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L'hébergement institutionnel d'un parent âgé ayant des pertes cognitives

Published online by Cambridge University Press:  31 March 2010

Hélène Belleau
Hélène Belleau*
Affiliation:
Université de Montréal
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Hélène Belleau, Professeure, Ph.D. en sociologie de l'Université de Montréal, Institut national de la recherche scientifique—Urbanisation, Culture et Société, 3465, rue Durocher, Montréal, QC H2X 2C6. ([email protected])
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Abstract

This study examines the decision of institutionalizing an elderly parent suffering from cognitive impairments and the various people involved in this process: the elderly person, the informal caregiver, certain family members and health and social service professionals. Based on a qualitative analysis of interviews conducted with 16 elderly people and their family networks, this study reveals the importance of considering the point of view of everyone involved. The results show that one of the main reasons behind the decision to institutionalize an elderly person is the appearance of disturbing behaviours related to his or her cognitive impairments. Diverse strategies used by family members and health and social service professionals in order to bring about the institutionalization of an elderly person when he or she is opposed to it are presented as well as the ethical dilemmas this raises. We conclude with a presentation of research and intervention recommendations.

Résumé

Cette étude examine la décision de faire héberger un parent âgé ayant des pertes cognitives en s'intéressant aux divers acteurs impliqués dans ce processus à savoir: la personne âgée elle-même, le proche aidant et certains membres de sa famille ainsi que les professionnels de la santé et des services sociaux. Partant d'une analyse qualitative d'entretiens auprès de 16 personnes âgées et leur réseau, cette étude révèle l'importance de considérer le point de vue de ces différents acteurs. Les résultats de l'enquête montrent qu'un des principaux motifs d'hébergement est l'apparition de comportements dérangeants chez la personne âgée qui sont liés aux pertes cognitives. Les diverses stratégies adoptées par les proches et les professionnels pour amener une personne en institution alors qu'elle s'y oppose sont présentées en lien avec les questions qu'elles soulèvent. Nous concluons cette réflexion par la présentation de pistes de recherche et d'intervention.

Keywords

aginginstitutionalizationelderlyinstitutionfamilyethicscognitive impairmentsvieillissementhébergementpersonne âgéeinstitutionfamilleéthiquepertes cognitives
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 26 , Issue 4 , Winter/Hiver 2007 , pp. 329 - 341
Copyright
Copyright © Canadian Association on Gerontology 2007

