear distinction between the world of the living on one hand, and, on the other the afterlife, during which one will undergo bodily resurrection, final judgement and assignation either to heaven or hell. In such a cosmology, the final journey can only ever be the journey which the resurrected body takes after judgement to its assigned destination (Rauf 2014), a journey which according to Islamic traditions involves traversing or falling from the bridge or sirat which spans hell (Smith and Haddad 2002). Hence the phrase ‘penultimate voyage’ to distinguish the final terrestrial journey of the hostel residents.

Constrained Returns

The penultimate voyage may be willingly undertaken in order to benefit from the care of one’s relatives, provided family ties have not been irreparably weakened through prolonged absence. “We know that [those] who still have ties with their family in the country of origin go back if at all possible in order to end their days around their relatives” (Bitatsi Trachet and El Moubaraki 2006: 109). Sometimes, however, there is a degree of constraint to these penultimate voyages. It is important to recognise that sometimes the ‘choice’ to return is more or less imposed by institutional actors, such as hostel managers or healthcare professionals. In other cases, they are ‘encouraged’ to return by friends and neighbours in the hostel.

In terms of institutional constraints, these may operate when individuals start to be perceived as a burden on resources. Some men become indebted, and can no longer pay for their hospital care, their medication, or their home care services. Martine (elder care coordinator, Val d’Oise) remarked that occasionally hospital personnel become “exasperated to the point where they say, ‘right, out you go, you’re no longer ill and you’re using up a bed’. But where to go?” Alternating between the local hospital and the hostel becomes impossible, since they cannot afford the hospital, and the hostel is not adapted to their health needs. In some cases, they are forcibly returned to the country of origin, or placed in a retirement home. Martine described this as “a form of institutional violence” when there are no family members to liaise with. An interview with Anne-Marie, who works in a major hospital as a crisis social worker, also broached this issue:

Sometimes, they arrive too late, that is to say the patients arrive too late at the hospital and they no longer have a choice, they can’t be returned to the hostels – they might have problems walking and there’s no lift – so either they have to be hospitalised for months, or a place in a nursing home has to be found, which is a bit complicated. So it’s good to work with them beforehand on a potential return home. (...) But frankly, I’ve never seen a single person accept this willingly (...) Really the ones who accept to return, it’s when they know they are going to die soon, because they are so completely dependent, that is to say, instead of going into a retirement home all alone when you have family back home, they reflect all the same on the possibility of returning to the family home, and having their wife or children look after them.

In other situations, left-behind family members are alerted by hostel management to the fact that their husband/father is sick in France and can no longer look after themselves in the hostel. In my discussions with Denis, a hostel manager, he mentioned that in the past managers were not required to ask residents for next-of-kin contact details. It is only recently, as head office began to grasp the extent of ageing and its consequences in the hostels, that recording such information has proved necessary. Thus relatives can be summoned from overseas to escort home a resident struggling with loss of autonomy – provided a visa can be secured, which is not always straightforward as some respondents mentioned (see Table 7.3).

The final instance where returns may be constrained pertains to the individual’s social circle within the hostel itself. Instead of seeing their ailing compatriot sent to a retirement home – which is seen as shameful and even as reflecting badly on the hostel residents collectively (Sonacotra 2005a) – neighbours prefer to donate money to a collection fund in order to purchase a ticket to enable the man to return. “Very often, the fellow residents say to the elderly person, ‘listen, you go home now; if it turns out OK you can come back, if not then you stay there’” (Béatrice, health advisor, migrant welfare association). An example of such a situation is found in the casefile in Table 7.2.

Table 7.2 Casefile n° FVA 2006-2
Full size table

The spareness and gravity of language by which the suffering of the individual in Table 7.2 is conveyed gives some insight, I think, into the institutional violence which is endemic and latent in hostel living. Such violence occurs, indeed seems inexorable, despite the good intentions of a number of actors. One can only speculate at the fate of this man. His example, anonymous though it is, underlines some of the limits of the hostel as a venue for ‘home care’, to which I now will turn.

7.2 Staying in the Hostel: Home Care

As in other European countries, the guiding principle of elder care policy in France is the notion of maintien à domicile, henceforth translated as ‘home care’ (Jamieson 1991; Walker and Maltby 1997). The objective of home care is to enable older people to live independently in their own homes for as long as possible. This is seen as important firstly because surveys indicate it is what older individuals themselves prefer, and secondly because care in institutional-residential settings is perceived as more costly by European governments (Walker and Maltby 1997). Surveying the diverse range of home care provision in Europe, Jamieson (1991) draws three principal categories: nursing care, undertaken by nursing professionals (giving injections, measuring blood pressure and so on); personal care (daily tasks such as washing and dressing); and home-making (tasks such as cleaning and cooking). In France, elderly care services provide all three types of assistance: home care provided by formal service providers is usually supplemented by informal care provided by family members and neighbours (Paraponaris et al. 2012).

