Gaudet M, Richard D
Médecine interne gériatrique CHRU Dijon, Centre de gériatrie de Champmaillot.
Rev Prat. 1994 Jun 1;44(11):1457-60.
Residents in geriatric institutions are progressively older, and they increasingly present psycho-behavioural disorders that affect the function of these institutions. Only after failure of classical medical investigation based on the observed symptoms and seeking a well-defined syndrome and treatment are these disorders attributed to progressive intellectual deterioration which escapes all classical "technical" medical efforts. Drug treatment thus becomes accessory and the disorders must be viewed as complex interactions between the subject and his institutional and familial circles. These interactions are highly pathogenic and feed the symptomatology, aggravating the disorders and producing new symptoms. For this reason, management must be adaptative, aiming at the best possible equilibrium of the subject in the institution. It should also be fully encompassing, engaging the whole of the actors within the institution. The objective can only be attained by a team equipped with gereologic knowledge, used to interdisciplinary work and constantly seeking an explicit institutional aim, taking into account all the required medical, psychological, social, familial, judicial and ethic factors.
