Gerontological care in nursing homes receives little interest from students and newly qualified nurses alike. Yet, this population does have ever-more complex needs that call for a wide array of nursing competencies. This article highlights the essential contributions of registered nurses in the context of nursing homes and is part of a research study aimed at grasping the nature of caring for elders. The researchers used the methodology inspired from activity analysis using focus groups. Situations identified by the respondents as being disruptive have been looked at in cross-perspective. The results show that the work carried out by the registered nurses constitutes the linchpin of institutional functioning. Their contribution consists of coordinating all the activities that take place, while striving to make them relevant to the caretakers, residents, and their relatives. This key role comprises three fields of activities: organizational and innovative activities; autonomous, person-centered activities; and ethical tension management activities. By helping to meet the daily challenges pertaining to the care and monitoring of very old people and by dealing with situations that are often tragic, they carry out tasks that are stimulating on human, intellectual, and relational levels.
How can older adults (OAs) live at home alone when they have health problems? Growing numbers of OAs live with chronic health problems and yet are determined to remain in their homes as long as possible. The risks associated with living alone are a source of grave concern not only for OAs but also for those around them. Knowing how OAs cope with the risks they face is a central issue for home care and support services. The present article describes the advantages of coupling an existential anthropology approach with an explicitation interview (EI) methodology as a means of understanding the details of how OAs manage their lives at home alone. Using this introspective methodology, we encouraged 20 participants aged 80 years or older to share very detailed elements of their subjective daily life experiences of coping with the risks inherent to their solitary lifestyles. Different types of risk coexisted with one another; some risks were physical, while others were existential. Physical risks appeared to be subordinate to other major fears: loss of identity, disintegration of one's internal coherence, lack of autonomy and control over one's personal situation, and decline in self-esteem and self-image. These fears acted as incentives for developing various practical coping mechanisms for their daily lives, including measures that involved taking risks with regard to their physical safety. Using our existential anthropology approach, supported by the EI methodology, we closely examined the details of interviewees' realities.
-Vivre seule avec d'importantes limites fonctionnelles amène la personne âgée à s'organiser-pratiquement et mentalement-pour se ménager une vie quotidienne en accord avec ses souhaits. Les efforts sont continus, autant pour juguler la douleur physique que pour faire face à la solitude et à la finitude. Cet article s'appuie sur 20 entretiens menés avec des personnes de plus de 80 ans domiciliées dans le canton de Vaud (Suisse) et bénéficiant des services d'aide et de soins à domicile. Les situations concrètes donnent à voir ce que l'« habiter et vieillir » seule à domicile suppose de ressources fonctionnelles et d'astuces, de stratégies pratiques et de raisonnements intimes. En filigrane, les récits évoquent la solitude et l'intégration de la finitude. Les considérations développées sont abordées sous deux angles : la vie qui se déploie entre ses « quatre murs », et habiter son environnement « hors de ses murs ». Nous posons une distinction entre risques vitaux et menaces existentielles et observons que la prévention des premiers est subordonnée au souci de maintenir à l'écart les secondes. La démarche d'enquête inspirée de l'« entretien d'explicitation » ouvre des perspectives de renouvellement du regard pour les soins et l'aide à domicile.
Résumé La plasticité cérébrale est un concept opératoire dans les neurosciences contemporaines. Une enquête sur l’émergence de cette notion et sur son évolution dans le champ des études sur le cérébral révèle qu’elle n’est ni l’apanage, ni une invention contemporaine des neurosciences. L’analyse du cheminement de la notion, depuis la fin du xix e siècle à nos jours, sert ici de révélateur aux mécanismes de construction des savoirs scientifiques 1 .
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