Central to the successful deployment of formal home care in France is a financial aid known as the Personalised Aid for Autonomy (aide personnalisée à l’autonomie: APA). This means-tested non-contributory benefit makes formal home care more affordable for individuals with difficulties in accomplishing daily tasks, especially for those on low incomes such as hostel residents. An important legal change occurred in 2000 enabling hostel residents to benefit from this aid: henceforth a hostel room could be considered in law as a ‘principal residence’Footnote 2 and thus home care services should be deployed there if needed.

Nonetheless, the layout of hostels often impedes the work of home care professionals. In many hostels “the very environment … is not adequate for [the residents’] situation, for someone who is old, sick etc, who should be nowhere near a hostel, in a room of 7 square metres, with external toilets and a collective kitchen” (Abdou, migrant rights association). Such physical constraints were seen in Chap. 1 in the photographs of the living spaces in the hostel where I was resident (see Figs. 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9 and 1.10 ). In order to facilitate home care and generally improve the situation of older residents, a large-scale programme of architectural renovation has been underway since 1997, part of the wider statutory transformation of migrant worker hostels (foyers de travailleurs migrant) into résidence sociales, as noted in Sect. 2.2. Examples of architectural improvements include enlarging and ergonomically adapting residents’ rooms, widening corridors and other collective spaces so that wheelchairs can be turned around, installing lifts to all floors, and placing hand rails in corridors and shower facilities (Adoma 2008). However it remains the case that in many hostels the programme of renovations has barely begun (see Sect. 2.2).

Retirement Homes?

The foregoing legal and architectural changes have led some commentators to ask whether hostels – originally created for young workers – now constitute de facto retirement homes ‘on the cheap’, reserved for migrants only (Serafini 1999; Vidalie 2008). The evidence gathered for this book suggests not. Overall, hostels cannot be considered as sites of dedicated elder care. Indeed, a very low proportion of older hostel residents are in receipt of the APA benefit. A Sonacotra-Adoma report showed that in 2005, “5% of [residents] over 60 are identified as having difficulties accomplishing everyday tasks (...) Only 12% of these people benefit from the aid which they could claim” (Adoma 2007: 4), in other words only 0.5% of all residents over 60. This compares with a take-up rate of 8% for all over 60s nationwide, rising to 17% for those aged over 75 (Debout 2010). Since the Sonacotra-Adoma report of 2005, slow progress has been made. A follow-up study in 2007 showed that the take-up rate had risen somewhat, with “2.06% of people over 60 receiving nursing care and 1.09% benefiting from home care” (Adoma 2007: 2). Nonetheless the discrepancies with the national take-up rates remain considerable: what is blocking the deployment of these services?

Firstly, the cost of the available services is highlighted as a principal factor explaining the men’s wariness to benefit from home care (Dherbey and Jurdan 2002). Home care is often viewed by migrants living in hostels or other low-cost housing as a luxury they cannot afford (Alidra et al. 2003), especially for those who are still burdened with the expectation of sending remittances home every month. The biographical particularity of this latter situation has been noted at several points in this book. As Béatrice (health advisor, migrant welfare association) put it, “even if it doesn’t cost a lot of money, it costs a bit, and many migrants want to keep this money to send home, they don’t want to have to pay someone for nursing, they prefer to ask a neighbour for help, or just muddle through themselves.”

A second, and related, biographical particularity is the hostel residents’ lack of family entourage, this being the customary source of support and information for senior citizens in France (Paraponaris et al. 2012). “Normally it’s older people who apply for help, or their families, but with us [i.e., at Sonacotra-Adoma] that doesn’t happen. [The residents] are all alone, they have no family, they don’t know the mechanisms, they don’t know the services” (health advisor, Sonacotra-Adoma). While some commentators argue that the absence of family members is partially assuaged by help from neighbours and friends in the hostel, other sources are not so optimistic. A Sonacotra-Adoma internal document notes that “[c]ommunity solidarity (...) is not sufficient to ensure an efficient early warning: in fact, this is often unsystematic, often late, and it is often not done as it should be” (Sonacotra n.d.: 4). Similarly, a Unafo document points out that “solidarity among residents exists, but it is neither intense nor durable. It reaches its limits when problems of dependency appear” (Unafo 2002: 47).

