AGGIR, GIR and APA: how France funds home care

The AGGIR grid explained: how it sorts each person into a GIR group (1–6), which groups unlock the APA benefit, and why nursing homes also need PATHOS. With 2026 ceilings.

The AGGIR grid (Autonomie Gérontologie Groupes Iso-Ressources) is France’s mandated national tool for measuring an older person’s loss of autonomy; it sorts each person into one of six GIR groups (Groupes Iso-Ressources), from GIR 1 (most dependent) to GIR 6 (autonomous), and that group decides who gets help and how much. If you build or run software for home-care services or nursing homes in France, AGGIR, the GIR groups it produces, and the benefits attached to them (chiefly the APA) are core data your product has to handle.

This guide gives the operator’s view: what AGGIR and GIR are, how APA works, why nursing homes need a second ruler called PATHOS, and how the 2024-2026 reforms affect the system around them. The reform dates are the moving part, so read them as “true when checked”, not “settled”.

AGGIR and the GIR groups

AGGIR (Autonomie Gérontologie Groupes Iso-Ressources) is France’s mandated national instrument for measuring loss of autonomy (dépendance). It is written into law as annexe 2-1 of the Code de l’action sociale et des familles. Its job is to sort a person into one of six groups, the Groupes Iso-Ressources, or GIR (see the official Comment le GIR est-il déterminé ?).

The grid records 17 activities, but only 10 decide the GIR. Each activity is coded A, B or C: A when the person does it alone, spontaneously and correctly; B when they manage only partially or irregularly; C when they cannot do it alone. The 10 variables discriminantes that feed the scoring cover coherence, orientation, washing, dressing, eating, elimination, transfers, moving around indoors, moving around outdoors, and communicating at a distance. The other seven, managing money, cooking, housework, transport, shopping, following treatment and leisure, are variables illustratives. They help shape the care plan, but they do not change the GIR.

The coding isn’t summed; it’s run through an official weighted algorithm (a decision tree) that outputs the group. In plain terms:

GIR 1: the most dependent, confined to bed or chair with severely impaired mental function and needing continuous presence, or end-of-life.
GIR 2: bed- or chair-bound with mental function partly preserved, or mentally impaired but still mobile (“dément déambulant”); needs help for most daily acts.
GIR 3: mental autonomy largely intact, partial physical autonomy, but needs help with body care several times a day.
GIR 4: needs help getting up, with body care or with meals, but otherwise moves about indoors.
GIR 5: needs only occasional help (washing, meals, housework).
GIR 6: autonomous for all the discriminating acts.

The boundary between GIR 4 and GIR 5 is the one that matters most in practice, because it is the line for the main benefit.

APA: the benefit AGGIR unlocks

The Allocation Personnalisée d’Autonomie (APA) is the core dependency benefit, and the GIR is its gate: it is open to people aged 60 or over, resident in France, in GIR 1 to 4 (see the official service-public.gouv.fr APA page). GIR 5 and 6 fall outside it (they may get smaller help through a pension fund). Income doesn’t decide eligibility; it only sets the co-payment.

APA comes in two forms. APA à domicile funds a personalised plan d’aide: home-help hours, teleassistance, respite for carers, assistive devices, meal delivery and small home adaptations. APA en établissement covers the dependency tariff (tarif dépendance) for a resident in a nursing home. Either way, the assessment and the money sit with the département. The conseil départemental’s équipe médico-sociale visits, scores the AGGIR grid, and, at home, proposes the plan d’aide.

Each GIR has a national monthly ceiling for the plan d’aide. From 1 January 2026 the à-domicile ceilings are €2,080.33 (GIR 1), €1,682.30 (GIR 2), €1,215.99 (GIR 3) and €811.52 (GIR 4); an income-based participation is then deducted, from nothing at low income up to 90% at the top. Those figures are re-set each year, so treat them as this year’s numbers, not fixed constants. For a fuller walk-through of how the APA amount is set and how to apply for APA à domicile, see the dedicated guide.

A worked example: from AGGIR to APA

Take Madame D., 82, living at home. On the médico-sociale team’s visit she needs help getting up in the morning and help with washing and dressing, but she moves about her flat unaided, eats on her own and her mind is clear. In AGGIR terms she is coded C on transfers, washing and dressing, but A on moving around indoors, eating, coherence and orientation. That profile — help needed to get up, with body care and meals, while otherwise mobile indoors — is the picture the grid’s algorithm reads as GIR 4.

Because GIR 4 sits inside the GIR 1–4 band and Madame D. is over 60 and resident in France, she is eligible for APA à domicile. Her plan d’aide is then built up to the GIR 4 monthly ceiling of €811.52, with an income-based participation deducted from it. Had the same visit found her fully autonomous on all the discriminating acts (GIR 6) or needing only occasional help (GIR 5), she would fall outside APA — the GIR 4 / GIR 5 line is exactly the boundary that decides it.

AGGIR or PATHOS: which ruler applies, and why nursing homes need both

AGGIR measures dependency: how much help with daily life a person needs. It does not measure the medical weight of their conditions. That distinction is why nursing homes carry a second instrument.

That second ruler is PATHOS. Where AGGIR describes loss of autonomy, a coupe PATHOS codes each resident’s pathologies and the care they require, and produces a picture of the medical care burden. Aggregated across a facility, the two give two averages: the GMP (GIR Moyen Pondéré) for dependency, and the PMP (Pathos Moyen Pondéré) for care load. They are combined into the GMPS with a formula that weights care more heavily than dependency: GMPS = GMP + (PMP × 2.59). The GMPS largely sets an EHPAD’s care funding.

