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{transform:rotate(90deg) translateX(4px);}\n.dbi-art-ae1838 .comparison-table {font-size:12px;}\n.dbi-art-ae1838 .comparison-table thead th, .dbi-art-ae1838 .comparison-table tbody td {padding:10px 12px;}\n.dbi-art-ae1838 .toc {padding:22px 20px;}\n}<\/p>\n<\/style>\n<p><script type=\"application\/ld+json\">\n{\n  \"@context\":\"https:\/\/schema.org\",\n  \"@type\":\"Article\",\n  \"headline\":\"Maladies apparent\u00e9es \u00e0 la maladie d'Alzheimer : comprendre, distinguer et adapter ses pratiques en r\u00e9sidence m\u00e9dicalis\u00e9e\",\n  \"description\":\"Guide clinique pour professionnels en EHPAD : d\u00e9mence frontotemporale, corps de Lewy, vasculaire, PSP, ACP. Signes distinctifs, contre-indications m\u00e9dicamenteuses, stimulation adapt\u00e9e.\",\n  \"author\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\",\"url\":\"https:\/\/www.dynseo.com\"},\n  \"publisher\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\",\"logo\":{\"@type\":\"ImageObject\",\"url\":\"https:\/\/www.dynseo.com\/wp-content\/uploads\/2021\/03\/logo-dynseo.png\"}},\n  \"datePublished\":\"2026-03-05\",\n  \"dateModified\":\"2026-03-05\",\n  \"mainEntityOfPage\":\"https:\/\/www.dynseo.com\/maladies-apparentees-alzheimer-ehpad\/\"\n}\n<\/script><\/p>\n<div class=\"dbi-art-ae1838\">\n<header class=\"article-hero\">\n<div class=\"article-hero-inner\">\n<nav class=\"article-breadcrumb\">\n      <a href=\"https:\/\/www.dynseo.com\/en\/\">Home<\/a> &rsaquo;<br \/>\n      <a href=\"https:\/\/www.dynseo.com\/en\/healthcare-professionals\/\">Professionals<\/a> &rsaquo;<br \/>\n      Alzheimer&#8217;s-related diseases<br \/>\n    <\/nav>\n<p>    <span class=\"article-category\">&#x1F9E0; CLINICAL GUIDE<\/span><\/p>\n<h1>Alzheimer&#8217;s-related diseases: understanding, distinguishing and <span class=\"hl\">adapting practices<\/span> in nursing home<\/h1>\n<div class=\"article-meta\">\n      <span>&#x1F4C5; March 2026<\/span><br \/>\n      <span>&#x23F1; 18 min read<\/span><br \/>\n      <span>&#x1F9D1;&#x200D;&#x2695;&#xFE0F; By the DYNSEO team<\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"article-hero-curve\"><\/div>\n<\/header>\n<div class=\"container\">\n<article class=\"article-body\">\n<div class=\"toc\">\n<h4>&#x1F4D1; Summary<\/h4>\n<ol>\n<li><a href=\"#panorama\">Overview of Alzheimer&#8217;s-related diseases<\/a><\/li>\n<li><a href=\"#distinguer\">Why distinguishing these pathologies is essential in nursing homes<\/a><\/li>\n<li><a href=\"#dft\">Frontotemporal dementia (FTD): when behavior takes precedence<\/a><\/li>\n<li><a href=\"#dcl\">Lewy body dementia (LBD): caution regarding treatments<\/a><\/li>\n<li><a href=\"#vasculaire\">Vascular dementia: a progression with ups and downs<\/a><\/li>\n<li><a href=\"#psp-acm\">PSP, MSA and other Parkinson-plus syndromes<\/a><\/li>\n<li><a href=\"#tableau-comparatif\">Comparative table: distinctive signs by pathology<\/a><\/li>\n<li><a href=\"#adapter-soins\">Concretely adapting care practices<\/a><\/li>\n<li><a href=\"#stimulation\">Cognitive stimulation: which tools for which profiles?<\/a><\/li>\n<li><a href=\"#equipe\">Working in a multidisciplinary team around differential diagnosis<\/a><\/li>\n<\/ol>\n<\/div>\n<pee>In nursing homes and EHPADs, Alzheimer&#8217;s disease occupies a central place in the training of care teams. This is legitimate: it accounts for 60 to 70% of dementia cases in France. However, this omnipresence sometimes creates a clinical blind spot: the <strong>Alzheimer&#8217;s-related diseases<\/strong> \u2014 Lewy body dementia, frontotemporal dementia, vascular dementia, progressive supranuclear palsy, posterior cortical atrophy \u2014 are frequently underdiagnosed or wrongly assimilated to &#8220;classic&#8221; Alzheimer&#8217;s disease.<\/pee>\n<pee>This confusion is not without consequences. Adapting practices to Alzheimer&#8217;s disease when actually accompanying someone with Lewy body dementia risks inappropriate medication, poorly targeted stimulation, and a misunderstanding of behaviors that exhausts the team and increases the suffering of the resident. Conversely, recognizing the specificity of each pathology allows for <strong>personalized support<\/strong>, prevents avoidable complications, and better supports families.