The reticence of hostel managers to communicate problems to the relevant care professionals also appears to be a barrier to residents’ wellbeing. A report by consultancy firm Icares regarding hostels in the Rhône-Alpes region declares that “it is not so much the functioning of the early-warning system which causes problems. In fact, when the [management] team has enough time (...) the observation and identification of problematic situations proceeds quite naturally. Where there are more problems is in the alerting of professionals about a given situation, and in the follow-up to this” (Sonacotra-Icares 2003: 15). Furthermore, care professionals may also show reticence to intervene in hostels. This can be attributed first of all to an ignorance of these places and people: if hostel managers do not contact them, care professionals are not necessarily going to know that there are vulnerable older people in the hostels. “Older immigrants [in hostels] live in an unusual habitat for gerontological actors” (Dherbey and Jurdan 2002 : 13). Typically, such actors are accustomed to dealing with people aged 75 and over, especially older women, living alone in private housing. As was mentioned earlier, the family entourage is often at hand to keep a watchful eye over an elderly relative. The population in the hostels is quite the contrary: male, prematurely showing loss of autonomy after 55 years of age, and living in communal accommodation yet where neighbourly solidarity cannot always be taken for granted.

Once this initial barrier of ignorance is overcome, there remain difficulties for professionals in actually gaining entry to hostels. This was one of the principal factors given when I asked care providers what impeded their work in the hostels. Dr Ismail, a geriatric specialist who volunteers in several Paris hostels, replied firstly that, “it’s a difficult terrain, there are difficulties of access.” But eventually, with the cooperation of hostel managers, an agreement can be reached for gaining entry. Sonia and Martine, elder care coordinators in Val d’Oise, bemoaned the mass of keys which is required to see a patient; first of all, a swipe card for the hostel entrance, then a key for the stairwell or lift, then a key for the corridor, then a key for the room itself. However, it was only when I accompanied home care auxiliary Dimitri, on his weekly visits to see his client Mr R, that I came to fully appreciate these problems of access. As my field notes record:

Unfortunately it was difficult getting into the hostel in the first place – we had to call up to Mr R’s room twice, and each time we had no reply. Finally we got in thanks to some other residents who were entering the building and left the door open for us. But clearly, if it wasn’t a busy time of day – mid-morning – then it would have been a real pain. Dimitri doesn’t have any keys as it costs €15 per set and Mr R doesn’t want to pay.

For other professionals I spoke to, the supposed ambiance of the hostels is not conducive to doing their work. This is the case especially in the former Sonacotra hostels, despite the name change to Adoma in 2007. “The reputation and image of Sonacotra also gets in the way” (Martine, elder care coordinator, Val d’Oise). This reputation is grounded in the ‘alterity’ which the hostels represent – a wariness of the ‘other’, fed by the negative local press coverage which hostels sometimes receive due to being associated with criminality or other faits divers (public interest stories). One fear concerns the violent or sexual proclivities which the men in this highly masculine environment are said to harbour. Martine observed a “fear of the male, in the corridors, all alone” among many of the (generally female) care professionals who are called to intervene in the hostels, closely related to “racist phantasms …the foreign man is more violent... these ‘other’ men, polygamous”. Her colleague, Sonia, talked about the prevalent stereotype of the foyer as a dangerous place:

The nurses aren’t very keen – because of the hostels’ reputation... these cut-throat hostels, hostels where there are problems, where you can get attacked, where your tyres get slashed, where your windows get broken. All in all a whole host of reasons why [female care providers] say ‘no, especially not there.’

Gendered anxieties resurface – but in mirror-image – in the discourse of the residents, who are reticent to be helped. Yet here it is the men’s modesty rather than their allegedly predatory nature which is at issue. The gender and age gap between themselves and their would-be carers is erected as a supposedly ‘cultural’ barrier to assistance. A Unafo report of 2002 argues that “in their culture, it is the wife who manages, alone, the domestic tasks, laundry, meals: support for elderly relatives is incumbent on the family members” (Unafo 2002: 47; also Alidra et al. 2003). Similarly, Vivianne (geriatric doctor) had this to say on the matter: “Home help – the person who comes to do your housework, the person who comes to help you get dressed, if you can no longer lift your arms – is something which they have problems accepting, since culturally it is the role of the wife or the daughter.”

Others I talked to had a more nuanced view and I feel it is important to step back from essentialising narratives in which everything is explicated through ‘cultural’ incompatibilities alone. Accepting outside aid to accomplish daily tasks is not easy for anyone, regardless of their age, gender or ethnicity. Equally, surveys in France and elsewhere show that in general older people experiencing loss of autonomy are much more likely to receive care from informal family sources than from outside professional services (Paraponaris et al. 2012). Furthermore, in France the probability of receiving informal care from one’s spouse is higher for men than for women; and regardless of the care receiver’s gender, receiving informal care from one’s children is also higher if one has daughters rather than sons (ibid). Such findings indicate that gendered care norms are also at work in the wider French population.

Clearly the family is a significant source of care for older people in France. In the next section I turn to an aspiration that a good number of my respondents shared, namely to be able to benefit from family care like the rest of the French population. Rather than returning to places of origin for care, this aspiration involves another migration pathway, that of late family reunification in France with their spouse or children.

