Estimated at 2.5 million in 2015, the population of dependent older people could reach 4 million by 2050. Despite the desire of French authorities to promote a “shift towards home”, établissements d’hébergement pour personnes âgées dépendantes (Ehpads, “residential establishments for dependent elderly people”) play a central role in the provision of care, as they now accommodate around 600,000 residents, i.e., 15% of the over-80 population living in France. The overall volume of public expenditure allocated to care and dependency in Ehpads increased by 30% between 2011 and 2019 – almost three times faster than GDP – reaching €11.24 billion in 2019. However, this significant increase in expenditure was not sufficient to meet the needs of an increasingly fragile segment of society. When considering the challenges of adjusting services accordingly, there seems to be a need for a better understanding of the development of conditions linked to dependency in the population, in order to anticipate future needs and to design plans able to meet the challenges. With this in mind, the Court suggests better integration of Ehpads into the territories, and strengthening medical care within them, as well as the quality approach.