La distance thérapeutique dans la prise en charge à domicile de maladies neurodégénératives

Abstract : When a patient with neurodegenerative disease is no longer able to move, the speech therapist has to go to his home to work. This home management of neurodegenerative diseases has its own specificities, because the speech therapist goes into the private and personal place of a patient who is at the end of his life. Because of the patient condition, the family circle is often involved in the session. Therefore the therapist has to take into account all these factors, and the therapeutic relationship is quite different being at home or at surgery. The question is how the homecare specificities can affect the right therapeutic distance acquisition. In order to find this out, we wanted to establish a picture from the angle of therapeutic distance. We send a questionary on Facebook to speech therapists, and conducted to look at the answers in a quantitative and qualitative way. The most frequent difficulties were related to the cost of time and energy spent, concern the helplessness with the patient's condition ; and isolation the therapist feels. Finally we think a generalisation of reflective practice might be a good solution. We also had a through look at therapists' choices to find out which ones are decisive, especially concerning the right therapeutic distance.
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Master thesis
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http://docnum.univ-lorraine.fr/public/BUMED_MORT_2015_LE_MEVEL_MAUD.pdf
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Maud Le Mevel. La distance thérapeutique dans la prise en charge à domicile de maladies neurodégénératives. Médecine humaine et pathologie. 2015. ⟨hal-01833190⟩

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