7.3 Late-in-life Family Reunification

Conscious of their increased care needs, a number of the hostel residents I met were hoping to bring their wives or children to France to care for them. Demographic analysis confirms the salience of late-in-life family reunification (Rallu 2016). Immigration to France of females aged 50–69 years is significant for sub-Saharan Africans; for North African older females, immigration rates are lower but still well above the rates for males at the same ages (ibid). However for hostel residents, the aspiration to bring wives to France is often foiled due to the ever-hardening legal conditions which have been imposed by successive French governments anxious to reduce family reunification’s share in the immigration statistics. The men’s difficulties in acceding to normal social housing highlight the vicious circle in which they are trapped as regards family reunification. On one hand, their current accommodation in hostels is a barrier since hostel rooms do not meet the standards required by the reunification regulations, in terms of surface area and layout (see Lo 2015). On the other hand, their lack of family dependents in France means they are not a priority population for in-demand social housing aimed at families. Another legal condition which impedes late-in-life family reunification is that wives and children are now subject to French language testing prior to departure: put crudely, family immigration decisions are now predicated on the assumed integration outcomes (Joppke 2007). Thus it is only getting more difficult to accomplish reunifications since for the immigration authorities the arrival of non-French speaking family dependents is assumed to constitute “a real cost” to the state (Martine, elder care coordinator, Val d’Oise). Furthermore, since they too are growing old, the men’s wives are perceived as a future burden on the welfare state.

The casefile in Table 7.3 illustrates the constraints to family reunification when loss of autonomy intervenes in a sudden manner. With no time to arrange a longer term visa or appropriate housing, the visit of the resident’s spouse is limited to the duration of a tourist visa. The spouse’s visit culminates with no other option but for both husband and wife to ‘return home for good’.

Table 7.3 Casefile n° FVA 2005-1
Full size table

7.4 Moving to a Care Home: The Last Resort

If informal care provided by relatives cannot be accessed through late family reunification, or if no relatives exist in countries of origin to whom an ailing resident can return for care, the last resort for those residents who can no longer stay in the hostel is for a different type of move, not international but institutional, namely admission to a care home. In France, care homes are commonly referred to by the two administrative acronyms used to define this accommodation, respectively EHPA and EHPAD.Footnote 3 Given the short period one can expect to live after entering a care home (Martikainen et al. 2014), ‘last resort’ is an apt expression to describe hostel residents’ perspectives on these establishments. As will be shown below, hostel residents very rarely agree to reside in such establishments of their own volition: generally when this occurs, there is an element of constraint.Footnote 4 Three main motivations account for this reluctance to envisage a move to a retirement home: cost, reluctance to leave the familiar social environment of the hostel, and perceptions of ethnic, cultural and gendered barriers to integrating into care homes.

Cost – a Brake on Remittances

Expense is the most straightforward reason why hostel residents rarely agree to move to care homes. In this respect the hostel residents do not distinguish themselves from other older populations in France, since for any older person – even those who have comfortable pensions – entry to a retirement home is an extremely costly affair. What is particular in the case of the hostel residents is – biographically speaking – the fact that many are expected to remain financially responsible for their extended family in countries of origin even after retirement (Sonacotra 2005a; Unafo 2002).

In 2009, when the research for this book was conducted, the monthly minimum tariff for a place in a care home ranged between €2,000 and €2,500. It is inconceivable that any hostel resident will be able to pay such fees given their lower than average pension incomes and the fact that they do not own any real estate assets in France which could be sold to cover this expense. Thus, any hostel resident who wishes to go into a care home will have to be supported by the state, under a mechanism known as aide sociale (see Grandguillot 2009: 123–124). This aid works on the basis that 90% of a claimant’s revenues are appropriated by the state to fund their care, with the state covering the outstanding balance owed to the institution concerned. This latter contribution from the state is a cash-advance, not a subsidy. In other words, the individual’s estate is seized by the state upon death, or if the individual’s financial situation improves. If the deceased has surviving relatives living in France, any monies due the state may be seized from them. Perhaps most critically in terms of hostel residents’ general refusal to enter such accommodation, however, is the fact that they have very little money to remit home once the 90% appropriation of their revenues is applied by the state. For those with very small pensions, the maximum sum which they are permitted to keep from the state, as of 2009, was €85 per month, “just enough to keep them in cigarettes basically”, as one respondent wryly commented.

Even assuming that older hostel residents are aware of this financial assistance on the part of the state, it is not hard to imagine the difficulties posed to family finances by this swingeing cut to remittance income. This led Dr Ismail to comment that “the retirement homes aren’t designed with the North Africans in mind.” In a similar vein, a senior civil servant had this to say on the matter:

We have noticed that few residents move to a care home. Few, if not very few, indeed astonishingly few! For reasons specific to these populations, notably when you enter a retirement home, it’s your entire income which goes towards paying for the accommodation (...) For all intents and purposes, to enter an EHPA or an EHPAD means renouncing the remittances which you send to your family each month – €100 – €150 – €200. Not simple. And yet this is the justification – I don’t say it’s the only reason for their presence in France, but it’s the justification for their presence in France, you see (...) And it means recognising that when you can no longer fulfil this function, it’s not simple (...) It’s to recognise that you haven’t succeeded in doing what you left for.