<\/pee>\n<pee>This guide is aimed at care professionals in nursing homes: nursing assistants, nurses, activity coordinators, psychologists, occupational therapists, care coordinators. It does not replace a medical diagnosis but provides you with the keys to <strong>observe, alert, and adapt<\/strong> appropriately on a daily basis.<\/pee>\n<p><!-- SECTION 1 --><\/p>\n<h2 id=\"panorama\">1. Overview of Alzheimer&#8217;s-related diseases<\/h2>\n<pee>The term &#8220;dementia&#8221; refers to a clinical syndrome characterized by a cognitive decline severe enough to impact daily life. This syndrome can be caused by many different pathologies. Alzheimer&#8217;s disease is the most common form, but it is far from the only one.<\/pee>\n<pee>The World Health Organization estimates that around 55 million people live with dementia worldwide, and this number will double by 2050. In France, there are approximately 1.2 million affected individuals. Among them, 30 to 40% have a pathology other than Alzheimer&#8217;s or a mixed form combining several pathological mechanisms.<\/pee>\n<pee>The main pathologies grouped under the term &#8220;Alzheimer&#8217;s-related diseases&#8221; are as follows:<\/pee>\n<ol class=\"numbered-list\">\n<li><strong>Frontotemporal dementia (FTD)<\/strong> \u2014 preferential involvement of the frontal and temporal lobes, often with early onset (50-65 years), marked by behavioral or language disturbances at the forefront.<\/li>\n<li><strong>Lewy body dementia (LBD)<\/strong> \u2014 the second leading cause of degenerative dementia after Alzheimer&#8217;s, characterized by a triad: cognitive fluctuations, early visual hallucinations, and parkinsonian syndrome.<\/li>\n<li><strong>Vascular dementia<\/strong> \u2014 a consequence of cerebrovascular damage (Stroke, lacunes, leukoaraiosis), with a progression often marked by ups and downs and a relative preservation of episodic memory in the early stages.<\/li>\n<li><strong>Progressive supranuclear palsy (PSP)<\/strong> \u2014 atypical parkinsonian syndrome with vertical oculomotor dysfunction, early postural instability, and frontal dysexecutive syndrome.<\/li>\n<li><strong>Posterior cortical atrophy (PCA)<\/strong> \u2014 a variant of Alzheimer&#8217;s with visual onset, spatial disorientation, early praxic disturbances, and agnosia, but with memory preserved for a long time.<\/li>\n<li><strong>Creutzfeldt-Jakob disease (CJD)<\/strong> \u2014 a rare spongiform encephalopathy, with very rapid progression (weeks to months), presenting polymorphically with cognitive disturbances, myoclonus, and diffuse neurological signs.<\/li>\n<li><strong>Mixed forms<\/strong> \u2014 very common in the elderly, combining an Alzheimer&#8217;s component with a vascular or Lewy body component. These forms make differential diagnosis particularly complex.<\/li>\n<\/ol>\n<div class=\"info-box\">\n  <pee><strong>&#x1F4A1; Key figure.<\/strong> According to a study by Inserm published in 2023, more than one third of people diagnosed with &#8220;Alzheimer&#8217;s disease&#8221; in geriatric practices actually present a mixed form or an alternative pathology. This figure rises to 50% in cohorts of autopsied patients. The improvement of diagnostic tools (biomarkers, advanced neuroimaging) is gradually allowing better identification of these forms, but daily clinical observation in nursing homes remains a valuable detection tool.<\/pee>\n<\/div>\n<p><!-- SECTION 2 --><\/p>\n<h2 id=\"distinguer\">2. Why distinguishing these pathologies is essential in nursing homes<\/h2>\n<pee>One might be tempted to think that, faced with a resident in a nursing home whose dementia is advanced, the distinction between Alzheimer&#8217;s and a related disease matters little: support will anyway be focused on comfort, safety, and quality of life. This reasoning, although intuitively appealing, is erroneous for at least four major reasons.