Évaluer les attitudes de médecins et infirmiers hospitaliers envers des aînés mésusant d’alcool. Alors que ce mésusage persiste après 65 ans, la souffrance induite est peu considérée : peut-on relier cette apparente négligence à des contre-attitudes négatives ?

Enquête par entretiens auprès d’infirmiers et de médecins, analyse des discours par le logiciel Alceste^®.

L’analyse de 45 entretiens menés à 69 % auprès de femmes et 58 % d’infirmiers, a fait émerger : la perception d’un caractère moins menaçant des aînés alcoolisés, le recours à l’humour dès que l’alcool est évoqué, la négation du manque de temps ou de formation pour les soins, et des effets favorables d’expériences en alcoologie.

Les attitudes soignantes à propos d’aînés mésusant d’alcool apparaissent moins négatives qu’attendu selon la littérature, laissant une place pour des soins entre addictologie et gérontologie.

While alcohol misuse remains over 65-age bracket, but the induced suffering is often overlooked. Is it possible to link this apparent neglect to negative counter-attitudes on the caregivers’ part? To evaluate the nursing attitudes of doctors and hospital nurses towards elderly who misuse of alcohol, while old age and alcohol misuse are only rarely considered together. When the prevalence of alcohol use disorder is located around 10% in the over 65 age bracket and such situations are encountered daily by hospital or nursing-home caregivers. Is it possible to consider this apparent neglect as a translation of negative counter-attitudes on the caregivers’ part?

A cross-sectional surveys by means of research interviews, were conducted among the nurses and the physicians working in 8 health facilities around Macon. The main objective was to approach the feelings, beliefs and attitudes of caregivers with older individuals who misuse alcohol. These variables were observed according to several socio-professional criteria. The interviews were recorded and the dialogue was processed both manually and by Alceste^® software.

The 45 research interviews were conducted with 16 physicians and 29 nurses, of whom 69% were women. Discourses analysis has highlighted some specific extracts out of them: a less threatening perception of alcoholized elderly individual, the use of humor appearing specifically when alcohol is mentioned and questioning about a lack of time or training for such care. The interviews allowed the highlighting of negative feelings and emotions and also emphasized the important role and the favorable impact of familiar experiences with sufferers of alcohol misuse in the life of the care provider. Such favorable effects of having had a life experience close to a familiar person misusing of alcohol, as a work experience in alcohology are highlighted.

Despite the limitations of the lack of focus groups, this study confirms the significant frequency with which caregivers come into care situations with elderly individuals misusing alcohol. This point calls into question the ignorance which surrounds these situations which helps us to better understand their negligence and which may explain the small percentage of skilled addictological help given to the elderly person after early screening. The classical allegation of lack of time or knowledge (and training) seems to be contradicted. These claims can be caregivers’ defensive rationalizations concerning situations experienced as difficult. The question of denial may be considered in the same way: often referred to without being wary of its repercussion. Caregivers’ attitudes about the elderly misusing alcohol appear to be variable, multifaceted, complex, being neither good nor bad. Beyond the phenomenology of attitude, there is the consideration of internal elements of the caregivers’ thinking and those cared for which undergird care providers’ behavior. This approach seeks to promote a psychodynamic regard on the elderly who misuse alcohol trough the care-givers approach.