Lecture de la clinique psychiatrique du sujet vieillissant âgé lors d'un exercice en pratique libérale

Psychiatric analysis of elderly people has not raised great interest among private psychiatric practitioners, so that progressively, this type of analysis has fallen into the domain of geriatrics. A largely normative neurogeriatrical reading has developed, at the cost of forgetting the great wealth of the elderly person's psychological life. It is as if psychiatrists, above all those in private practice, are ill at ease with this aspect of their medical curriculum, resulting in the exclusion of large areas of medical symptomatology. In an attempt to remedy this situation, we discuss how clinical practice can consider, first of all, the older person as an “aging older subject” with a full diachronic and synchronic dimension. We also invite psychiatrists to take a position in their praxis in order to confront their own limits. In order to achieve this, we suggest two states of praxis to be targeted: being a psychogeriatrist and/or a gerontopsychiatrist, recognizing how to maintain this equilibrium without becoming inflexible, that is to say, being able to understand social and medical orientations and sometimes ignoring them. The goal of this proposal is to concentrate on the psychiatry of the aging old subject, a psychiatry enabling very diverse analysis where the confrontation with the subconscious is free to take place. Once the parameters of their work have been clearly defined, private practitioners can develop the analysis under optimum conditions.