Familiarity of the Foyer

Care homes can feel ‘foreign’ to older hostel residents in the sense of strange or unfamiliar. As with all older people, hostel residents may be upset by a change in environment: “new surroundings and language problems lead to significant difficulties in adapting” to the care home environment (Sonacotra 2005a). As has been noted at several points in this book, many residents have lived in their hostels for 30 years or more. Under such circumstances, it is not surprising to find that “[t]o leave a residence, in which they have spent the better part of their life, is a difficult act” (Unafo 2002: 45). Indeed, transferring one’s residence to a care home can be validly described as a “new immigration” (Sonacotra 2005a). Put simply, to leave the hostel is to leave home, even if it is not everyone’s ideal of home.

Care homes tend to operate according to a model of individualised, personalised residential care. For some of my respondents this approach was tantamount to separating and banishing older people from the wider community, which was anathema to their views on appropriate care for older people. For example, some of my respondents in Dembancané expressed outrage at what they called the ‘Western’ model of elder care: older returnees in the village were relieved that they had managed to avoid ending up in a care home in France. What is specific to the hostel population vis-à-vis other care home clienteles is the transition “from a lifestyle where the collective served as the means to withstand the difficult life conditions which they were made to experience, to a lifestyle where everything is very individualised, inside the EHPA or EHPAD” (senior civil servant). According to this same interviewee:

it would be necessary that the EHPAs or EHPADs take into account the specific history of these persons. What has enabled them to survive is life in a group, so it’s very likely for someone who is liable to spend a significant period of time in an EHPA for example, that it’s not just one person on their own, it has to be three or four people who understand each other, who know each other a little.

Interestingly, a handful of experiments have been developed by the two largest hostel companies Sonacotra-Adoma and Aftam-Coallia, aimed at creating EHPA or EHPAD ‘annexes’ for more dependent residents on the sites of existing hostels. Proponents of these experiments argue that creating such institutions on the same site as hostels means the users will not have to endure a difficult change in their routine and social circle. The interventions of home care auxiliaries and nurses will also be facilitated, due to the larger and better adapted rooms available. Others are less sanguine, cautioning that “it’s a subject all the same which demands some reflection, because we can’t very well make a network of nursing or retirement homes reserved for immigrants only” (senior civil servant). Indeed, for the Chief Executive of Sonacotra-Adoma, Bruno Arbouet, such experiments are “fausses bonnes idées”, good ideas which have backfired. In his testimony to the Parliamentary Commission on Older Migrants in 2013, he noted with embarrassment how he was forced to cancel the inauguration of one such annex at Bobigny, near Paris, in the presence of the President of the National Assembly, because only three out of 85 rooms were to be occupied by former hostel residents (Bachelay 2013).

Foreign Bodies: Ethnicity, Culture, Age and Gender

A final important brake on admission to care homes was summed up neatly by Germain (outreach officer, social and legal rights charity) – himself a migrant of Togolese origin – with his reference to ‘foreign bodies’, a phrase he used to imply the ethnic alterity which is posed in such establishments by the presence of ex-hostel residents, in this case of North African origin:

And cohabiting with a population which isn’t North African is also a question. Indeed, you will see very few North Africans [in care homes]. First of all it’s a question of expense, then, when it does happen, there are rejections. You are once again a foreigner amongst people that you have never mixed with before. Moreover, things go badly in retirement homes in general. If, in addition, you constitute a foreign body there, I am very pessimistic for the future of those people.

Beyond ethnicity, the older hostel residents constitute ‘foreign bodies’ in the care home on account of their gender. As was discussed in Sect. 7.2, gender norms and stereotypes can be a barrier to care in terms of the relationship between carer and cared-for, but gender poses a problem also at the level of relations between care home residents, a fact underlined by a report from Unafo, the Union of Professionals in Accompanied Housing: “Retirement homes appear to be ill-adapted to the [male] migrant population (...) due to the very high percentage of women who live there” (Unafo 2002: 45). This is a point also underlined by a Sonacotra-Adoma working document from 2005, which noted that “[t]he relations among EHPAD residents can pose a problem, notably between men and women” (Sonacotra 2005a).

Not only do retirement homes tend to house a predominantly female population, they are also marked by the preponderance of that fraction of the elderly described as ‘the oldest old’ (i.e., aged 85 and over). Yet, with the hostel residents one is dealing with a prematurely ageing population, given the difficult living and working conditions which they have known earlier in life (see Chap. 4). As a health advisor at Sonacotra-Adoma put it: “the average age in the existing EHPADs is 87 years (...) Our old migrants have difficulties well before then.”

