The caregiver reference applicable in 2026 is not just a pedagogical update of the state diploma. It is linked to a text that modifies its practical scope: the decree of June 26, 2026, setting the new list of nursing acts. This second text expands the scope of what nurses can delegate, and by extension, what caregivers are expected to perform on a daily basis. Understanding this mechanism requires reading both texts together.
Decree of June 26, 2026, on nursing acts: the text that changes the game for caregivers
Most available content treats the DEAS reference from the decree of February 26, 2025, as if it solely encompasses the new caregiver acts for 2026. The regulatory reality is more complex.
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The decree of June 26, 2026, increases the list of nursing acts from 46 acts to 72 acts, divided into four categories: independent role, acts on prescription or protocol, acts on prescription with possible medical presence, and participation in medical acts. This expansion of the nursing scope has a direct consequence on the caregiver profession.
Several actions previously strictly reserved for state-certified nurses can now be subject to a structured delegation under nursing protocol. It is this IDE/AS collaboration mechanism, backed by the new acts decree, that constitutes the real change of 2026. The DEAS training reference prepares future graduates for these actions, but it is indeed the June 2026 decree that opens the legal possibility.
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To master the caregiver reference 2026 to know, one must read the DEAS reference and the nursing acts decree as two parts of the same system.
Technical acts under protocol: what IDE/AS delegation implies in practice
Delegation under protocol is not a completely new concept. What changes is its extent and structure. The 2026 framework formalizes situations where the caregiver intervenes in technical care (simple dressings, monitoring parameters, certain medication administrations) provided that a protocol written by the nurse frames each action.
This logic relies on three cumulative conditions:
- A written protocol, validated by the referring nurse, describing the action, its limits, and alert criteria
- A prior assessment of the caregiver’s skills by the care team
- Traceability in the care record, with systematic feedback to the nurse in case of anomalies
The protocol does not turn the caregiver into a nurse. It structures a collaboration where each professional remains within their area of responsibility. The nurse prescribes and supervises, the caregiver executes within a defined framework. Field feedback varies on this point: some facilities have already refined this organization, while others struggle to formalize protocols due to a lack of available nursing time.
Updating skills for caregivers certified before 2021
The 2026 reference primarily concerns students in initial training. For professionals already in position, the situation depends on the date of diploma acquisition.
Caregivers certified before the decree of June 10, 2021 are the first to face a need for updating. Their initial training did not include the skill blocks introduced by the DEAS reform, nor the dimension of technical collaboration with the nurse as it is now emerging.
Several organizations offer short updating courses. The Croix-Rouge Compétence, for example, structures these pathways around targeted modules. The format favors sessions of a few days, compatible with maintaining employment. The content focuses on delegable technical acts, contributions to the care record, and digital tools in health.
A training effort that largely relies on establishments
The available data do not allow for a conclusion on the actual rate of already trained professionals. The funding for these updates comes through the training plans of establishments, the personal training account, or branch schemes. In a context of pressure on caregiver staffing, freeing up training time remains a major organizational challenge for facility management.
DEAS 2026 reference and level 4: what the upgrade modifies in training
The state diploma for caregivers is now classified at level 4 of the national certification framework, equivalent to the baccalaureate. This upgrade is not cosmetic. It translates into a structure of independently assessable skill blocks, an increase in the volume of clinical internships, and a strengthening of theoretical teachings.
Among the strengthened axes:
- Clinical evaluation: structured observation of health status, identification of alert signs, targeted communication to the nurse
- Clinical reasoning: ability to relate observations to care situations, to adapt practice based on context
- Digital health: use of patient record software, computerized traceability of acts, compliance with GDPR
This transition to level 4 repositions the caregiver as a fully-fledged health professional within the care team, with assessed and documented skills. It also opens pathways to other training in the health sector in the long term.
Legal responsibility and new caregiver acts: an area to clarify
The expansion of the intervention scope raises a question that the current texts do not fully address: where does the responsibility lie in the event of an incident regarding a delegated act? The legal framework relies on IDE/AS collaboration, where the nurse assumes responsibility for the protocol they write and the caregiver for the compliant execution of that protocol.
In practice, the boundary can become blurred. A caregiver performing a technical care without an updated protocol, or in a clinical context that exceeds the intended framework, exposes themselves to legal risk. The MACSF reminds that the nurse/caregiver collaboration must remain framed by written and traceable protocols.
This legal dimension deserves to be better integrated into updating training. Professionals in position who expand their practice without a formalized framework find themselves in a gray area that neither the DEAS reference nor the June 2026 decree explicitly cover.