France

International Women's Day: Doctor with a different approach to end-of-life care

Dr Nicole Mourain-Jacquin is the co-founder of Anggel’Dom which offers a system designed to facilitate the sharing of medical data of elderly persons living at home, via a tablet.
Dr Nicole Mourain-Jacquin is the co-founder of Anggel’Dom which offers a system designed to facilitate the sharing of medical data of elderly persons living at home, via a tablet.PHOTO: ANGGEL'DOM

PARIS -  “I didn’t want to put my 86-year-old mother in a cold, impersonal place where the staff are overstretched,” said Mr Jean, a 58-year-old bailiff from Greater Paris.

Instead, last July, he called upon Anggel’Dom, a home-based care service that is designed to improve living conditions for elderly people wishing to remain in their own homes.

Launched in 2017, there are four co-founders behind this nascent project, one of whom is Dr Nicole Mourain-Jacquin, 64.

“Once I get an idea in my head, I have to see it through”, Dr Mourain-Jacquin said.

That’s somewhat of an understatement. When she was 25, she successfully defended her thesis in general medicine and embarked on a career in geriatric medicine at a hospital in Paris, before setting up on her own at 50. Now retired, she has set her sights on revolutionising home-based care.

Empathy and patience

Having spent a quarter of her life in hospitals, Dr Mourain-Jacquin decided to go back to school in 2002 when she was 49. The mother of three enrolled herself in the Ecole de management des medecins des hopitaux (School of Management of Hospital Doctors) in Paris.

After graduating, she managed various retirement homes in the French capital. But as a strong advocate of “empathy and patience” with the elderly, she found herself confronted with a mentality of “filling spaces”. Six years later, she became a geriatrician, a profession that she had already been practising part-time.

Passionate about her job, Dr Mourain-Jacquin nevertheless lamented what she saw as a culture of “hypocrisy around the subject of end-of- life” in France. The question was “often taboo and is rarely raised by doctors, despite its primordial importance; especially given that France has an ageing population”, she said.

Determined to help make up for these failings, in 2010, she founded the National Association of Geriatricians and Gerontologists - Liberal Professionals, which she presided over for six years.

 

This group came up with a system designed to facilitate the sharing of medical data of elderly persons living at home, via a tablet. Through this technology, medical practitioners who visit the patient at home - doctors, physiotherapists, dentists - could record various data such as prescriptions, heart rate and recent incidents. This enabled them to keep one another updated.

Since the tablet was connected 24/7 to a specialised platform, both family and doctors could be informed of any problems. The system helped limit unwanted hospital stays, as well as over-medication. In 2016, it was tested on 30 patients over an 18-month period.

Population growth

The findings were conclusive. Dr Mourain-Jacquin and three of her collaborators - one of whom was her husband - decided to commercialise the service under the name, Anggel’Dom. It was an arduous task, hampered by “lengthy administrative procedures”, which finally met with success in May 2017.

Initially limited to a few departments in the Greater Paris region, the start-up had recently spread to the capital and had a dozen clients on its books, scattered between Paris and Neuilly, which is west of the capital.

Dr Mourain-Jacquin was optimistic about the project, especially when she compared the cost of Anggel’Dom (starting from 180 euros or S$294 per month) with the fees of a place in a retirement home.

Dr Philippe Taurand, geriatrician at Simone Veil Hospital in the northern suburbs of Paris, said he saw the development of this type of home-based care as a very positive step.

Given “huge population growth, what elderly people want for themselves, as well as current technological progress”, this type of initiative was even a “necessity”, he concluded. 

Passing on our stories

In setting up this service, Dr Mourain-Jacquin hoped to not only improve end-of-life care for the elderly - as she did for her own father, who died in 2017 - but also to prevent them from being neglected by their relatives.

The retired doctor was convinced that “every elderly person has a story to tell” and regretted that “knowledge that could be passed down from generation to generation was being lost”. 

Her hope for the coming years was to extend the scope of Anggel’Dom to people with disabilities and those suffering from chronic illnesses, both in France and internationally.

It’s a natural step for Dr Mourain-Jacquin who, for the last seven years, has been dividing her time between France and Morocco - a destination she chose for its gentle pace of living, and proximity to Paris.