GIR Scale: Understanding France's Autonomy Assessment for Elderly Care

GIR: the number that determines your parent's support

"Your mother is classified GIR 4." You nod in the social worker's office, but you don't really know what that means. How many hours of help? How much funding? And most importantly — does it actually reflect her situation?

GIR (Groupe Iso-Ressources) is France's system for evaluating autonomy loss in elderly people. This number determines whether your parent qualifies for the APA allowance, and how much they'll receive. Understanding it means being able to advocate for them.

While this scale is specific to France, many countries use similar assessment tools. Understanding how dependency is measured helps caregivers everywhere navigate their local systems more effectively.

The AGGIR grid: how it works

The principle

AGGIR (Autonomie Gérontologie Groupes Iso-Ressources) is an evaluation grid that observes what the person actually does in daily life — not what they could theoretically do.

It evaluates 17 variables, of which 10 are "discriminating" (determining the GIR level):

The 10 discriminating variables

Variable	What it measures
Coherence	Ability to converse and behave sensibly
Orientation	Awareness of time and place
Bathing	Ability to wash independently
Dressing	Ability to dress and undress independently
Eating	Ability to eat independently (serving and bringing food to mouth)
Elimination	Managing urinary and fecal hygiene independently
Transfers	Getting up, lying down, sitting independently
Indoor mobility	Moving around inside the home
Outdoor mobility	Moving around outside the home
Remote communication	Using a phone, alarm, or doorbell

The scoring system

Each variable is assessed at 3 levels:

• A: does it alone, spontaneously, completely, regularly, and correctly
• B: does it partially, or irregularly, or incorrectly
• C: does not do it

An algorithm combines the scores of the 10 discriminating variables to assign a GIR from 1 to 6.

The 6 GIR levels

GIR 1 — Total dependency

The person is bedridden or confined to a chair. Mental functions are severely impaired. They require continuous care.

Typical profile: end-of-life, advanced severe dementia, very severe disability.

APA allowance: maximum — 1,914 EUR/month in 2026.

GIR 2 — Severe dependency

Two possible situations:

• Impaired mental functions but ability to move (wandering, flight risk)
• Preserved mental functions but significant physical dependency (needs help for most daily activities)

Typical profile: moderate Alzheimer's with wandering, stroke with major motor impairment.

APA allowance: 1,548 EUR/month in 2026.

GIR 3 — Moderate dependency

The person retains mental autonomy and partial mobility, but needs help several times daily for personal care.

Typical profile: lucid elderly person needing help with bathing, dressing, and meals.

APA allowance: 1,119 EUR/month in 2026.

GIR 4 — Mild to moderate dependency

The person can move independently indoors but needs help with:

• Getting up / going to bed
• Bathing and dressing (sometimes)
• Meal preparation

This is the most common GIR — representing about 40% of APA recipients.

Typical profile: your 80-year-old parent who "manages" but whom you need to check on daily to make sure they eat, take their medication, and don't fall.

APA allowance: 747 EUR/month in 2026.

GIR 5 — Autonomy with occasional help

The person needs occasional help: housework, shopping, meal preparation. They're autonomous for essential daily activities.

Not eligible for APA. But may qualify for other support programs.

GIR 6 — Full autonomy

The person is autonomous for all daily activities.

Not eligible for APA or home help subsidies.

How the assessment works

Who evaluates?

The assessment is conducted by a member of the médico-social team from the département (local government):

• A doctor
• Or a nurse
• Or a social worker trained in the AGGIR grid

Where?

At the person's home. This is essential — a hospital-based assessment doesn't reflect daily reality.

How?

The assessor observes and questions the person for 30 minutes to 1 hour, evaluating each variable under normal living conditions.

The classic trap: the "visit day" effect

Your parent will make an effort on assessment day. They'll dress properly, answer precisely, minimize their difficulties. It's the "visit paradox" — the same thing that happens when the doctor asks "How are you?" and your mother answers "Fine!" despite falling three times that week.

How to prepare for the assessment

Be present

This is the most important advice. The assessor needs your testimony to complement what they observe. Your parent won't spontaneously mention that they forget to eat, get lost in their own home, or fell last week.

Prepare a written document

Before the visit, write a factual summary:

• Daily difficulties: bathing, dressing, meals, mobility
• Recent incidents: falls, forgotten medication, confusion, nighttime wandering
• Current support: home care hours, nurse visits, family help
• Recent changes: cognitive decline, loss of mobility, hospitalization

Don't minimize

Caregivers tend to minimize out of habit: "Oh, it's fine, we manage." No. Describe reality as it is. If your mother can't get up alone in the morning, say it. If she forgets to eat when no one is watching, say it.

An underestimated GIR = less support = more burden on you.

What if the assigned GIR seems too high?

Contesting the result

If you believe the GIR doesn't reflect reality, you can:

1. Request a reassessment from the département with a motivated letter
2. Attach a medical certificate from the treating doctor or specialist attesting to the actual dependency level
3. Provide your written testimony and that of other caregivers (home aide, nurse)

Periodic reassessment

The GIR is not set in stone. A reassessment can be requested at any time when the situation changes. The département must conduct it within one month.

Comparable systems worldwide

While GIR is specific to France, similar dependency assessment tools exist elsewhere:

Country	Assessment tool	Scale
France	GIR (AGGIR grid)	1-6 (1 = most dependent)
UK	NHS Continuing Healthcare	Decision Support Tool
Germany	Pflegegrad	1-5 (5 = most dependent)
Japan	Kaigo-do	Support 1-2, Care 1-5
Australia	ACAT assessment	Levels of care

The principle is universal: an objective evaluation of what the person can and cannot do, determining access to public support.

Key takeaways

Key point	Detail
APA-eligible levels	GIR 1 to 4
Assessment	At home, by the département's médico-social team
Your role	Be present, prepare a written document, don't minimize
Contest	Reassessment possible at any time upon request
Most common GIR	GIR 4 (~40% of APA recipients)

GIR is a technical tool, but its consequences are very real for your daily life as a caregiver. Understanding how it works gives you the power to secure the support your parent deserves.