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References

Bibliographie

Akamigbo, B.A., et Wolinsky, F.D. (2006). Reported expectations for nursing home placement among older adults and their role as risk factors for nursing home admissions. The Gerontologist, 46, 464–473.CrossRefGoogle ScholarPubMed
Aneshensel, C.S., Pearlin, L.I., Mullan, J.T., Zarit, S.H., et Whitlatch, C.J. (1995). Profiles in caregiving: The unexpected career. San Diego, CA: Academic Press.Google Scholar
Baker, J.C. (2002). Neighbors, friends, and other nonkin caregivers of community-living dependent elders. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57, S158–S167.CrossRefGoogle Scholar
Barrett, A.E., et Lynch, S.M. (1999). Caregiving networks of elderly persons: Variation by marital status. The Gerontologist, 39, 695–794.CrossRefGoogle ScholarPubMed
Belleau, H., et Saint-Laurent, C. (2005). La décision d'hébergement des personnes âgées en institution: Le point de vue des différents acteurs. Dans F-R Ouellette, R. Joyal, et R. Hurtubise (dir.), La famille et l'éthique. Familles en mouvance : quels enjeux éthiques? (pp. 317–332). Québec: PUL/IQRC.Google Scholar
Berg-Weger, M., Rauch, S.M., Rubio, D.M., et Tebb, S.S. (2003). Assessing the health of adult daughter former caregivers for elders with Alzheimer's disease. American Journal of Alzheimer's Disease and Other Dementias, 18(4), 231–239.CrossRefGoogle ScholarPubMed
Black, B.S., Rabins, P.V., et German, P.S. (1999). Predictors of nursing home placement among elderly public housing residents. The Gerontologist, 39, 559–568.CrossRefGoogle ScholarPubMed
Bogo, M. (1987). Social work practice with family systems in admission to homes for the aged. Journal of Gerontological Social Work, 10(1/2), 5–20.CrossRefGoogle Scholar
Bourgeois, M.S., Beach, S., Schulz, R., et Burgio, L.D. (1996). When primary and secondary caregivers disagree: Predictors and psychosocial consequences. Psychology and Aging, 11, 527–537.CrossRefGoogle ScholarPubMed
Brault, M-MT (1998). Mères et filles au bout de la vie. Récits de femmes âgées de 55 ans et plus. Québec: PUL/IQRC.Google Scholar
Buhr, G.T., Kuchibhatla, M., et Clipp, E.C. (2006). Caregivers' reasons for nursing home placement: Clues for improving discussions with families prior to the transition. The Gerontologist, 46, 52–61.CrossRefGoogle ScholarPubMed
Caron, C.D., Ducharme, F., et Griffith, J. (2006). Deciding on institutionalization for a relative with dementia: The most difficult decision for caregivers. Revue canadienne du vieillissement, 25, 193–194.CrossRefGoogle ScholarPubMed
Caron, C.D., Griffith, J., et Arcand, M. (2005). End-of-life decision making in dementia: The perspective of family caregivers. Dementia: The International Journal of Social Research and Practice, 4, 113–136.CrossRefGoogle Scholar
Cohen, C., Gold, D., Shulman, K., Wortly, J., McDonald, G., et Wargon, M. (1993). Factors determining the decision to institutionalize dementing indiduals: A prospective study. The Gerontologist, 33, 714–720.CrossRefGoogle Scholar
Dandurand, R., et Ouellette, F-R (1995). Famille, État et structuration d'un champ familial. Sociologie et Sociétés, 27(2), 103–119.CrossRefGoogle Scholar
Déchaux, J.H. (1990). Des relations de parenté inédites ? Esprit, 163, 91–105.Google Scholar
Dilworth-Anderson, P., Williams, I.C., et Cooper, T. (1999). The contexts of experiencing emotional distress among family caregivers to elderly African-Americans. Family Relations, 48, 391–396.CrossRefGoogle Scholar
Dilworth-Anderson, P., Williams, I.C., et Gibson, B.E. (2002). Issues of race, ethnicity and culture in caregiving research: A 20-year review (1980–2000). The Gerontologist, 42, 237–272.CrossRefGoogle ScholarPubMed
Favrot-Laurens, G. (1995). Soins familiaux ou soins professionnels : La construction des catégories dans la prise en charge des personnes âgées dépendantes. Dans J.C. Kaufman (dir.), (pp. 213–232). Faire ou faire-faire ?. Rennes: Presses Universitaires de Rennes.CrossRefGoogle Scholar
Fisher, L., et Lieberman, M.A. (1999). A longitudinal study of predictors of nursing home placement for patients with dementia: The contribution of family characteristics. The Gerontologist, 39, 677–686.CrossRefGoogle ScholarPubMed
