[Refusal of care by the elderly]. / Le refus de soins en gériatrie.

Refusal of care is a frequent occurrence in geriatric medicine, especially among people with neurocognitive diseases, particularly in the advanced stages. These refusals of care are a daily burden, not only for the patients themselves, but also for their carers and caregivers. Although they can be prevented, the absence of a single, simple strategy for overcoming them is a real challenge for professionals and carers alike. Their management calls for an approach that is essentially non-pharmacological, always interdisciplinary, humanistic and ethically grounded.

[Design of information tools on technical aids for front-line professionals working with people losing their autonomy]. / Conception de supports d'information sur les aides techniques pour les professionnels travaillant auprès de personnes en perte d'autonomie.

The use of technical aids has a positive impact on the autonomy and quality of life of elderly or disabled people, and is also beneficial for the caregivers and professionals who support them. Nevertheless, there are still major obstacles to their use, notably a general lack of information on technical aids. This observation led us to produce a set of information tools to help people better understand these aids and how to use them.

Consent and Inclusion of People Living with Dementia (PLWD) in Research: Establishing a Canadian Agenda for Inclusive Rights-Based Practices.

BACKGROUND: People living with dementia (PLWD) may want to participate in research, but the guidelines and processes enacted across various contexts may prohibit this from happening. OBJECTIVE: Understanding the experiences of people with lived experiences of dementia requires meaningful inclusion in research, as is consistent with rights-based perspectives. Currently, the inclusion of PLWD in Canadian research is complex, and guidelines and conceptual frameworks have not been fully developed. METHODS: This research note outlines a three-year proof-of-concept grant on the inclusion and consent of PLWD in research. FINDINGS: It presents a brief report on some of the contradictions and challenges that exist in legislation, research guidelines, and research practices and raises a series of questions as part of an agenda on rights and inclusion of PLWD in research. DISCUSSION: It suggests conceptual, legal, and policy issues that need to be addressed and invites Canadian researchers to re-envision research practices and to advocate for law and policy reform that enables dementia research to align and respect the rights and personhood of PLWD.

[Meleis theory: a tool for better understanding city-hospital transitions]. / La théorie de Meleis : un outil pour mieux comprendre les transitions ville-hôpital.

Meleis' theory: a tool for better understanding the hospital/town transitions. The purpose of this article is to provide a critique of the transition theory conceptualized by Afaf Meleis. A clinical vignette is used to highlight the strengths and limitations of the theory in the care of elderly people returning home after hospitalization for heart failure. The discussion is based on Peggy Chinn and Maeona Kramer's method of critical analysis.

[Preventing emotional disorders in the elderly with programs based on cognitive-behavioral therapies]. / Prévenir les troubles émotionnels des personnes âgées avec des programmes fondés sur les thérapies cognitivo-comportementales.

The cognitive-behavioral approach is particularly well-suited to older people who are looking for a short-term therapeutic solution to many emotional problems, without necessarily resorting to psychotropic drugs. One of the major advantages of this type of psychological treatment is that it helps seniors develop coping skills that can be beneficial in both the short and long term. However, some adjustments are sometimes necessary to achieve this goal.

[Better identifying and understanding post-traumatic stress disorder in the elderly]. / Mieux repérer et comprendre le TSPT du sujet âgé.

Post-traumatic stress disorder (PTSD) is particularly common in the elderly, including those with cognitive impairments. We need to stress the importance of early detection to better understand the specific signs of this disorder in the elderly. Psychotherapies such as cognitive-behavioral therapy and Eye Movement Desensitization and Reprocessing are being explored for their effectiveness and adaptability with the elderly. Identifying post-traumatic stress disorder should be a shared responsibility, for the mental health of the elderly.

[A post-Covid-19 approach to loneliness and isolation in old age]. / Approche post-Covid-19 de la solitude et de l'isolement au grand âge.

The Covid-19 pandemic has accentuated loneliness and isolation among the elderly, affecting their physical and mental health. The post-Covid-19 approach needs to strengthen early detection of loneliness and isolation while promoting social engagement.

[The supportive environment in SRH: characteristics that promote self-determination]. / L'environnement soutenant en SSR : les caractéristiques qui favorisent l'autodétermination.

Hospitalization is an important stage in the life of the elderly. All too often, this experience is accompanied by both physical and psychological decline. Based on self-determination theory, the aim was to qualitatively characterize support for self-determination in follow-up care and rehabilitation services (behaviours and attitudes of healthcare professionals, and patients' perception of them).

[Sexuality among the elderly: understanding the weight of stereotypes]. / Sexualité chez les personnes âgées : comprendre le poids des stéréotypes.

Sexuality is an integral part of health and accompanies human beings throughout their lives. It contributes to well-being and improves quality of life. The social representations conveyed by Western society modulate sexuality and can play a decisive role in the expression of seniors' sexuality.

