[Elderly patients suffering from dementia in nursing homes: a daily challenge for nurses]. / Les personnes âgées atteintes de démence en établissement médico-social: défis quotidiens pour les soignantes.

In partnership with the EMS of French-speaking Valais, Switzerland, this study has brought to light certain characteristics in the care of elderly patients suffering from dementia. The interviews were conducted between two professional groups: 19 certified nurses' aides (CNA) and 19 registered nurses (RN). The medical facilities were investigated on the basis of psycho-sociological representations, time, professional security, interactions, the types of services offered, and work satisfaction. The CNAs confuse the depictions of aging and dementia, which corresponds to the belief of the general public. The RNs identify with a professional ideal which, as a consequence, fails to differentiate between the individuals who have been treated. These accounts give a reliable perspective for the two professions, but also serve as a screen for the diversity of situations involving elderly patients suffering from dementia. Concerning the time needed for the supplementary workload, the CNAs and RNs favor its efficiency, and the time needed is justified by the end results. The nurses' aides go about their work essentially on the basis of the tasks and services required by the institution, which is largely inspired by the hospital model. Confronted by the unconventional behavior of the residents suffering from dementia, the risk of assault results in deliberations for CNAs, whereas the unpredictability of the situations is fundamental for RNs. The lack of security measures is equally due to the shortcomings of the medical profession regarding dementia and the specific types of care required. These interactions, while regarded as essential by both CNAs and RNs, are not considered therapeutic, despite the fact that communication is a primary function! Both groups share the types of care offered. Ils limitations are chiefly in the area of satisfaction regarding psychological needs. This health-care project is better able to answer the needs of institutionalized patients rather than in providing individual attention. CNAs and RNs are said to be satisfied by their work with patients suffering from dementia with regards to its utility and professional ideal. In conclusion, the particulars of health care are first of all relative to the context (structure, make-up of personnel, type of residents), relying to a lesser degree on the kind of training obtained by the health care professionals.

[Palliative care network and the elderly: what autonomy do they have?]. / Soins palliatifs en réseau et patients âgés: quelle autonomie pour eux?

Several Swiss institutions of a socio-sanitary region have put together a network with the view of assuring efficient palliative care. A research was conducted in partnership with four health-care establishments in order to verify if the concept of autonomy conceived by professionals corresponded to the patients' needs. Semi-directive interviews were conducted, along with questionnaires. The analysis showed a considerable disparity between palliative philosophy and the real needs of elderly patients. The aging process experienced by the people interviewed was synonymous with illness, loss, suffering and quality of life are associated with youth. The dimension of the projects and partnerships is difficult for them to imagine.