Les unités de soins spécialisés Alzheimer : une seconde peau psychique ?

Abstract

Context

Based on our clinical experience in gerontopsychiatry and on psychoanalytical concepts, we wish to discuss the therapeutic effects of specialized Alzheimer care units on the subjects they accommodate.

Objectives

In the context of a public health problem, these units have developed particular characteristics and aims, in order to attempt to respond. Their therapeutic role is not self-evident and it can be effective only under certain conditions. Through this reflection, we attempt to identify the operators of the processes of changes in psychic functioning and to understand which conditions allow them to be deployed. When these conditions are absent, these units can crystallize certain excesses, whether at the institutional or the individual level.

Method

This reflexion is based on the concept of the « Moi-Peau » (the Self-Skin or the Skin-Self), here used to clarify the functions of symbolization and interface, but also their toxic effects when the counter-transference invades the relationship. When these special care units function as a transitional area, they can support the psychological dynamics of symbolization and exchanges in demented subjects, and can bring about therapeutic effects on behavioral disorders. When this transitionality is not effective, these units become a place of confinement where the balance between life and death is lost, which can lead to the intensification of the dementia process and the loss of relational links.

Results

This reflection opens up avenues of research, both qualitative and quantitative, on the functioning of these units, which are bound to develop in response to the increasing number of people suffering from dementia ias the population ages.

Conclusion

It's the way in which these units are invested that allows them to have their therapeutic character. Therefore, it's necessary to develop knowledge about how Alzheimer units are investing in order to adjust care strategies to the characteristics of this population and to support people with dementia and behavioral problems.