Who does what: the facility’s médecin coordonnateur runs the coupe PATHOS with the team, and a doctor from the regional health agency (ARS) validates it. For software that means a nursing home isn’t only tracking GIR; it has to capture and export GMP and PMP too, because those numbers move the budget.

The system is being rebuilt (2024-2026)

The instruments above are stable. What sits on top of them is not. France is in the middle of a long reorganisation of how autonomy is governed and paid for, and several pieces landed or moved in 2024-2026:

A fifth branch of the Sécurité sociale for autonomy, run by the CNSA, has existed since the 2020 law that created it. It is the financing backbone for everything else.
The loi “bien vieillir” of 8 April 2024 is the enacted reform, not the long-promised and still-missing “loi grand âge”. Among other things it creates a Service public départemental de l’autonomie (SPDA), a single door per département for information and orientation, now rolling out unevenly across the country.
Home-care categories are merging. A 2023 decree folds the old SAAD, SSIAD and SPASAD into a single Service Autonomie à Domicile (SAD), in a help-only form and a help-and-nursing form, with services expected to meet the new national cahier des charges by the end of 2025 and to consolidate legally by 2028. Our guide to the Service Autonomie à Domicile reform unpacks what changes for operators.
EHPAD financing is being tested in a new shape: a 2025 decree runs an experiment in 23 volunteer départements (mid-2025 to end-2026) that fuses the separate “soins” and “dépendance” tariffs into a single global forfait paid by the ARS. It is still an experiment, not the national rule.

None of this replaces AGGIR or PATHOS. It changes who pays, through which door, and with what reporting. That is exactly the layer software has to track.

What it means for your software

For a home-care or nursing-home product in France, the assessment tools are only the start; the harder requirements are the digital-compliance rules wrapped around them.

Two are effectively mandatory. Télégestion, the electronic time-stamping of each home visit, underpins the contrôle d’effectivité that départements use to check APA hours were actually delivered. A 2024 decree fixed the reference period at no less than six months; our guide to télégestion and contrôle d’effectivité covers what that reporting has to prove. The Ségur du numérique programme requires the resident record itself, the Dossier Usager Informatisé (DUI), to be a Ségur-referenced solution that speaks the national plumbing: the INS (the qualified national health identifier), MSSanté secure messaging, and the feed to Mon espace santé / the DMP. The ESMS numérique programme has been funding this migration, with 2025 as the last year to commit the first wave of credits and a second wave (documents published in March 2026) running to a 2029 deadline; see our guide to ESMS numérique, Ségur and DUI conformance for the funding and compliance detail. The direction is moving from incentive to obligation.

Put together, a serious product has to do more than score a grid. It has to carry AGGIR/GIR and the plan d’aide, capture and export GMP/PMP for facilities, run télégestion with six-month effectivité reporting, and be a Ségur-referenced DUI doing INS-qualified identity, MSSanté and the Mon espace santé feed. Off-the-shelf packages move at their own pace on that list, which is often where the mismatch with your workflow appears.

Frequently asked questions

What is the difference between AGGIR/GIR and PATHOS?

AGGIR measures loss of autonomy: how much help someone needs with daily life. It sorts them into a GIR group from 1 to 6. PATHOS measures the medical care burden of their conditions. Home-care benefits key off AGGIR/GIR; nursing-home care funding uses both, combined through the GMPS.

Who assesses AGGIR, and who can get APA?

The conseil départemental’s équipe médico-sociale scores the AGGIR grid, usually during a home visit. APA is open to people aged 60 and over, resident in France, assessed in GIR 1 to 4; GIR 5 and 6 are not eligible. Income affects only the co-payment, not eligibility.

Is France switching to BelRAI or interRAI?

No. France’s national instruments are AGGIR (dependency) and PATHOS (care burden). interRAI has a research and pilot history in France and continues to draw interest, but it is not the mandated national tool, and there is no legal move to adopt it nationally. Treat “France is moving to interRAI” as speculation.

Does our software need to change?

Usually yes. Beyond scoring AGGIR, a French home-care or nursing-home product is expected to run télégestion with contrôle d’effectivité, export GMP/PMP where facilities are involved, and be a Ségur-referenced DUI that handles the INS, MSSanté and the Mon espace santé feed. These obligations are tightening, not loosening.

Each part of the French system above has its own deep-dive:

When the assessment changes, your software has to keep up

France turns care-needs assessment into structured data: AGGIR, GIR, GMP and PMP. That data has to move between the département, the ARS and the national digital-health systems, under rules that keep shifting. Off-the-shelf software can lag behind that kind of operational detail. AppSky builds software for home-care and nursing teams, where assessment, care planning and billing sit in one flow and can follow the rules as they change. Building Domihome, the detail that surprised us most was how much of an operator’s week goes into keeping the plan d’aide, the télégestion log and the billing export telling the same story — which is why we designed those three to share one record rather than three. See what we did for Domihome, or book an intro call.

This guide is informational and not billing, legal or medical advice. France’s autonomy rules and its digital-health obligations are evolving, and several 2024-2026 reforms are still in transition. Confirm current rules and figures with the official sources, including pour-les-personnes-agees.gouv.fr, the CNSA, and, for the digital requirements, l’Agence du Numérique en Santé. Last verified 12 July 2026.

AGGIR, GIR and APA: how France funds home care

AGGIR and the GIR groups