[Caring for a person affected by Alzheimer's disease: specific aspects of grief in family caregivers and their social support].
Alzheimer's disease (DTA) leads to some behavioural, physical and psychic modifications in the patient that the natural helper (family-spouse-child) will have to face throughout the course of the disease. The authors have tried to identify the nature of losses experienced by helpers so as to bring out some preventive and curative support tracks. This preparatory research-action was conducted with 27 families through semi-directive conversations which enabled to reveal their difficulties (somatic-emotional-affective-organizational), their reactions of adaptation in echo with the losses of the patient along the course of the DTA as well as the elements enabling to maintain or not the ill person's family/close relation link. The analysis of obtained results is proposed according to the concepts of adaptation, affection and separation, systemic approach and coping. The comments and behaviours of helpers are put in relation with the symptoms of mourning as well as with the medical interactions, helper or not. Five chronological times were identified (before diagnosis-moment of the diagnosis-keeping at home-admission in institution-life in institution). The period of white mourning (connected to the loss of the recognition of his/her close relations by the patient) is mainly felt as a vector of suffering. As part of the dynamics of social support, the proposed tracks of nursing interventions mainly target the admission and life in institution; their aim is to offer an adapted support to natural helpers, whether they make the choice or not to support their close patients throughout the institutionalization. In appendices, all the key ideas helping to track down the elements contributing to maintain the ill person's helper/close relation link or accelerating his/her breaking down.
Hôpital Corentin-Celton, APHP.
Evelyne
E
Malaquin-Pavan
Marylène
M
Pierrot
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology; D002755:Choice Behavior; D005190:Family / Q000523:psychology*; D005260:Female; D006117:Grief; D006302:Health Services Research; D006701:Home Nursing / Q000523:psychology; D006801:Humans; D007326:Institutionalization; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D011368:Professional-Family Relations; D012649:Self Concept; D012944:Social Support; D011795:Surveys and Questionnaires; D013997:Time Factors