<\/pee>\n<h3>Vital medication contraindications<\/h3>\n<pee>Lewy body dementia perfectly illustrates this issue. Classic neuroleptics (haloperidol, chlorpromazine) are frequently prescribed to manage behavioral disorders in Alzheimer&#8217;s disease. In LBD, they cause severe hypersensitivity reactions, potentially fatal: extreme rigidity, coma, malignant hyperthermia. A hospitalized LBD resident for agitation treated with neuroleptics may not survive. The vigilance of the care team regarding signs indicative of LBD can literally save a life.<\/pee>\n<h3>Different cognitive stimulation modalities<\/h3>\n<pee>Standard cognitive stimulation in nursing homes is often modeled on the needs of Alzheimer&#8217;s disease: episodic memory exercises, fact recall, temporal orientation. This approach is counterproductive, even painful, for a resident with frontotemporal dementia whose episodic memory is long preserved but who presents severe apathy or disinhibition. It is unsuitable for a patient with primary progressive aphasia who can no longer perceive space correctly. <strong>Adapting cognitive stimulation to the resident&#8217;s actual neuropsychological profile<\/strong> is a condition for its effectiveness.<\/pee>\n<h3>A better understanding of disruptive behaviors<\/h3>\n<pee>Aggression, disinhibition, and aberrant eating behaviors of a frontotemporal dementia resident are sometimes interpreted as &#8220;Alzheimer&#8217;s agitation&#8221; and managed by inappropriate behavioral measures. Understanding that these behaviors are the direct consequence of frontal damage \u2014 and not of bad will or anxiety \u2014 radically changes the approach. The team can anticipate, structure the environment, and de-dramatize rather than react in urgency.<\/pee>\n<h3>Better support for families<\/h3>\n<pee>Families of residents with frontotemporal dementia or LBD are often bewildered by symptoms they had not anticipated. LBD, in particular, affects relatively young people and often presents with personality changes that those around interpret as a &#8220;change in character&#8221; or a psychiatric problem. A trained team can help the family recontextualize these behaviors within the framework of the disease, which reduces guilt and improves the quality of visits.<\/pee>\n<div class=\"article-quote\">\n  <pee>\u00ab&nbsp;When I understood that my husband&#8217;s aggression was not directed at me but was a neurological consequence of his illness, something was released in me. I was able to start visiting him again peacefully.&nbsp;\u00bb<\/pee>\n<div class=\"quote-author\">\u2014 Testimony from a wife of a resident with FTD, Nursing home Loire-Atlantique<\/div>\n<\/div>\n<p><!-- SECTION 3 --><\/p>\n<h2 id=\"dft\">3. Frontotemporal dementia (FTD)&nbsp;: when behavior takes precedence<\/h2>\n<pee>Frontotemporal dementia is a group of degenerative pathologies characterized by a preferential impairment of the frontal and anterior temporal lobes. It differs from Alzheimer&#8217;s disease by several major clinical features.<\/pee>\n<h3>An earlier onset<\/h3>\n<pee>The average onset age of FTD is 58 years, compared to 73 years for Alzheimer&#8217;s. This difference is fundamental in a Nursing home&nbsp;: a 60-year-old resident with severe behavioral disorders, whose episodic memory remains relatively preserved, should be directed towards FTD rather than atypical Alzheimer&#8217;s. Care in a traditional geriatric facility is often unsuitable for these younger, more active profiles, with different social needs.<\/pee>\n<h3>Three main clinical variants<\/h3>\n<pee>FTD has three main presentations. The <strong>behavioral variant (bvFTD)<\/strong> is the most common (50&nbsp;% of cases). It manifests as disinhibition, apathy, loss of empathy, stereotyped behaviors, changes in eating habits (hyperphagia, preference for sweets). Episodic memory is initially preserved, but executive functions are severely impaired.<\/pee>\n<pee>The <strong>semantic aphasia variant (SV)<\/strong> is characterized by a progressive loss of meaning of words and concepts. The resident speaks fluently but empties their sentences of semantic content (\u201c&nbsp;thing&nbsp;\u201d, \u201c&nbsp;stuff&nbsp;\u201d, descriptions instead of names). They may no longer recognize famous faces or common objects. The <strong>non-fluent primary progressive aphasia (NFPA)<\/strong>, the third variant, is characterized by significant speech effort, apraxia of speech, progressive dysarthria with language comprehension preserved for a long time.