[Procedures of therapeutic action in geriatric psychiatry (apropos of dementia states)].
In order to exist, geriatric psychiatry must have its roots in action to help the patients, the family and the caring staff. This approach to psychiatry must be directed both at the present situation of the patient and at the future of the disease. However, in order to act, one must introduce a meaning and a direction which become determined through action. In this context, the symptomatological approach is often hindered by a tendency to over-simplification and reductionism due to terminological flaws and to the inadequacy of its underlying rigid concepts. Such an approach is hindered also by the very nature of a type of medical practice, which establishes the observation of behaviours before making a therapeutic decision and starting treatment. Thus we can contrast two therapeutic procedures in relation to the dementias. On the one hand, a classical view which procedes from diagnosis to treatment. Its aim is to develop precise etiological and physiopathogenic references. Its objective is to eradicate disease and obtain a cure. On the other hand, another--contemporary and complementary--approach begins at the point of the patient's difficulties. These difficulties define the therapeutic aims, and from these, the appropriate symptomatology can be selected. This approach puts an emphasis on care and rehabilitation. It constantly throws back upon us the need to think about the quality of our work and allows us to avoid a clumsy use of the available resources. It provides the basis for the development of new alternative knowledge and introduces a new spirit into medicine from which demented patients will surely benefit.
Richard
J
J
D000368:Aged; D001925:Brain Damage, Chronic / Q000628:therapy; D003704:Dementia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006801:Humans; D009483:Neuropsychological Tests; D010347:Patient Care Planning
Les procédures d'action thérapeutique en psychiatrie gériatrique (à propos des états démentiels).