In addition to ethnicity, age and gender, a further obstacle consists of divergent religious orientations. As Vivianne (geriatric doctor) puts it, “the culture is not the same, the religion is not the same, which means that [hostel residents] do not feel at home in the EHPADs at all.” One example in this regard is the fear which hostel residents have of being given non-halal food to eat in care homes (interview with senior civil servant). Likewise, hostel companies underline the “difficulty of practising one’s religion, which becomes more necessary in later life” (Sonacotra 2005a). Indeed, religion assumed its greatest meaningfulness for my respondents precisely in the very last stages of life, in the approach to death and the hereafter. It is to this theme that I now turn.

7.5 Last-Minute Returns and Posthumous Returns

The prospect of death is often present in the hostels. As the epigraph to this chapter revealed, every day across Sonacotra-Adoma’s 450-odd hostels the deaths of three residents are recorded. During my period of residence in a hostel in the suburbs north-west of Paris, three residents died in the space of a month. Bad news like this circulates quickly in accommodation where the living is at close quarters, in the stairways, kitchens, shower blocks and prayer rooms. In this final section, I seek to understand how older hostel residents approach dying and death, and analyse how these issues influence their mobility decisions after retirement. The conclusion to Chap. 6 noted that some norms and cultural expectations could be ignored or disregarded in the context of emigration (e.g., consumption of alcohol). Yet such compromises do not seem permissible in death: for hostel residents, the rituals associated with death must be undertaken back home. This geographical preference speaks to wider questions of what it means to die a ‘good death’ (Ariès 1983; Kellehear 2007; Walter 2003) and what it means to ‘belong’ to a particular place. As seen in Table 7.2, some residents leave France in the utmost urgency, aware that death could be imminent: these are the ‘last-minute returns’ alluded to in this section’s title. For the less prescient, an elaborate patchwork of formal and informal channels exists to ensure posthumous return, from market-based insurance schemes to consular assistance and ad hoc solidarity among residents, as will be described below.

Bad Dying, Good Deaths?

For a long time, dying and death in migratory contexts was rarely a subject of social interest or scrutiny in labour-importing Western countries. In public discourse, the image conveyed of migrants was one of young people, of working age, finally as ageless and immortal, to reprise John Berger’s ascerbic critique of guestworker capitalism in A Seventh Man (Berger and Mohr 1975; see Sect. 1.1). This disinterest was also a feature of academia: indeed, it is only relatively recently that the social scientific study of death and dying in migration contexts has developed (e.g. Attias-Donfut and Wolff 2005; Balkan 2016; Chaïb 2000; Gardner 2002; Gunaratnam 2013; Hunter and Soom Ammann 2016; Oliver 2004; Venhorst 2013). One axiom emerging from this body of work is that migration leads to attachment to multiple places, unsettling fixed assumptions about the question of final resting place. One writer who has gone further than most in interrogating this relationship between migration, place and death is Yassine Chaïb. Focussing his attention on the posthumous mobility of North African migrants (for whom, as Muslims, burial is essential), Chaïb writes: “In the choice of place of burial, the soil/earth becomes a fundamental ‘where’, a stable basis by which the place of origin is precisely defined” (Chaïb 2000: 24; author’s translation).

Although death in migratory contexts is an underexplored topic, the issues it provokes resonate with the much more established literature on ‘good’ and ‘bad’ deaths (Ariès 1983; Kellehear 2007). What constitutes ‘good’ or ‘bad’ death has varied greatly over time and from one society to another (Walter 2003). Under conditions of late modernity, when sudden death is rare and dying in old age from degenerative disease is the norm, dying has become more individualised, medicalised and controlled (Kellehear 2007). One aspect of good death thus centres on the degree of control a dying person has over where death takes place. Although such control is never absolute, in many types of society good deaths tend to be associated with dying ‘at home’ in the company of loved ones, whereas dying alone and in unfamiliar surroundings equates to bad death (Seale 2004). Developing the notion of good and bad deaths, research in palliative care has explored the circumstances under which bad dying can become good death, through the care shown to dead bodies and the mediation of ritual specialists (Soom Ammann 2016). As will be elaborated below, correct performance of funerary ritual is the key consideration in hostel residents’ preference for last-minute or posthumous return.