<\/pee>\n<h3>What this changes for the caregiving team<\/h3>\n<pee>When faced with a bvFTD resident, the team should expect disconcerting behaviors&nbsp;: lack of modesty, inappropriate comments, excessive food consumption, rigidity regarding daily rituals. These behaviors are neither malice nor a refusal of authority&nbsp;: they are the direct consequence of frontal disinhibition. The strategy is not confrontation but <strong>reorientation and structuring<\/strong>.<\/pee>\n<div class=\"key-points\">\n<h3>&#x1F9E0; Warning signs of DFT to monitor in Nursing home<\/h3>\n<ul>\n<li>Onset age between 50 and 65 years<\/li>\n<li>Marked personality changes before memory disorders<\/li>\n<li>Social disinhibition (inappropriate remarks, inappropriate sexual behaviors)<\/li>\n<li>Profound apathy without sadness or depressive mood<\/li>\n<li>Hyperphagia, sudden preference for sweet foods<\/li>\n<li>Repetitive or ritualized behaviors (counting, organizing, stamping)<\/li>\n<li>Loss of empathy and interest in others<\/li>\n<li>Relatively preserved episodic memory at the beginning of evolution<\/li>\n<\/ul>\n<\/div>\n<p><!-- SECTION 4 --><\/p>\n<h2 id=\"dcl\">4. Lewy body dementia (LBD)&nbsp;: vigilance on treatments<\/h2>\n<pee>Lewy body dementia is the second leading cause of degenerative dementia, accounting for about 15 to 20&nbsp;% of cases. It is caused by the accumulation of alpha-synuclein protein in neurons in the form of Lewy bodies, affecting the cerebral cortices and subcortical structures.<\/pee>\n<h3>The characteristic clinical triad<\/h3>\n<pee>The diagnosis of LBD is based on three cardinal symptoms. <strong>Cognitive fluctuations<\/strong> are significant variations in attention and alertness throughout the day or from day to day&nbsp;: the resident may be clearly awake and communicative in the morning, then prostrate and confused in the afternoon, without apparent reason. These fluctuations are often mistakenly interpreted as simulation or depression.<\/pee>\n<pee><strong>Early and recurrent visual hallucinations<\/strong> are almost pathognomonic of LBD. They typically involve images of animals, children, or unknown people, often described accurately and relatively calmly by the resident. They may precede cognitive decline by several years. The <strong>spontaneous parkinsonian syndrome<\/strong> \u2014 rigidity, bradykinesia, postural instability, sometimes tremor \u2014 completes the triad.<\/pee>\n<h3>Major medication risks<\/h3>\n<pee>One of the most critical issues of LBD in Nursing homes is the <strong>extreme sensitivity to neuroleptics<\/strong>. Classic antipsychotics (haloperidol, chlorpromazine) as well as some atypicals (risperidone, olanzapine) can cause in LBD a syndrome of severe sensitivity&nbsp;: abrupt worsening of cognitive disorders, massive rigidity, hyperthermia, stuporous state that can be fatal. This reaction occurs in 30 to 50&nbsp;% of LBD cases exposed to neuroleptics.<\/pee>\n<pee>Equally problematic&nbsp;: <strong>anticholinergic effect medications<\/strong> (certain antihistamines, tricyclic antidepressants, urinary antispasmodics) are poorly tolerated in LBD and worsen confusion. The care team must systematically alert the coordinating physician before introducing any new treatment for a resident suspected of having LBD.<\/pee>\n<h3>Appropriate support in Nursing homes<\/h3>\n<pee>Hallucinations in LBD are rarely anxiety-provoking if one does not seek to &#8220;correct&#8221; them. The most effective strategy is to <strong>not confront the resident<\/strong> about the reality of their visions, but to accompany them in their experience (\u201cDo these people scare you? Would you like us to stay with you?\u201d). Activities should take into account cognitive fluctuations&nbsp;: plan stimulation workshops at times of better alertness, usually in the morning.