Franks, M.M., et Stevens, M.A. (1992). Multiple roles of middle-generation caregivers: Contextual effects and psychological mechanisms. Journal of Gerontology, 47(3), S123–129.CrossRefGoogle ScholarPubMed
Friss Feinberg, L., et Whitlatch, C.J. (2001). Are persons with cognitive impairment able to state consistent choices? The Gerontologist, 41, 374–382.CrossRefGoogle Scholar
Gaugler, J.E., Edwards, A.B., Femia, E.E., Sarit, S.H., Stephens, M-AP, Townsend, A., et al. (2000). Predictors of institutionalization of cognitively impaired elders. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 5(5), P247–255.CrossRefGoogle Scholar
Gaugler, J.E., Mendiondo, M., Smith, C.D., et Schmitt, F.A. (2003). Secondary dementia caregiving and its consequences. American Journal of Alzheimer's Disease and Other Dementias, 18, 300–308.CrossRefGoogle ScholarPubMed
Greenfield, W.L. (1984). Disruption and reintegration: Dealing with familial response to nursing home placement. Journal of Gerontological Social Work, 8(1/2), 15–21.CrossRefGoogle Scholar
Guberman, N., Lavoie, J-P, Gagnon, E., Bourgeois-Guérin, V., Fournier, M., et Grenier, L. (2005). Valeurs et normes de la solidarité familiale : Statu quo, évolution, mutation ?. Rapport de recherche présenté au FQRSC. Québec : Centre de santé et de services sociaux Cavendish/CAU en gérontologie sociale.Google Scholar
Guberman, N., Maheux, P., et Maillé, C. (1991). Et si l'amour ne suffisait pas ? Femmes, familles et adultes dépendants. Montréal: Remue-ménage.Google Scholar
Haley, W.E., Levine, E.G., Brown, S.L., et Batolucci, A.A. (1987). Stress, appraisal, coping and social support as predictors of adaptational outcome among dementia caregivers. Psychology and Aging, 2, 323–330.CrossRefGoogle ScholarPubMed
Healy, T.C. (1999). Community-dwelling cognitively impaired frail elderly: An analysis of social workers' decisions concerning support for autonomy. Social Work in Health Care, 30(2), 27–47.CrossRefGoogle ScholarPubMed
Karlin, N., Bell, P.A., et Noah, J.L. (2001). Long-term consequences of the Alzheimer's caregiver role: A qualitative analysis. American Journal of Alzheimer's Disease and Other Dementias, 16, 177–182.CrossRefGoogle ScholarPubMed
Kellett, U.M. (1999). Transition in care: Family carers' experience of nursing home placement. Journal of Advanced Nursing, 29, 1474–1481.CrossRefGoogle ScholarPubMed
Kleban, M.H., Brody, E.M., Schoonover, C.B., et Hoffman, C. (1989). Family help to the elderly: Perceptions of sons-in-law regarding parent care. Journal of Marriage and the Family, 51, 303–312.CrossRefGoogle Scholar
Laperrière, A. (1994). Les critères de scientificité des méthodes qualitatives. Dans Les méthodes qualitatives en recherche sociale : Problématiques et enjeux. Actes du colloque du Conseil québécois de la recherche sociale tenu à Rimouski le 17 mai 1993, pp. 45–66. Québec: Éditeur officiel.Google Scholar
Lavoie, J-P (2000). Familles et soutien aux parents âgés dépendants. Montréal: L'Harmattan.Google Scholar
Lesemann, F., et Chaume, C. (1989). Familles-providence : La part de l'État. Montréal: Saint-Martin.Google Scholar
Lieberman, M.A., et Fisher, L. (1995). The effects of nursing home placement on family caregivers of patients with Alzheimer's disease. The Gerontologist, 41, 819–826.CrossRefGoogle Scholar
Liken, M.A. (2001). Critical incidents precipitating institutionalization of a relative with Alzheimer's. Western Journal of Nursing Research, 23, 163–178.CrossRefGoogle ScholarPubMed
Miller, B., et Guo, S. (2000). Social support for spouse caregivers of persons with dementia. Journal of Gerontology: Social Sciences, 55B(3), S163–172.CrossRefGoogle Scholar
Miller, S.C., Prohaska, E.T.R., et Furner, S.E. (1999). Nursing home admission for African-Americans with Alzheimer's disease. Journal of Gerontology: Medical Sciences, 54A(7), M365–369.Google Scholar
MSSS, Ministère de la Santé et des Services sociaux (1999). Un défi de solidarité : Les services aux aînés en perte d'autonomie. Plan d'action 2005–2010. Gouvernement du Québec, Québec. Consulté le 12 novembre 2007 : http://publications.msss.gouv.qc.ca/acrobat/f/documentation/2005/05-830-01.pdf.Google Scholar
Montgomery, R.J., et Williams, K.N. (2001). Implications of differential impacts of caregiving for future research on Alzheimer's care. Aging and Mental Health, 5(1), S23–34.CrossRefGoogle Scholar
