Le travail psychique de l'accompagnement dans la maladie d'Alzheimer

The meeting with some caregivers evidenced the preservation of a particular relationship with the patient, relationship within which the caregiver perceives in return the unspeakable weight of a disease, which works silently. Alzheimer's disease induces psychological modifications and requires great investment by caregivers, which is grafted on an earlier relationship. We should not consider the modifications in a linear relationship patient-caregiver but in a circular relationship, which complicates the relation of the couple and makes it indecisive. The violence of the confrontation with this disease results from multiple factors: social representations, impact of the diagnosis, evolution of the disease, affectivity and permanent interactions, in spite of the non verbal communication of the patient, which associates a love story, behaviour disorders and the impact on the social circle. The family's responses are for example denial, overprotection, mothering and aggressiveness in caregiving in order to maintain the relationship. Becoming a caregiver is difficult because of the limit between professional and caregiver. Accompaniment is not a simple role of watching and caring. Because of the love, because of the strength of the communication which continues even in the absence of words, the investment remains massive and Alzheimer's disease opens a distance where the relationship, if it is perturbed, is none the less reactivated, and makes the accompaniment possible, however painful it may be.