La famille idéale : une injonction paradoxale ?

Family presence in end-of-life inpatient units often raises questionings and difficulties. In the light of these observations, we aimed at better understanding the place of the families within these units and what an “ideal” family for caregivers would be. Our assumption is that the place made for the families could be understood as a paradoxical injunction, and explaining to some extent communication difficulties between families and caregivers. On the basis of the metapsychological theory of paradoxical injunction, three categories of caregiver interviews were analysed. We found in these reports the paradoxical nature of the position the families are waited. But, beyond these reports, this paradoxical injunction must be read in the light of the institution in which they were recorded. Indeed, the institution allows only two places: caregiver or patient. Caregivers alternatively summon the families at either one or the other of the two places, while notifying them that the access to these positions is impossible. The families are thus faced with a double constraint: not to have a defined place within the hospital institution while having the duty to hold one. Each team has to face the following major topic: how do we manage the families, and which place do we accept to spare for them?