<\/pee>\n<div class=\"error-box\">\n<div class=\"error-box-title\">&#x26A0;&#xFE0F; Frequent and dangerous error<\/div>\n<pee>Prescribing or administering a classic neuroleptic to &#8220;calm&#8221; an agitated resident presenting visual hallucinations without having excluded a DCL. This error typically occurs during an emergency hospitalization when the diagnosis of DCL is not mentioned in the transfer record.<\/pee>\n<\/div>\n<div class=\"error-fix\">\n<div class=\"error-fix-title\">&#x2705; Good practice<\/div>\n<pee>Explicitly mention &#8220;suspicion or diagnosis of DCL \u2014 neuroleptics contraindicated&#8221; in any transfer document, discharge prescription, and shared care record. Some nursing homes place a specific alert in the computerized record.<\/pee>\n<\/div>\n<p><!-- SECTION 5 --><\/p>\n<h2 id=\"vasculaire\">5. Vascular dementia: a stepwise progression<\/h2>\n<pee>Vascular dementia is the consequence of brain damage of vascular origin: multiple infarcts, diffuse subcortical lesions (leukoaraiosis), or sequelae of a strategic stroke affecting a key brain area. It represents about 15% of dementias, but this proportion is likely underestimated due to the frequency of mixed forms.<\/pee>\n<h3>A clinical presentation distinct from Alzheimer&#8217;s<\/h3>\n<pee>Unlike Alzheimer&#8217;s, whose decline is progressive and regular, vascular dementia often evolves in a <strong>stepwise manner<\/strong>: the patient experiences a sudden deterioration at the time of a new vascular event, followed by a period of relative stability, then another decline. This discontinuous progression is an important warning sign.<\/pee>\n<pee>Episodic memory is often relatively preserved at the onset, unlike in Alzheimer&#8217;s. It is the <strong>executive and attentional functions<\/strong> that are affected first: slow processing, planning difficulties, concentration problems, psychomotor slowing. Associated neurological signs are common: gait disturbances, early urinary incontinence, pseudobulbar syndrome (spasmodic laughter and crying).<\/pee>\n<h3>Vascular risk factors at the heart of prevention<\/h3>\n<pee>Vascular dementia is the only form of dementia for which preventive action remains effective even after the first symptoms. <strong>Control of vascular risk factors<\/strong> \u2014 high blood pressure, diabetes, atrial fibrillation, dyslipidemia, smoking \u2014 slows the onset of new lesions and stabilizes the clinical picture. In nursing homes, vigilance regarding blood pressure, anticoagulant treatment in case of fibrillation, and overall therapeutic adherence are integral to care.<\/pee>\n<h3>Adapting support to the vascular profile<\/h3>\n<pee>The vascular resident tires quickly and shows great variability in performance depending on the time and conditions. Activities should be short, well-structured, with simple and clear instructions. Stimulation of executive functions \u2014 sorting, organizing a task sequentially \u2014 is more relevant than episodic memory exercises. Attention to <strong>gait disturbances and fall risks<\/strong> is also crucial.<\/pee>\n<p><!-- SECTION 6 --><\/p>\n<h2 id=\"psp-acm\">6. PSP, ACM, and other Parkinson-plus syndromes<\/h2>\n<h3>Progressive supranuclear palsy (PSP)<\/h3>\n<pee>PSP is an atypical parkinsonian syndrome caused by the accumulation of tau protein in the neurons of the brainstem and basal ganglia. It is distinguished from Parkinson&#8217;s disease by <strong>early and severe postural instability<\/strong> (falls in the early years), a <strong>disorder of gaze verticality<\/strong> (difficulty looking down, a nearly pathognomonic sign), and <strong>marked dysarthria<\/strong>.<\/pee>\n<pee>Cognitive disorders in PSP are of the fronto-subcortical type: ideomotor slowing, dysexecutive syndrome, apathy. Episodic memory is initially preserved. Swallowing impairment is a severe and early complication, warranting careful monitoring and rapid adaptation of food texture.<\/pee>\n<h3>Posterior cortical atrophy (PCA)<\/h3>\n<pee>PCA is a variant of Alzheimer&#8217;s in which lesions predominate in the parietal and occipital cortices. The clinical picture is dominated by <strong>early and severe visuospatial disorders<\/strong>: inability to locate objects in space, to read, to recognize faces or objects (visual agnosia), to perform complex gestures (apraxia). Memory and language are preserved for a long time, creating a disconcerting gap between the resident&#8217;s verbal abilities and their functional incapacities.