[Addictions in the elderly: the viewpoint of an IPA working in EMPSA]. / Les addictions chez le sujet âgé : regard d'une IPA exerçant en EMPSA.

Many elderly people live well and at home, but some require somatic and psychiatric care. Mobile psychiatric teams for the elderly are called upon to intervene with people aged 65-70 and over who are experiencing psychological distress. Among senior citizens, addictive disorders are very common, and are associated with psychiatric and geriatric co-morbidities. Alcohol, tobacco and benzodiazepine use disorders require holistic, individualized care, based on identification, prevention and referral, as well as training and coordination of professionals and caregivers.

Risk Factors Associated with Missing Incidents among Persons Living with Dementia: A Scoping Review.

Worldwide, over 55-million people have dementia, and the number will triple by 2050. Persons living with dementia are exposed to risks secondary to cognitive challenges including getting lost. The adverse outcomes of going missing include injuries, death, and premature institutionalization. In this scoping review, we investigate risk factors associated with going missing among persons living with dementia. We searched and screened studies from four electronic databases (Medline, CINAHL, Embase, and Scopus), and extracted relevant data. We identified 3,376 articles, of which 73 met the inclusion criteria. Most studies used quantitative research methods. We identified 27 variables grouped into three risk factor domains: (a) demographics and personal characteristics, (b) health conditions and symptoms, and (c) environmental and contextual antecedents. Identification of risk factors associated with getting lost helps to anticipate missing incidents. Risk factors can be paired with proactive strategies to prevent incidents and inform policies to create safer communities.

Employee Experiences Providing Nutritional Care during the COVID-19 Pandemic.

Nutritional care is a critical, yet often overlooked component of quality care in long-term care (LTC) that is linked to culture, socialization, and residents' psychological and physiological well-being. Given that several COVID-19 infection control protocols affected nutritional care, this study aimed to understand employees' experiences of these changes. Seven semi-structured interviews were conducted with Saskatchewan healthcare employees from several disciplines, all of whom had a role in supporting nutritional care in LTC. The resulting interview transcripts were analyzed using reflexive thematic analysis. Three main themes characterized the interviewees' reflections: regression to an institutional mealtime environment, unrealistic expectations, and concern for residents. Given the centrality of nutritional care to quality of life, strategies tailored to support staff in providing relationship-centered nutritional care must be further articulated to maintain standards of care for LTC residents in future outbreaks and epidemics.

[The nurse and psychotic disorders in neurocognitive diseases]. / L'infirmière face aux troubles psychotiques au cours de maladies neurocognitives.

Psychotic disorders, such as delusions and hallucinations, cause stress for individuals, their caregivers and healthcare professionals. Attitudes, perceived as behavioral tendencies, in the presence of these symptoms, can either alleviate or exacerbate them. How should we position ourselves in the presence of these disorders? What are the most effective attitudes for calming day-to-day situations?

[Improving the experience of racialized immigrant seniors in Quebec]. / Améliorer l'expérience des personnes âgées immigrantes racialisées au Québec.

In Quebec, racialized immigrant seniors (AIRs) are a significant presence in long-term care facilities (CHSLDs) in the Greater Montreal area. To identify interventions that best meet their needs, this study interviewed 12 RIAs, including their families, about their experience in CHSLDs. The results show that RIAs face three challenges: food, clothing and play. Addressing these issues could improve their LTRCC experience.

Curso virtual "Informática Básica" para la formación técnica en Enfermería

Fundamento: en la última década se han realizado numerosas experiencias de aprendizaje en Enfermería utilizando la web como plataforma. Su proceso enseñanza aprendizaje mediado por el computador es una realidad disponible regularmente en sus instituciones. Objetivo: diseñar un curso virtual como apoyo al proceso enseñanza aprendizaje de la asignatura "Informática Básica" para la formación técnica en Enfermería. Métodos: se realizó una investigación-acción en la Facultad de Ciencias Médicas "Calixto García" en el segundo semestre de 2022. Se aplicaron métodos del nivel teórico: histórico-lógico, analítico-sintético e inductivo-deductivo; y empíricos, la observación y cuestionario a expertos. Resultados: en el diseño del curso virtual "Informática Básica" para la formación técnica en Enfermería se aprovecharon las herramientas que ofrece la plataforma Moodle. Incluye actividades orientadas por los profesores y contenidos adicionales contextualizados al plan de estudio. Se precisaron la organización del contenido, los recursos e interacción, así como la autoevaluación y evaluación. Conclusiones: el curso virtual de "Informática Básica" para la formación técnica en enfermería fue valorado por criterios de especialistas por su pertinencia y asequibilidad para su aplicación a favor del aprendizaje.

