[Entertainment committee in accommodation facilities for dependent elderly, functional importance and psychic stakes]. / Comité d'animation en Ehpad, importance fonctionnelle et enjeux.

In accommodation facilities for dependent elderly, entertainment is found in various forms. It is the place that promotes the stability and development of the relational, social and cultural life of the residents. Listening to what is said and experienced during the sessions allows a useful representation of the movements within the establishment. If daily difficulties may be encountered, the creation of an entertainment committee offers the opportunity to combine them and make them an added value.

[Diogenes syndrome]. / Syndrome de Diogène.

Diogenes syndrome is mostly a complaint from the caregiver or neighbours. Its psychopathological signification isn't so easy to disclose.

[Elder abuse and emergency care units]. / Maltraitance envers les personnes âgées et services d'urgence.

Elder abuse could present with various aspects: physical, psychological, sexual aggression, embezzlement, neglect or self-neglect. According to epidemiological studies, between two and ten percent of the elderly population are concerned, but only few cases are reported, but this rate will likely increase with the growing elderly population. This paper highlights the risk factors for elder abuse. Most of the time, abuse is perpetrated by family members or close relatives, who often are dependent on the victim. It could also be a usual mode of interrelationship in some families, in which careful attention should be paid for the risk of abuse against the younger generation. In emergency care units, physicians infrequently report elder abuse because they fear offending patients or families and believe they do not have appropriate assessment tools. Victims often have low self-esteem, do not want to admit their vulnerability and do not imagine a different way for living with their aggressor. However, assessment and management of elder abuse could be supportive if all members of the team are concerned with this issue and have received appropriate information and education. The best approach is to focus on both the patient and the caregiver and to accept that there are no other tool to reveal abuse than to obtain the confidence of the patient. Every people concerned should remain respectful with each individual and not experience feelings of guilt in this upsetting situation.

[Hysteria and aging]. / Hystérie et vieillissement.

In the elderly, the manifestations of hysteria can take uncommon aspects such as durable conversion disorders for which a diagnosis is difficult in the context of polypathology, dissociative symptoms looking like some dementia syndromes, noisy psychiatric symptomatology with, in particular, severe depressive episodes or hallucinations. These disorders can appear without a context of histrionic personality. The evolution of hysterical disorders during life is not well known. First of all, because the nosographic systems are not constant and, secondly, because the disorders themselves can vary when observed at different times. The aging subject is exposed to an increasing symptomatology or conversely, to an improvement due to the waekening of the narcissism. It is also possible that a continuum could be established from hysterical symptoms in the adulthood to delusions or hallucinations in the elderly. The relation with the old hysteric subject must be marked by empathy and by the conviction that improvement will only lead back to a basal symptomatology.

[Affective disorders specific to ageing]. / Evolutions affectives spécifiques au vieillissement.

With time, affects evolution can lead old people to a pathological organisation of their own mental universe. A general feeling of ill-being (syndrome of ageing badly) may appears and must be differentiated from an usual depressive syndrome. Post-traumatic disorders indicate a current or an old inability to metabolise painful life events. The "syndrome de glissement" (failure-to-thrive) generate not only bedridden state often irreversible but also guilt or depressive symptoms in caregivers. Those particular forms of ageing determine the relation with the practitioner and can induce feeling of dissatisfaction or hostility.