<\/pee>\n<pee>In nursing homes, the PCA resident is often perceived as &#8220;strange&#8221; or &#8220;a simulator&#8221; because they can hold a coherent conversation but are unable to find their room, recognize their plate, or use a spoon. Understanding this neuropsychological profile by the team is essential to adapt the environment (strong visual signage, uncluttered environment, assistance with daily gestures) and avoid paradoxical injunctions.<\/pee>\n<div class=\"info-box\">\n  <pee><strong>&#x1F4A1; Posterior cortical atrophy and reading.<\/strong> ACP residents often lose the ability to read long before they lose the ability to speak. If a resident expresses frustration with newspapers or books brought to them, they are not &#8220;refusing to engage&#8221;: they may genuinely no longer see letters as meaningful units. Audiobooks, podcasts, and radio shows are valuable alternatives.<\/pee>\n<\/div>\n<p><!-- SECTION 7 --><\/p>\n<h2 id=\"tableau-comparatif\">7. Comparative table: distinctive signs by pathology<\/h2>\n<table class=\"comparison-table\">\n<thead>\n<tr>\n<th>Pathology<\/th>\n<th>Onset age<\/th>\n<th>First symptom<\/th>\n<th>Episodic memory<\/th>\n<th>Medication alert<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Typical Alzheimer&#8217;s<\/td>\n<td>70-80 years<\/td>\n<td>Recent forgetfulness, disorientation<\/td>\n<td>Early and severe impairment<\/td>\n<td>Anticholinergics discouraged<\/td>\n<\/tr>\n<tr>\n<td>Behavioral variant FTD<\/td>\n<td>50-65 years<\/td>\n<td>Personality change, disinhibition<\/td>\n<td>Long preserved<\/td>\n<td>Risky neuroleptics<\/td>\n<\/tr>\n<tr>\n<td>Semantic variant FTD<\/td>\n<td>55-70 years<\/td>\n<td>Loss of meaning of words<\/td>\n<td>Long preserved<\/td>\n<td>Little specificity<\/td>\n<\/tr>\n<tr>\n<td>Lewy body dementia<\/td>\n<td>65-80 years<\/td>\n<td>Visual hallucinations, fluctuations<\/td>\n<td>Moderate early impairment<\/td>\n<td>CONTRAINDICATED neuroleptics<\/td>\n<\/tr>\n<tr>\n<td>Vascular dementia<\/td>\n<td>65-80 years<\/td>\n<td>Slowing, executive disorders<\/td>\n<td>Relatively preserved<\/td>\n<td>Adjust antihypertensives<\/td>\n<\/tr>\n<tr>\n<td>PSP<\/td>\n<td>60-70 years<\/td>\n<td>Falls, downward gaze disorder<\/td>\n<td>Long preserved<\/td>\n<td>L-Dopa minimally effective<\/td>\n<\/tr>\n<tr>\n<td>Posterior cortical atrophy<\/td>\n<td>55-65 years<\/td>\n<td>Visuospatial disorders, apraxia<\/td>\n<td>Long preserved<\/td>\n<td>Anticholinergics discouraged<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<pee>This table is a clinical orientation tool, not a diagnostic one. It serves to structure observation and formulate relevant questions for the coordinating physician or neurologist. The formal differential diagnosis relies on a comprehensive neuropsychological examination, neuroimaging (brain MRI), and increasingly, on biomarkers in the CSF or through amyloid PET.<\/pee>\n<p><!-- SECTION 8 --><\/p>\n<h2 id=\"adapter-soins\">8. Concrete adaptation of care practices<\/h2>\n<pee>Knowing the different pathologies is necessary but insufficient. The added value of this knowledge is measured in the concrete adjustments it allows on a daily basis. Here is how the specificities of each pathology translate into adapted care practices.<\/pee>\n<h3>Communication and caregiver-resident relationship<\/h3>\n<pee>In <strong>FTD<\/strong>, the relationship must be firm without being confrontational. The resident is unaware of their inappropriate behaviors (frontal anosognosia): arguing is pointless. The technique of diversion and proposing an alternative activity is more effective. The team must be prepared not to take inappropriate remarks personally.<\/pee>\n<pee>In <strong>AD<\/strong>, cognitive fluctuations make exchanges very variable. The caregiver must adapt to the resident&#8217;s level of alertness in the moment, not insist during phases of confusion, and resume communication during phases of better clarity. Hallucinations deserve an empathetic, not corrective response (&#8220;I don&#8217;t see the same things you do, but I hear you&#8221;).