Naleppa, M.J. (1996). Families and the institutionalized elderly. Journal of Gerontological Social Work, 27, 87–111.CrossRefGoogle Scholar
O'Donnel, B.F., Drachman, D.A., Barnes, H.J., Peterson, K.E., Swearer, J.M., et Lew, R.A. (1992). Incontinence and troublesome behaviors predict institutionalization in dementia. Journal of Geriatric Psychiatry and Neurology, 5, 45–52.CrossRefGoogle Scholar
Ory, M.G., Hoffman, R.R., Yee, J.L., Tennstedt, S., et Schulz, R. (1999). Prevalence and impact of caregiving: A detailed comparison between dementia and nondementia caregivers. The Gerontologist, 39, 177–185.CrossRefGoogle ScholarPubMed
Paquet, M. (1999). Les professionnels et les familles dans le soutien aux personnes âgées dépendantes. Montréal: L'Harmattan.Google Scholar
Penning, M.J. (2002). Hydra revisited: Substituting formal for self and informal in-home care among older adults with disabilities. The Gerontologist, 39, 177–185.Google Scholar
Penrod, J., et Dellasega, C. (1998). Caregivers' experiences and making placement decisions. Western Journal of Nursing Research, 20, 706–732.CrossRefGoogle ScholarPubMed
Reece, D., Waltz, T., et Hageboeck, H. (1983). Intergenerational care providers of non-institutionalized frail elderly: Characteristics and consequences. Journal of Gerontological Social Work, 5(3), 21–34.CrossRefGoogle Scholar
RRSSSM, Régie régionale de la santé et des services sociaux de Montréal-Centre (1996). Cadre de référence : Continuum de services aux personnes âgées. Le CLSC : Guichet unique d'accès aux services de longue durée. Direction de la programmation et de la coordination, Services aux personnes âgées. Montréal: RRSSSM.Google Scholar
Saillant, F., Dandurand, R., Gagnon, E., et Sévigny, O. (2000). Contexte, modèles et perspectives critiques au Québec. Retraite et Société, 31, 39–53.Google Scholar
Savundranayagam, M.Y., Hummert, M.L., et Montgomery, R.J.V. (2005). Investigating the effects of communication problems on caregiver burden. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60, S48–55.CrossRefGoogle ScholarPubMed
Schulz, R., Belle, S.H., Czaja, S.J., McGinnis, K.A., Stevens, A., et Zhang, S. (2004). Long-term care placement of dementia patients and caregiver health and well-being. Journal of the American Medical Association, 292, 961–967.CrossRefGoogle ScholarPubMed
Steele, C., Rowner, B., Chase, G.A., et Folstein, M. (1990). Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. American Journal of Psychiatry, 147, 1049–1051.Google ScholarPubMed
Stevens, A., Owen, J., Roth, D., Clay, O., Bartolucci, A., et Haley, W. (2004). Predictors of time to nursing home placement in White and African American individuals with dementia. Journal of Aging and Health, 16, 375–397.CrossRefGoogle ScholarPubMed
Stoller, E., Forster, L., et Duniho, T. (1992). Systems of parent care within sibling networks. Psychology and Aging, 14, 28–49.Google Scholar
Strain, L.A., et Blandford, A.A. (2003). Caregiving networks in later life: Does cognitive status make a difference? Revue canadienne du vieillissement, 22, 261–273.CrossRefGoogle Scholar
Suk-Young Kang, (2006). Predictors of emotional strain among spouse and adult child caregivers. Journal of Gerontological social work, 47(1–2), 107–131.CrossRefGoogle ScholarPubMed
Thompson, E.H., Futterman, A.M., Gallagher-Thompson, D., Rose, J.M., et Lovett, S.B. (1993). Social support and caregiving burden in family caregivers of frail elders. Journal of Gerontology, 48(5), S245–254.CrossRefGoogle ScholarPubMed
Vézina, A., et Pelletier, D. (1998). Éléments entourant la famille et le fonctionnement familial. Une même famille, deux univers ; aidants principaux, fonctionnement familial et soutien à domicile des personnes âgées. Université de Montréal et Centre de recherche sur les services communautaires, (pp. 45–98), Montréal.Google Scholar
Vitaliano, P.P., Young, H.M., et Russo, J. (1991). Burden: A review of measures used among caregivers of individuals with dementia. The Gerontologist, 31, 67–75.CrossRefGoogle Scholar
Wolinsky, F.D., Callahan, C.M., Fitzgerald, J.F., et Johnson, R.J. (1992). The risk of nursing home placement and subsequent death among older adults. Journal of Gerontology: Social Sciences, 47(4), S173–182.CrossRefGoogle ScholarPubMed