Background: in the last decade, numerous learning experiences have been carried out in nursing using the web as a platform. Its computing-mediated teaching-learning process is a reality regularly available in its institutions. Objective: design a virtual course to support the teaching-learning process of the subject "Basic Computing" for technical training in Nursing. Methods: an action research was carried out at the "Calixto García" Faculty of Medical Sciences in the second semester of 2022. Methods at the theoretical level were applied: historical-logical, analytical-synthetic and inductive-deductive; and empirical ones, observation and questionnaire to experts. Results: in the design of the virtual course "Basic Computing" for technical training in Nursing, the tools offered by the Moodle platform were used. It includes activities guided by teachers and additional content contextualized to the study plan. The organization of content, resources and interaction, as well as self-assessment and evaluation, were specified. Conclusions: the virtual "Basic computing" course for technical training in nursing was evaluated by specialist criteria for its relevance and affordability for its application in favor of learning.

[ELDERLY UNDERNUTRITION IN HOSPITALS IN LOMÉ: EPIDEMIOLOGICAL, CLINICAL AND BIOLOGICAL ASPECTS]. / Dénutrition du sujet âgé en milieu hospitalier à Lomé: Aspects épidémiologique, clinique et biologique.

Introduction: La dénutrition protéino-énergétique est un déséquilibre entre les apports et les besoins protéino-énergétiques. L'objectif était d'étudier les aspects épidémiologiques, cliniques et biologiques de la dénutrition chez les personnes âgées. Méthodes: Etude transversale sur 200 patients d'au-moins 60 ans en consultation gériatrique en médecine interne aux CHU Sylvanus Olympio et Campus effectuée de Novembre 2017 au 31 janvier 2020. Nous avons évalué l'IMC, MNA, et l'albuminémie. Résultats: On notait une prédominance féminine avec 122 femmes (sex-ratio H/F= 0,64). L'âge moyen était de 75 ans ± 08,6 ans avec des extrêmes de 60 à 99 ans. Les personnes âgées (PA) étaient regroupées en 03 tranches d'âge : 60-74ans, 75-84ans et plus de 85 ans. Les tranches d'âge les plus représentés étaient 60 -74ans (49,0%) suivi de 75-84ans (35,5%). 98(49,0%) étaient mariés et vivaient en couple, 82(41,0%) étaient veuf(ve)s, 11(05,5%) étaient célibataire, et 09(04,5%) étaient divorcés. Cinquante (25%) avaient IMC<21kg/m². 160 (80%) avaient un score de dépistage individuel inférieur à 12selon MNA-SF. La prévalence de la dénutrition et de risque de dénutrition selon MNA complet était de 87% (36% de dénutris et 51,0% de risque de dénutrition). Quatre-vingt-deux (41%) avaient une albuminémie inférieure à 35g/l. L'état nutritionnel selon MNA variait de manière significative avec le statut matrimonial, l'IMC la consommation de lait et les régimes restrictifs alors que celui selon l'albumine variait avec le sexe, les régimes restrictifs, les pathologies neuropsychologiques, la polypathologie et la polymédication. Conclusion: La dénutrition est fréquente en gériatrie d'où la nécessité d'un dépistage et une prise en charge précoce.

[The nurse, recurrent cries]. / L'infirmière face aux cris récurrents.

Recurrent screaming and vocal agitation complicate geriatric and psychogeriatric care. They are among the psychobehavioral symptoms that accompany neurocognitive diseases. Reputedly difficult to manage, they require a comprehensive pharmacological and non-pharmacological approach. How can the care team deal with these disorders in the absence of a doctor?

[Supporting the life course of the elderly at home]. / Accompagner le parcours de vie des personnes âgées à domicile.

The management and support of dependency is an area of expertise deployed within care facilities and medico-social establishments. At home, however, the needs are equally great, with a high risk of caregiver burnout. A nurse working in the Occitanie region of France shares her experience of implementing a cooperation protocol entitled "Intervention of liberal nurses in the home to diagnose and initiate care for frail elderly subjects".

[The ISP, officer and caregiver: two visions for optimal care]. / Rôle de l'infirmier de sapeurs-pompiers lors d'une opération de secours routier.

In 2021 a new operational doctrine of roadside rescue was born, and the firefighters nurses had to get back up to speed to better take charge of the victims. Expert, the firefighters nurses have a real place in a road rescue yard, it is an indispensable link between the fire brigade and the medical team.

[Human rights and transgender surgery]. / Droits de la personne humaine et chirurgie de la transidentité.

René Sève recalls that Contemporary Law in the Western World is based on autonomy of equal subjects, mutually recognizing the right to each carry out their own life project. The LGBTQIA+ person therefore exercises their ability to be their own species, according to Kirkegaard's word. It remains that "life project" also implies a constraint of stability and rationality. The author then shows, using Canadian and French statistical data, the difficulties of achieving this ideal for minors and, for adults, the other medical, paramedical and social conditions required. The rights of LGBT people cannot be considered independently of the physical and financial limits of the health system and therefore of the public debate on its priorities.