Dying to Return

Hostel residents tended not to shy away from discussing death with me. Some even approached the topic in a jocular manner, although this may have been a psychological coping mechanism to deflect underlying anxieties about mortality. One fear which was voiced by residents, however, was the prospect of dying alone in the hostel room in France, being equated to a ‘bad death’ (see also Samaoli 2007). Among my respondents, this fear of dying alone in the hostel room was particularly widespread, as evidenced by residents’ repeated comments that their rooms are coffins or tombs. Indeed, such fears were already being voiced in the early 1980s, as Mireille Ginesy-Galano’s work makes clear (Ginesy-Galano 1984: 59). These sentiments are only accentuated as the residents approach their latter years:

[AH: Where do you feel more at ease, here or there?] Over there, with my kids, my family. Here it’s nothing more than a tomb (c’est une tombe) ... It’s no life, this! [At this point Mehdi stretches out his legs from the bed and touches the other wall with his feet, to indicate the cramped conditions]. Look! ... But we had no choice: here in the hostels it’s cheaper. (Mehdi, 64, Chlef, Algeria)

Here in the hostel, the room is like a coffin (cercueil). What about the residents who die in their rooms and lie there for several days before anyone notices? Where are the nurses who come every day like in retirement homes for French people? That’s my question. (Rahman, 60s, Algeria)

This evening, when I was in the kitchen Moncef told me that a guy on the ground floor of our stair had died, but the body was only found yesterday, several days after his death, once it started to smell badly. Hence the strong smell of disinfectant in the corridor today and yesterday, and the (usually locked) door left wide open at all times in an effort to aerate the corridor. Moncef said it had been five days that the guy had been dead, adding: “it’s sad to die like that.” (From my fieldnotes, 17 June 2009)

This situation recorded in my fieldnotes is in itself an example for hostel residents of not ‘dying well’, in the manner prescribed by Islamic ritual which urges burial as soon as possible after death. Delaying burial is anathema in Islamic eschatology since the soul of the deceased is said to be separated from the body for the period between death and burial and the soul is therefore able to witness the processes which occur in this interim period (the decomposition of the body, relatives mourning and so on). This is believed to be very traumatic for the soul (Smith and Haddad 2002; Venhorst 2013). Furthermore, it is recommended that the attestation of faith (shahada) be said over the deceased at the moment of death, which clearly could not have taken place in the death described immediately above. In a study of Bengali Muslim elders in London, Katy Gardner records how critical the presence at the death-bed of family or friends is to ‘dying well’, so that the appropriate ritual processes are set in motion (Gardner 2002). Far from their families, in the institutionalised context of the hostel, residents cannot have confidence that these rites will be observed correctly.

Beyond the confines of the hostel, there are other factors specific to France which increase the risks for residents of a ‘bad death’, notably for those contemplating burial in France. Three significant barriers to burial in France should be noted. Firstly, in some municipal areas there is no Muslim burial provision whatsoever as separate confessional burial space is highly constrained in French law, owing to the governing principle of laïcité which dictates that cemeteries should be neutral in confessional terms (Aggoun 2006). Secondly, French cemeteries require the deceased to be placed in a coffin (Sueur and Lecerf 2006), whereas in the Islamic rite bodies are wrapped in a white sheet prior to burial, since direct contact with organic matter is believed to have purifying effects (Chaïb 2000). Thirdly, gravespaces in municipal cemeteries may be automatically reused after a certain period of time – sometimes as short as 5 years – involving exhumation and relocation of the remains to a common ossuary. In some communes the practice has been to proceed to incineration of ossuary remains, which is entirely incompatible with Islamic funeral rites.Footnote 5 Thus, the only means to ensure the undisturbed repose of the deceased in France is to purchase – at great expense – a burial concession in perpetuity. Yet some communes no longer offer perpetual concessions, as there is not enough cemetery space to meet demand.

Given the multiple barriers to achieving a burial in accordance with Islamic principles, it is unsurprising that many Muslim migrants in France opt for repatriation following death in France (Chaïb 2000). Indeed, there exist numerous solutions to ensure that one will be repatriated in the event of death. For example, financial institutions are involved in this domain. Repatriation insurance products are offered by several North and West African banks operating in France. I had the opportunity to discuss such products with an employee of the Moroccan bank BMCE (Banque Marocaine du commerce extérieur). The product which this bank offers in the event of a client’s death is an assistance, not an assurance (i.e. there are no cash benefits, just benefits in kind). At the time of the interview in 2009, the annual fee was under €20. According to my contact at the bank, almost every account holder at their Paris branches has signed up for this product.

Hometown associations are also mobilised to facilitate repatriation, as noted briefly in Chap. 6. Indeed, the mutual aid function of the hometown associations – not just in times of death, but also in cases of unemployment or ill health – tends to pre-date their development role (Manchuelle 1997; Timera 1996). As with the West African hometown associations, mutual funds have been set up by North African hostel residents to facilitate posthumous repatriation, but on a more ad hoc basis. For example, several deaths occurred in the hostel where I undertook participant observation during my time as a live-in resident. In more than one case the deceased did not have repatriation insurance, so his friends collected money from fellow residents to facilitate this. In addition to such initiatives in hostels, local mosques may be solicited for funds. Usually, between these two sources enough money is raised to fund the cost of repatriation. This can be expensive, typically costing between €2,000 and €3,000. If there is any excess money after repatriation costs have been paid it is sent to the bereaved family in the place of origin. In the hostel where I lived, the president of the Residents’ Committee, Saleem (60, Tiznit, Morocco), sometimes even travels to present this money to the family personally.

