[Activity and rehabilitation of senile dementia. Methodological suggestions for an ergotherapy in psychogeriatrics]. / Activité et réhabilitation dans les démences de la vieilesse. Propositions méthodologiques pour une ergothérapie en psychogériatrie.

The aim of this study is to make clear the conditions of an ergotherapy particularly fit for the aged suffering from senile dementia. It should keep the intellectual instruments in working condition and, eventually, postpone their impairment. The general frame in which theory and experiment are inscribed is the Piaget's theory. Especially the part that concerns the different stages of childhood development of which, one thinks, can be observed the deterioration "in reverse" during the senile dementia impairment processes. Some special hypothesis concern:--the different parts of reality in which relations between patient and society are disturbed --the activities that are connected in a network of relations between the conceptual instruments required to realize these activities --the fact that the steadiness of a particular activity should help to recover another one, thought to be close in the way by which its realization puts into action the same cognitive processes. Thus, we have been able to fix the way of directing a first examination for the taking in charge in ergotherapy; examination that should point out the fields in which the patient can be mobilized (as well from the level where he is as from the investment one can expect in regard to the pleasure or the interest that he shows for a work rather than another). Besides, we tried to represent the channels of activities and their relations, starting from the most elementary one to reach the most complicated one, that is to say the ones that allow us to work on reality. It is in the network of these channels that the proposed activities should find their place in the ergotherapy workshop and their application should permit the readaptation to everyday actions in a progressive way.

[Reality approach in senile dementia. Fundamental methodologies of occupational therapy in psychogeriatrics]. / L'approche du réel chez le dement senile. Fondements méthodologiques de l'ergothérapie en psychogériatrie

Occupational therapy in psychogeriatrics has always been practiced empirically, aimed mainly at merely occupying patients. In the light of recent findings from the old age psychological research, a specific method should cope with certain forms of lost intellectual capacities. The purpose of this work is to define as accurately as possible the field of occupational therapy in psychogeriatrics. Three main concepts towards a systematic approach can be proposed: a) Those related to a careful observation of spontaneous activities dealing with the relationship between the patient and the world around him, and which lead to a classification of these activities. b) Concepts related to the most elementary level of intervention in occupational therapy termed as "objective relationship", in other words the construction of the external objective world as opposed to the world of phantasms or magical thought. c) Concepts, at a more sophisticated level, related to the instrumental aspects of traditional occupational therapy. An important distinction should thus be made between local and inclusive constituent parts of an activity.