<\/pee>\n<pee>In <strong>ACP<\/strong>, verbal comprehension being long preserved, the resident understands what is said to them. However, visual information reaches them distorted. The caregiver must <strong>verbally guide<\/strong> each gesture, orally describe what they are going to do, and avoid solely gestural instructions.<\/pee>\n<h3>Environmental adjustments<\/h3>\n<pee>For the <strong>FTD<\/strong> resident, structuring the environment means reducing uncontrolled stimuli (access to food, freedom to wander in unsuitable areas) while maintaining marked spaces of freedom. Rituals and routines are resources, not constraints: rely on them rather than breaking them.<\/pee>\n<pee>For the <strong>ACP<\/strong> resident, the environment must be visually uncluttered and well marked. Bright color cues on the bedroom door, a clearly defined path to the dining room, contrasting dishware with the tablecloth: these simple adjustments significantly reduce functional disorientation and situations of failure.<\/pee>\n<pee>For the <strong>PSP<\/strong> resident, fall prevention is a priority. The bed must be at a minimum height, the chair must provide good back support to compensate for postural instability, and thick-soled shoes should be avoided. The bedside table and elements of the room must be accessible without the resident having to lower their gaze.<\/pee>\n<h3>Nutrition and nursing care<\/h3>\n<pee>Swallowing disorders are early in <strong>PSP<\/strong> and late in Alzheimer&#8217;s. A speech therapy evaluation of swallowing should be anticipated well before the onset of significant aspiration. The texture and consistency of meals must be gradually adapted. Mealtime is also a risk moment for falls in PSP: the resident may tip backward while trying to look at their plate.<\/pee>\n<pee>In <strong>FTD<\/strong>, hyperphagia can be managed in small portions (several small servings) and by offering healthy alternatives freely accessible. Total removal of access to food leads to great agitation; it is better to channel than to prohibit.<\/pee>\n<div class=\"case-study\">\n<div class=\"case-study-header\">\n<div class=\"case-study-emoji\">&#x1F469;&#x200D;&#x2695;&#xFE0F;<\/div>\n<div>\n<div class=\"case-study-label\">\u00c9tude de cas &mdash; DCL<\/div>\n<div class=\"case-study-title\">Monsieur R., 76 ans, chutes inexpliqu\u00e9es et \u00ab&nbsp;visions&nbsp;\u00bb<\/div>\n<\/p><\/div>\n<\/p><\/div>\n<pee>Monsieur R. est admis en EHPAD pour des chutes \u00e0 r\u00e9p\u00e9tition et une d\u00e9sorientation progressive. L&#8217;\u00e9quipe note rapidement qu&#8217;il \u00ab&nbsp;parle \u00e0 des gens qui n&#8217;existent pas&nbsp;\u00bb et que ses capacit\u00e9s varient fortement selon les jours. Le m\u00e9decin coordonnateur prescrit un bilan neuropsychologique complet qui oriente vers une DCL. Une alerte \u00ab&nbsp;neuroleptiques contre-indiqu\u00e9s&nbsp;\u00bb est imm\u00e9diatement int\u00e9gr\u00e9e \u00e0 son dossier.<\/pee>\n  <pee>L&#8217;\u00e9quipe adapte le planning des ateliers aux cr\u00e9neaux de meilleure vigilance (10h-12h). Les hallucinations \u2014 des enfants jouant dans la chambre \u2014 sont g\u00e9r\u00e9es par validation \u00e9motionnelle sans confrontation. La famille est inform\u00e9e de la sp\u00e9cificit\u00e9 de la DCL et form\u00e9e \u00e0 r\u00e9pondre aux hallucinations de fa\u00e7on non anxiog\u00e8ne.<\/pee>\n<div class=\"case-study-result\">\n    <pee>&#x2705; <strong>R\u00e9sultat&nbsp;:<\/strong> Apr\u00e8s 3 mois, les \u00e9pisodes d&#8217;agitation nocturne ont diminu\u00e9 de fa\u00e7on significative. La famille rapporte des visites plus apais\u00e9es. Deux hospitalisations aux urgences ont \u00e9t\u00e9 \u00e9vit\u00e9es gr\u00e2ce \u00e0 l&#8217;alerte m\u00e9dicamenteuse dans le dossier de transfert.