Such a system again demonstrates the solidarity which it is possible to find in many hostels. Nonetheless, more marginal members of the hostel community cannot rely on such mutual aid. Recently, this situation has attracted the attention of consular authorities in France, as my interview with two chargé d’affaires at the Moroccan Embassy in Paris revealed. These officials noted one particular problem: the situation of Moroccans in France who die sans ressources (i.e. penniless). The consular staff acknowledged the existence of structures of “parallel solidarity” – mosques, associations, collections in hostels, and so on – but this solidarity always operates “on a case by case basis. Now we’re going to systematise the procedure.” Thus the Fondation Hassan II, an agency of the Moroccan government which represents Moroccans living aboad, has recently inaugurated a social fund for the posthumous repatriation of those whose families are too poor to arrange this themselves.

7.6 Conclusion

The present chapter has discussed hostel residents’ mobility and residential strategies to manage their impending frailty, loss of autonomy, and ultimately, the end of life. Such factors have been under-researched as influences on international migration in later lifeFootnote 6, but the material above indicates that these factors are salient for older hostel residents.

Several possibilities are open to hostel residents regarding place of residence once loss of autonomy intervenes. The data presented in this chapter suggest that the ideal for hostel residents is to return home definitively in order to benefit from family care. As described in Sect. 7.1, return may be voluntary if a resident still has sufficient agency to undertake the voyage, or alternatively be more or less forced upon residents through a combination of institutional and peer pressures. I then turned to the various options available for those who would remain in France, the first of which is maintaining residence in the hostel in order to benefit from home care services. However Sect. 7.2 drew attention to the numerous institutional, financial and architectural constraints to adequate home care provision in hostels. Instead, given the role of the family as a significant source of care for older people in France, a number of my respondents aspired to bring a relative (usually their spouse) to France, in order to receive informal care. Section 7.3 discussed this phenomenon of late family reunification. Unfortunately, due to difficulties of eligibility for social housing, hostel residents are liable to be trapped in a vicious circle which leads to their applications for family reunification being refused.

If informal care provided by relatives cannot be accessed through late family reunification, or if no relatives exist in countries of origin to which an ailing resident can return for care, the last resort for those residents who are too frail to continue living in hostels is for a different type of move, not international but institutional, namely entry into a care home. However, as Sect. 7.4 made clear, several barriers are erected to this final form of late-in-life mobility. Because of the expense involved, moving to a care home is tantamount to abandoning the life-long mission of remittance sending. The men’s ‘non-standard’ biographies are also problematic from the perspective of those charged with caring for them in residential homes. These biographical factors include lack of family entourage and premature ageing. There are also problems of cohabitation in the largely feminine environment of the care home, and perceived ‘cultural’ or religious incompatibilities.

Considering this last point, religion assumes its greatest meaningfulness for hostel residents at this stage of life, in the approach to death and the hereafter. The vast majority of hostel residents hail from Muslim societies in North and West Africa. In Sect. 7.5, I analysed how end-of-life issues influenced my respondents’ mobility. In general, dying in France was envisioned as a ‘bad death’ since hostel residents cannot be assured that Islamic death rites will be correctly observed, hence the practice of ‘last minute’ returns. Equally worrying is the thought of being buried in France, since French cemetery practices contravene many Islamic stipulations on the issue. Repatriation for burial in the place of origin therefore is an existential imperative and the ‘last request’ of hostel residents should they happen to be dying in France.

Appropriately, this final empirical chapter has raised points which are pertinent to all four explanatory models of late-in-life mobility presented in Chap. 2. As has just been said, burial in ancestral lands exerts a strong normative pull over hostel residents. The structuralist approach to return migration insists that a successful or sustainable return depends on respecting “vested interests and traditional ways of thinking” in places of origin (Cerase 1974: 258). For those who were not able to return with their ‘heads held high’ while alive – due to the economic or moral failure of their sojourn abroad – a last-minute or posthumous return nonetheless speaks eloquently of the normative hold of the community of origin over its exiles abroad. Furthermore several informal and formal mechanisms are available to ensure repatriation of the deceased. This highlights the cross-border activities of state and non-governmental institutions – consulates, banks and hometown associations – all of which are actors seen as crucial in the transnationalist approach. For those who are not able to benefit from informal care provided by relatives because time and absence have weakened the ties to the family and the community of origin, the last resort is to be admitted to a care home. In so doing, such individuals become bound to the social systems logic of the welfare state, in which access to care is predicated on meeting various biographically-defined expectations of inclusion. For those residents who continue to be implicated socially and economically in the lives of their left behind kin, the financial cost of a move into a care home conflicts with the desire to keep remitting until the last possible moment. This demonstrates the extent to which the logic of the new economics of labour migration remains pertinent – albeit in a distorted way – even in the very last stages of the hostel residents’ lives.