A new term has been coined to refer to social and medico-social work with seniors and people with disabilities: “autonomy policies”. The idea is not simply to more broadly encompass traditional sectors but to situate action in its local and territorial dimension and thus connect it to the paradigm of the inclusive society. But are we witnessing a true cognitive transformation among players in the field? On the basis of an empirical study of policies, systems and support practices for seniors and people with disabilities in two French departments, this article provides a nuanced response to that question. Local policies towards these populations do indeed appear to be informed by the desire to innovate and transform conventional care approaches. Organisation structures and services are being decompartmentalised and growing closer to users, and territories are mobilising. These evolutions are nevertheless hindered by the approaches of specialised sectors – which continue to dominate – and it is proving difficult in practice to build action on the basis of individuals and their particular needs and life projects.