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ELDERLY-SERVICE

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geriatrie

Dr Pierre Guillet Chronicle: The five pillars of successful aging - Chap.1
Advancing the space of healthy life

We are, today, the parent of the person we will be tomorrow. Gerontology, which is the science of evolution of living beings in time, also serve to reflect on this future. This reflection allows to prepare, based on past history and the realities of the day, what we can become with age. It includes prevention, that is to say, how to organize themselves to avoid a bad aging. The area of healthy life, that is to say life without self need anyone to ensure the actions of everyday life is to progress.

What are the pillars of a successful aging? What should you be careful, how to fix problems before it's too late? The answer to these questions came to me after a thirty years experience in general medicine, the Association of Gerontology of the thirteenth arrondissement of Paris, in a study of the main reasons that cause one day, suddenly in this or that person an abrupt change of life and an entry in the dependency. Most of the time, said older people just ask for a partial relief, regardless of their overall living conditions. Now life is moving in a succession of periods of equilibrium and crises rather than dispersing aid throughout the aging is mainly the crisis we must focus our attention. Although analyzed, they can afford to find another balance health as good as before for the person and his entourage. While unforeseen or aggravated by clumsy aid, they are to create situations of loss of autonomy.

We call frail difficulty or inability to provide only the basic needs of life: drinking, eating, elimination, but also wash, dress, and beyond, maintaining the house, manage accounts, shopping and meet other people. All of these disabilities is addictive and there are fears of old age. It may, for various reasons linked to disease or inadequate living space, needing outside help once or several times a week: it is a small frail. If you need daily assistance for many tasks, it is an average loss of autonomy. Finally, the great loss of autonomy is defined by the need to be helped 24 to 24 hours on his home or be placed in institutions, often called médicalisée.Ce assistance to old age does that on extreme periods of life, where a dependency is already apparent. Although it softens, but does not change the duration.

The gerontological balance sheet aims to identify a set of elements that determine the proper age of an individual. Then, a "dialogue" between family members, medical responders and / or social and the individual itself, enabling the latter to understand where she is, what it can count. That gives him time to be accompanied to navigate his life. See, for example, that housing is inadequate does not necessarily mean that we accept his amendment without fear. As with other life changes, it will reflect a maturing.

It is architecture that gave me the idea of "Pillars". Controlling the strength of buildings such as palaces of Venice and the Bridges of Paris requires regular monitoring of the most important pillars. Similarly, we can not consider a "successful aging" without a permanent control of the "pillars" that support the most important daily life, namely resources, housing, health, social and emotional life. In humans, only the physical health, been more or less regular assessments. But health is not the only pillar of balance of good aging. It should be read in a broader context.

Successful aging requires a harmony between health, desire and pleasure of living and ways of living. It is a balance between risk and lifestyle choices, between an individual and his environment, and each of these terms is as important as others. We will see in future columns the importance of these five pillars.

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Comment by khelil omrane on August 23, 2010 at 10:45am

The pain in the elderly
Summary of discussions organized by the North West Metropolitan LINC February 26, 2010

Jean FoucartLe Friday, February 26, 2010, John FOUCART, Doctor of Sociology, Lecturer in Social Department of the Haute Ecole Charleroi-Europe, speaking at the agglomeration EPSM Lille-Site Lommelet Marquette-lez-Lille, the Theme: "Suffering in the Elderly" as part of the 16th conference-debate organized by the LINC Metropolitan North West.

"I'm interested in issues related to suffering over the past fifteen years. I asked myself the question of suffering, my positioning as a sociologist. I actually wrote a first book entitled "Sociology of suffering."

Suffering is always true, but it came on the front of the social scene there are about a quarter of a century, 25 years at most. Previously, the pain was within the private sphere. Today we speak of the suffering of the elderly, but also the suffering of social workers, the bus drivers who feel constantly assaulted, "burn out", etc..

The common denominator in this scene of suffering: a precarious social
Suffering: The sociological perspective

In the preamble must admit that if we speak of suffering and elderly, we do not need to establish a link. We must not establish a link between objective conditions and suffering. Indeed, being a senior does not mean being in pain. Similarly being unemployed may be a source of suffering for 90% of people, but still 10% of people who themselves, may be pleased not to go to work at the plant each morning!

We can not identify the pain and suffering. Great athletes admit they go after themselves, even pain, but there is no real pain because they enjoy and to excel. They inflict pain. So pain is not always a source of suffering. Here we see that everything depends on the project within which the person. Consideration of context is essential.

Speaking of suffering, and requires the intervention of the context, the project. What characterizes the pain is really unbearable notion.
Suffering is the unbearable, "the in-integrable, what did not make sense, what I can not give meaning.
"The unbearable is the in-integrability of the impossibile" says Levinas.

Sociology examines how the relationship between actors are built, and should make this link between the unbearable and the construction of social relations.
The concept of transaction is essential.
A transaction is a set of actors who connect, build a life together and yet separate because they have different interests. My hypothesis is that the unbearable is unable to build a "living together", with its microphones compromise that structure everyday life.
What is the elderly? Who is the elderly?

Ageing and Materiality
Today we talk of old age, seniors, retirees ... more poetically we say "these people who arrived in the autumn of life, and more brutal" at the end of the trail. The words we use are important, which leads me to say that to analyze the term "elderly" must adopt a constructivist theory. The use of the term "elderly" is the result of a social construction.
Of course we must not forget that there is also a parallel connection with a materiality (eg physical problems related to old age).

