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A Subject in Search of Meaning: Frailty and Dignity in Very Old Age

Published online by Cambridge University Press:  28 February 2024

F. Blanchard ,
F. Duarte  and
F. Munsch
F. Blanchard
Affiliation:
Rheims and Cernay
F. Duarte
Affiliation:
Rheims and Cernay
F. Munsch
Affiliation:
Rheims and Cernay

Extract

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An ageing population and increased life expectancy are a characteristic of the Western world. Nevertheless, as Roger Fontaine writes, “although we should be glad about this fact, it should also be stressed that old age reveals profound discrepancies between individuals. In fact, we should not speak of ‘old age’ but ‘old ages’. Specialists make a distinction between normal old age, successful old age, and pathological old age.”

Catherine Guchet points out that, at the end of the twentieth century, two images of old age coexist, utilitarian in conception: that of ‘flamboyant’ old age and that of ‘dependent’ old age. The latter is associated with a loss of autonomy and dignity, especially for subjects affected by senile dementia, described as ‘unconscious’. We shall focus on these more problematic forms of old age.

Type
Research Article
Information
Diogenes , Volume 48 , Issue 190 , June 2000 , pp. 84 - 93
Copyright
Copyright © ICPHS 2000

References

Notes

1. Roger Fontaine (1999). Manuel de psychologie du vieillissement. Paris: Dunod.

2. Catherine Guchet (2000). Chronique d'une mort programmée. Revue de la Fédération JAMALV: Le long mourir, 60, March, 9-13.

3. Etymologically, ‘dementia' stems from de and mens, demented, deprived of reason, without thought, out of the mind. It was only in the nineteenth century that J.-E.D. Esquirol, Director of La Salpêtrière, made the first exact description of dementia, concluding that "the mentally backward has always been poor, whereas the dementia-sufferer was rich and has become poor".

4. J. Messy (1992). La personne âgée n'existe pas. Paris: Editions Rivages.

5. Jean-Pierre Bois (1989). Les vieux, de Montaigne aux premières retraites. Paris: Fayard.

6. J.-P. Gutton (1988). Naissance du vieillard. Paris: Aubier, collection historique.

7. F. Blanchard, S. Blique, M.-Y. George, J. Prentzynsky (1993). La validation, un outil pour vivre avec les personnes âgées et disorientées. Société Gérontologique de l'Est (Salines Royales d'Arc and Senans, A.G.E.), March, 127-37.

8. J.-P. Bois, Les Vieux, de Montaigne aux premières retraites, op. cit.

9. Jean-Pierre Bois op. cit.

10. We should note that problems with memory or disorientation are not part of ‘good-quality' ageing. Moreover, memory problems can be mild or short-term and are not evidence of an illness. Not every memory disorder is senile dementia. And, with the very old, not all dementia-type illnesses are Alzheimer's Disease.

11. See J. Madeleine Nash (2000). The new science of Alzheimer's. Time Magazine, 24 July, 56-63.

12. Marie-Françoise Rochard (1994). Soignants face à la démence. Mémoire pour la capacité en gériatrie. Rouen.

13. This concern led us to found, over ten years ago, a French-speaking association of medico-social profes sionals, carers, and representatives of civil society. This association, APVAPA (Association pour promouvoir la Communication et la Validation avec les personnes agées) is a forum for the exchange of views, reflec tion, and education, and for multi-focused and interdisciplinary research. It develops education programmes designed for professionals and close relatives and supports action for improvement in the quality of life of dementia-sufferers (www.initialis.com/dwp/apvapa).

14. Boris Cyrulnik (1993). Les nourritures affectives. Paris: Odile Jacob éditions.

15. Sigmund Freud (1990). The Origin and Development of Psycho-Analysis (1910). In The Major Works of Sigmund Freud. Great Books of the Western World, 54, 2nd edition. Chicago: Encyclopedia Britannica, p. 4, col. 1.

16. C. G. Jung (1973). Ma vie: souvenirs, rêves et pensées. Paris: Dunod.

17. E. Erikson (1978). Reflexions on Aging: Aging and the Elderly. Atlantic Highlands, N.Y.: Humanities Press.

18. Carl Rogers (1995). Le développement de la personne. Paris: Dunod.

19. Naomi Feil (1993). The Validation Breakthrough: Simple Techniques for Communicating with People with ‘Alzheimer's-Type' Dementia. Baltimore and London: Health Professions Press.

20. Ibid.

21. Ibid. pp. xxvi-xxvii. We have also used and adapted for very old age skills taken from communication techniques propounded, among others, by the general semantics of Korzybsky, the systemic approach developed by the Palo Alto School, the transactional analysis of Eric Berne, the neuro-linguistic programming of Grindler, Bandler and, above all, Robert Dilts, the reconstruction of life histories by means of the genogramme as mapped out by Anne Ancelin Schutzenberger and so on.

22. Naomi Feil grew up in an old person's home, where her psychologist father was administrator. This was how she met Florence Trew (1872-1963), who later made it possible for her to begin to ‘understand' senile dementia. Naomi Feil spent thirty years working with people like Florence Trew. Thanks to all these disorientated old people, she could observe, "When present time and place fade, when work goes, when rules no longer matter, when social obligations have lost meaning, a basic humanity shines through…. When their eyes fail and the outside world blurs, very old people look inside. They use their vivid mind's eye to see. People from the past became real. When recent memory goes and time blurs, very old people begin to measure life in terms of memories, not minutes. When the very old lose their speech, similar sounds, rhythms, and early learned movements substitute for words. To survive the present-day losses, the very old restore the past. They find much wisdom in the past." Naomi Feil (1993), op. cit., pp. xxv-xxvi.

23. F. Blanchard, S. Blique, M.-Y. George, and J. Prentaynsky (1993), op. cit. 127-37; E. Hall (1971). La dimension cachée. Paris: Seuil; Paul Watzlawick, Janet Helmick Beavin, and Don D. Jackson (1970). Une logique de la communication. Paris: Seuil. [English-language editions: (1967; 1968) Pragmatics of Human Communication: A Study of Interactional Patterns, Pathologies and Paradoxes. New York: Norton; London: Faber.]

24. Carl Rogers (1995). Le développement de la personne. Paris: Dunod.

25. R. Bandler and J. Grinder (1976). Structure of Magic: A Book about Language and Therapy. Palo Alto: Science and Behaviour Books.

26. Naomi Feil (1993), op. cit.