[Touch and care, skills to develop in a team]. / Le toucher et les soins au corps, des compétences à développer en équipe.

The relationship with the body requires constant adjustment between the patient, the caregiver and the team. A learning organisation supporting the use of touch at the heart of care favours the therapeutic alliance with the patient and the inter-disciplinary implementation of this approach.

[Sensory functions and Alzheimer's disease: a multi-disciplinary approach]. / Les fonctions sensorielles et la maladie d'Alzheimer : une approche multidisciplinaire.

Relations between sensory functions and Alzheimer's disease are still under-explored. To understand them better, the Fondation Médéric Alzheimer has brought together a multi-disciplinary expert group. Aristote's five senses must be enhanced by today's knowledge of proprioception, motor cognition and pain perception. When cognition breaks down, the person with dementia perceives the world around her with her sensory experience, yet is unable to integrate all this information to understand the context. The treatment of multiple sensory inputs by the brain is closely linked to cognitive processes. Sensory deficits reduce considerably the autonomy of people with dementia in their daily life and their relations with others, increase their social isolation and the risk of accidents. Professionals involved with neurodegenerative diseases remain poorly aware of sensory deficits, which can bias the results of cognitive tests. However, there are simple tools to detect these deficits, notably for vision, hearing and balance disorders, which can be corrected. Many interventions for cognitive rehabilitation or quality of life improvement are based on sensory functions. The environment of people with dementia must be adapted to become understandable, comfortable, safe and eventually therapeutic.

[Defining and questioning intrusion in care situations]. / Définir et questionner l'intrusion dans les situations de soins.

Most care procedures require the patient to give personal information and to reveal their body in order to enable a clinical examination or a care procedure to be carried out, which can leave them feeling embarrassed. Considering as a team what causes the feeling of intrusion in a care procedure enables nursing strategies to be adopted which can help the patient overcome their modesty and feel secure, becoming a partner in a care procedure for which they understand the clinical need and underlying intentionality. Testimonies.

[Fitting a male sheath urinal while respecting the patient's intimacy]. / Poser un étui pénien dans le respect de l'intimité du patient.

The fitting of a male sheath urinal directly concerns the patient's area of sexual intimacy. The modesty of the patient and caregiver as they interact is tested, leading to discomfort or clumsiness which can provoke a feeling of intrusion. Preparing this care procedure favours the adherence of both parties.

[Nursing diagnoses and educational diagnosis, differences and complementarity]. / Diagnostics infirmiers et diagnostic éducatif, différences et complémentarité.

The coordination between nursing diagnoses and the educational diagnosis still remains a difficult task. The educational approach arises from clinical reasoning derived from the caregiving approach. In collaboration with the team, the nurse analyses the data collected, makes nursing diagnoses and then shares with the patient care objectives and educational objectives.

[The language of touch in care]. / Le langage du toucher dans les soins.

At the heart of the care relationship, the hands of the caregiver the body of the patient interact. The language of touch is therefore expressed in addition to the verbal and nonverbal elements of human communication.

[Basic principles of patient education]. / Principes de base de l'education thérapeutique du patient.

The objective of therapeutic education is to enable patients to reconcile their life project, disease and treatment. To achieve this, it aims notably to make them autonomous in the management of their health. Often practised in a multi-disciplinary team, it is an essential component of the management of patients with chronic diseases.

[Knowing how to transfer knowledge, a challenge of professionalization]. / Savoir transmettre, un enjeu de professionnalisation.

Transferring knowledge is a delicate exercise. Understanding the notions of posture, identity construction, reflexivity and learner organisation helps to put the way knowledge is transferred into perspective. At the heart of skills development, these conceptual reminders throw light on the mechanisms in play in intergenerational transfer, aiming at professionalisation.

[Internal skills certification, sharing experiences]. / Certification interne de compétences, partages d'expériences.

An internal skills certification entitled, "The care relationship in situations of impaired communication" has been set up by the Paris hospitals authority (Assistance publique-hôpitaux de Paris). It enables healthcare workers practising in geriatrics to build on the practical experience they have developed. The fruit of an individual introspection helping to formalise the verbal and non-verbal methods they use in their practice, it requires a specific institutional, managerial and personal framework to be put in place.

[Treatment-related pain, definitions and help with detection]. / La douleur liée aux soins, définitions et aide au dépistage.

Treatment-related pain can be provoked, iatrogenic or induced. Some of its causes are known. They guide observation and clinical examination as well as the choice of assessment strategies and steps to prevent treatment-related pain.

[Pain and treatment, clinical situations and lines of questioning]. / Douleur et soins, situations cliniques et pistes de questionnement.

The pain provoked by a treatment is difficult to understand by professionals, individually or collectively. Guilt, a feeling of powerlessness or doubt can arise with the healthcare worker who witnesses it or performs the treatment, and lead him/her to avoid talking about it, once the treatment is carried out. The study of clinical situations aims to incite reflection among teams to improve understanding of the complexity of these situations, influenced by the representations, perceptions and emotions of everyone involved.