Comment aborder le vieillissement et la fin de vie avec les personnes âgées en médecine générale

Abstract : Introduction: Introducing patients to aging and near end-of-life matters is considered as one of the general practitioner missions. This is however a complex task, especially as the family physicians are not offered any supporting tool to fulfil it the best possible way. Goal: Investigate how family physicians and seniors introduce aging and near end-of-life reflexion. Approach: This qualitative investigation was carried in the Apt basin (Vaucluse, France) by conducting semi-structured interviews over two populations : general practitioners was the first interviewed population, and seniors over 80 years old was the other one. Results: 9 general practitioners and 11 patients were interviewed by 2 investigators between December 2017 and February 2018. The results were at first analysed separately and then in a synthesis. The interviews highlight the impossibility of proposing a standardized tool for dialogue : the discussion must be adapted to every patient, with deep knowledge gained with a good doctor-patient relationship. The discussion may be initiated by either the doctor or the patient. Advance directives may constitute an interesting support for discussion. Some avenues to engage a more respectful discussion were identified : choice of the right moment, content graduation, respect of the patient personality and emotions, practical anchoring in the senior’s daily life with the introduction of suitable aids and discussion about the place the patient’s life would likely end. Conclusion: Introducing senior patients to aging and near end-of-life matters requires to evaluate the relevance of such a discussion according to the patient's situation and personality, to conduct it in a sensitive way, to propose practical applications and to be ready to move the discussion ahead in a timely manner and to follow the patient’s pace.
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https://dumas.ccsd.cnrs.fr/dumas-01960214
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Submitted on : Wednesday, December 19, 2018 - 11:45:13 AM
Last modification on : Thursday, April 18, 2019 - 11:35:27 PM
Long-term archiving on : Wednesday, March 20, 2019 - 6:45:24 PM

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Marie Geyer, Anne-Cécile Le Bihan. Comment aborder le vieillissement et la fin de vie avec les personnes âgées en médecine générale. Sciences du Vivant [q-bio]. 2018. ⟨dumas-01960214⟩

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