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This article compares the organisation of social support to disabled or ill older people in England and France. Data from respective surveys representative of the urban population of over 75s living in their own homes reveal strong similarities between the demographic profiles of the two countries. Residential proximity and frequency of contact between elderly parents and their children are very similar. Both countries appear to have the same distribution of support given by family and professionals. More than one third of over 75s who receive a form of support linked to their ill health depend uniquely upon their families or personal social networks and one half have both types of intervention. The independent and voluntary sectors however, traditionally more developed in England than in France, play a greater role in the delivery of services in England. In France, unpaid help is first and foremost family help, either by a spouse or children. In England, forms of voluntary support and help given by children appear to account for a greater proportion of support given to over 75s than support given by spouses. These differences may be due to strategies for supporting carers which have been in place longer in England than in France.