[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.

[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?

[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?

[Announcement of the diagnosis of Alzheimer's disease or a related disorder in a geriatric short-stay unit]. / Annonce du diagnostic de maladie d'Alzheimer ou apparentée en service de court séjour gériatrique.

The disclosure of the diagnosis of Alzheimer's disease or a related disorder, or rather the time of the diagnostic disclosure, is a crucial step in the care of people with these neurocognitive diseases. While the disclosure procedures are well defined for practitioners who work in memory consultations, there is a grey area for hospital professionals who work in acute medical units.

Delirium and Covid-19 in the old adults: practical implications / Confusion et Covid-19 chez la personne âgée : implications pour la pratique

Covid-19 is the pathology associated with infection with the pandemic SARS-Cov-2 coronavirus. In people over 75 years of age, several studies alert clinicians to specificities. In particular, the confusion, acute brain failure, appears to be linked to Covid-19. This review of the literature explores the implications for practice of the presence of delirium during Covid-19 at the level of: epidemiology, pathophysiology, diagnostic phase, prerequisites and management. It also details the implications of post-acute infection.

La Covid-19 est la pathologie liée à une infection au coronavirus pandémique SARS-Cov-2. Chez les personnes âgées de plus de 75 ans, plusieurs études alertent les cliniciens sur des spécificités. En particulier, la confusion, altération fonctionnelle cérébrale aiguë, semble être liée à la Covid-19. Cette revue de la littérature explore les implications pour la pratique de la présence d'un tableau confusionnel dans la Covid-19 au niveau : de l'épidémiologie, de la physiopathologie, de la phase de diagnostic, des préalables et de la prise en charge. Elle détaille aussi les implications dans les suites de l'infection aiguë.

[Delirium, a possible typical presentation of COVID-19 in the elderly]. / La confusion aiguë, une possible présentation typique de la Covid-19 chez la personne âgée.

COVID-19 has hit the entire world since late 2019 and is starting to be medically better known. Its clinical presentation is atypical in the elderly. Acute confusion is a sometimes unrecognized warning sign. It is also an  element of severity of COVID-19. This viral infection should be systematically investigated for any confusional syndrome in the elderly population.

[Can empathy be taught to caregivers?] / L'empathie peut-elle être enseignée aux soignants ?

The concepts of empathy and care are the subject of numerous publications that testify to a surge in interest in the subject. What are the possibilities of teaching empathy to medical and nursing students? A proposed definition and a literature review can be developed to identify the effects of empathy in care and the opportunities for teaching empathy to students and practicing professionals.