One aspect of this social construction is the transformation of a physical element of the elderly, such as a certain loss of physical strength into social property.
According generations, centuries, eras, some aspects are more important than others.
The loss of physical force at the time of the Merovingian was a true sign of old age.
The man was losing value. The companies valued the oral memory and the status of the elderly. These people represent "memory" could feel valued. Today we are more in a recovery of the written word, and we no longer need this memory.
Another aspect may be some alteration of features: Renaissance conveyed a certain ideal of beauty, where the old had no place. Ronsard speaks of old age "shameful."
At the time of ancient Greece, in the same vein, Euripides spoke of "Age sad" and "The Old odious gathers all evils."
Unlike the Middle Ages, he, gave a much more enviable status of the elderly.

The material can occur at a micro level office. The aging couple will have to rebuild his life by taking into account aspects related to old age suffered.

Ageing and Social Structure

Many historians have been interested in the link between old age and social structure. They were interviewed and noted the importance of looking down on the elderly. The report to the elderly is linked to many different factors.
Ex: In the 14th century the plague killed millions of people and strangely it largely spared the elderly. Thus, the "group" of elderly has become more important than that of young adults and has regained some political and economic power.

Another example: In the 16th and 17th century, a hundred great artists, to mention that Michael Angelo, 70% were seniors.

Old age is the result of a social construction.

In sociology it is still investigating how reality is constructed. A reality is not always seen / read as a problem. Ex: poverty has not always been as a problem in the United States, according to times.

Speaking of social problem is appoint people, classifying people and empower them or not. How does one class seniors?
Isolation elderly - photo credit fotoliaLa pain in the elderly

Since the end of the last century life expectancy has increased tremendously. It now has a fourth category to speak of old age: The third category is 60-65 years or people up to age 75 (but beware, these figures are not official!), And then we pass the 4th grade. The crux of the social problem affecting this fourth category is the dependence. The dependence is when the elementary acts of daily life can not be achieved alone. But sociologists have observed that people could manage a radically different way the issue of dependence, their cultural level, social position, their life history (trajectory), income level, etc.. And these are the people of a lower social level, those with fewer resources, etc.. that will be truly "trapped" by addiction.

The sociologist Anne-Marie Guillemard, speaks of "social death" to describe the situation of these people with few resources at the age of dependency.

What is the social construction of old today? How the name? In his book "The vulnerable. Democracy against the poor, "Helen Thomas, professor of political science, a sociologist and psychoanalyst, including how you cut the now elderly, poor and dependent, exercise their human rights and fundamental freedoms. She described their treatment that combines "close protection" and remote control with individualization and psychologizing of their condition.

Isolation elderly - photo credit fotoliaDans his book "The frail elderly between hospitalization and hospicialisation," she warns against the excesses of the system. It describes the whole series of protections that have developed as an extension of the phenomenon "hospice". She uses the term "voluntarily" hospicialisation ": arranged word derived from word" hospice "where previously there were placed the elderly which we did not know how.
It was a place with a model disciplinary hygienist, coercive, based on maintaining "economic and physical indigent elderly.

We talk of social protection, to help people, to protect people ... Sometimes willingly or by force, when there is no agreement thereof.
And what are the elderly poor, who have a weakness in the economic and cultural resources, which are mainly affected by this phenomenon of "hospicialisation.

The old defined as dependent, vulnerable, lonely, or incapable adults, would be put under protection to preserve their dignity. But we will achieve not perverse?

The problem of the heatwave in 2003 has fueled the image of the elderly person who was "outside", which no longer had social ties, no family, etc.. Yes there so people "désafilliées" as the sociologist Robert Castel calls: a person "désafilliée" no longer has contact with his immediate family, his environment (neighborhood, etc..). But in reality these people are a minority. 80% of people continue to have a network of professional relationships and "profane" (family, friends ...).

Regarding the phenomenon of "hospicialisation, conversely we will talk about" super affiliate "means the persons concerned are not excluded, we care about them too and this is also the problem! Institution where they are in their homes, they are surrounded by a dense network (family, friends, etc. ...) which exercises control over them important enough. It merged with the concept of dependence.

In France there are 210,000 Aids-Family, it is 99.99% of women. The average age is 43 years and 50% of these people have no qualifications. And there are sometimes that can create a real dependence between the senior and caregiver, so that the elderly can not even express gestures of gratitude. It will just suffer.

In the case of "super affiliate", everything is decided by the caregivers, family and social surroundings.
Do not forget that "Hell is paved with good intentions." We try to do the best for the person, but the disappropriated his choice and that's where we can speak of suffering. There is a dependency vis-à-vis the family circle, professional ...

This suffering is the inability to find the individual to construct microphones constituting the everyday compromises, build transactions. Suffering then is the psychological aspect of this "change transaction" or breach of conditions of trust. The situation is a little old man that the psychiatric internment.
The pain is related to impotence. If I'm in a situation that is unbearable, I will put in place strategies to get out, and the height of suffering is not to be allowed, the capacity of self-construction strategies.

The complaint is a mode of physical expression or word that is used when one is in a position of powerlessness. In other cases there will be violence as a mode of expression of impotence.
To help a person suffering, we must start from the complaint and not be based on objective requirements or projections (ex: This is not because "I" I fear the retirement home that I'm projecting my fear on the other. Everybody is not unhappy to settle in a retirement home, far from it!).

Some authors have reported that too often, we disqualified the complaint, we analyzed as a result of a depression, a sign of old age. Sometimes we hear of someone "He did not realize how lucky he is! . Or they will translate the complaint in a medical or psychological language, so that suffering may be linked to a set of social problems.

Download the document suffering in the elderly

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