<\/pee>\n  <\/div>\n<\/div>\n<div class=\"case-study\">\n<div class=\"case-study-header\">\n<div class=\"case-study-emoji\">&#x1F9D3;<\/div>\n<div>\n<div class=\"case-study-label\">\u00c9tude de cas &mdash; DFT<\/div>\n<div class=\"case-study-title\">Madame C., 62 ans, \u00ab&nbsp;chang\u00e9e&nbsp;\u00bb depuis 2 ans<\/div>\n<\/p><\/div>\n<\/p><\/div>\n<pee>Madame C. est admise \u00e0 62 ans pour \u00ab&nbsp;troubles du comportement s\u00e9v\u00e8res&nbsp;\u00bb apr\u00e8s une p\u00e9riode de deux ans pendant laquelle sa famille a observ\u00e9 une d\u00e9sinhibition croissante, un d\u00e9sint\u00e9r\u00eat pour ses proches et des comportements alimentaires aberrants. Le diagnostic de DFT variante comportementale est pos\u00e9 par le neurologue au terme d&#8217;une IRM et d&#8217;un bilan neuropsychologique.<\/pee>\n  <pee>En EHPAD, les comportements d\u00e9sinhib\u00e9s cr\u00e9ent des tensions avec les autres r\u00e9sidents. L&#8217;\u00e9quipe met en place un environnement structur\u00e9 avec des rituels fixes (promenades \u00e0 heure r\u00e9guli\u00e8re, ateliers de cuisine adapt\u00e9e). Les soignants sont form\u00e9s \u00e0 la r\u00e9ponse non confrontationnelle. Un espace de d\u00e9ambulation s\u00e9curis\u00e9 lui est d\u00e9di\u00e9.<\/pee>\n<div class=\"case-study-result\">\n    <pee>&#x2705; <strong>R\u00e9sultat&nbsp;:<\/strong> La compr\u00e9hension de la nature neurologique des comportements a transform\u00e9 l&#8217;approche de l&#8217;\u00e9quipe. La charge \u00e9motionnelle des soignants a diminu\u00e9. La famille a pu reprendre des visites qu&#8217;elle avait espac\u00e9es faute de comprendre ce qui se passait.<\/pee>\n  <\/div>\n<\/div>\n<p><!-- SECTION 9 --><\/p>\n<h2 id=\"stimulation\">9. Stimulation cognitive&nbsp;: quels outils pour quels profils&nbsp;?<\/h2>\n<pee>La stimulation cognitive en EHPAD est souvent pens\u00e9e comme un bloc homog\u00e8ne d&#8217;activit\u00e9s b\u00e9n\u00e9fiques pour \u00ab&nbsp;les personnes d\u00e9mentes&nbsp;\u00bb. La r\u00e9alit\u00e9 neuropsychologique est bien plus nuanc\u00e9e. <strong>Stimuler de fa\u00e7on inadapt\u00e9e peut \u00eatre aussi d\u00e9l\u00e9t\u00e8re qu&#8217;une absence de stimulation<\/strong>&nbsp;: une activit\u00e9 de rem\u00e9moration pour un r\u00e9sident DFT dont la m\u00e9moire est pr\u00e9serv\u00e9e mais dont le comportement est d\u00e9sorganis\u00e9 aggrave l&#8217;agitation sans apporter de b\u00e9n\u00e9fice cognitif. Un exercice de lecture pour un r\u00e9sident ACP sans adaptation sensorielle est une source d&#8217;\u00e9chec et de frustration.<\/pee>\n<h3>Principes g\u00e9n\u00e9raux de la stimulation diff\u00e9renci\u00e9e<\/h3>\n<pee>Le premier principe est de <strong>partir du profil neuropsychologique r\u00e9el<\/strong> du r\u00e9sident et non du diagnostic seul. Deux r\u00e9sidents DFT peuvent avoir des profils tr\u00e8s diff\u00e9rents selon la variante et le stade de la maladie. Une \u00e9valuation neuropsychologique actualis\u00e9e, m\u00eame sommaire, guide plus efficacement le choix des activit\u00e9s qu&#8217;un diagnostic de cinq lettres.<\/pee>\n<pee>Le deuxi\u00e8me principe est de <strong>cibler les fonctions pr\u00e9serv\u00e9es<\/strong> autant que les fonctions d\u00e9ficitaires. La stimulation des capacit\u00e9s r\u00e9siduelles maintient l&#8217;estime de soi et l&#8217;engagement motivationnel. Un r\u00e9sident DCL peut avoir des capacit\u00e9s musicales longtemps pr\u00e9serv\u00e9es (m\u00e9moire proc\u00e9durale musicale)&nbsp;: la musicoth\u00e9rapie est un levier puissant. Un r\u00e9sident DFT variante s\u00e9mantique peut b\u00e9n\u00e9ficier de travaux manuels qui font appel \u00e0 la m\u00e9moire proc\u00e9durale plut\u00f4t qu&#8217;au langage.<\/pee>\n<h3>Le num\u00e9rique comme outil de stimulation adaptable<\/h3>\n<pee>Les outils num\u00e9riques de stimulation cognitive pr\u00e9sentent un avantage consid\u00e9rable pour les maladies apparent\u00e9es \u00e0 Alzheimer&nbsp;: la <strong>modularit\u00e9 fine des exercices<\/strong>. L\u00e0 o\u00f9 un atelier papier-crayon propose un niveau de difficult\u00e9 fixe, une application sur tablette peut adapter en temps r\u00e9el la complexit\u00e9, le nombre de distracteurs, le temps de r\u00e9ponse autoris\u00e9 et la modalit\u00e9 de pr\u00e9sentation (visuelle, auditive, combin\u00e9e).<\/pee>\n<pee>Pour un r\u00e9sident <strong>DCL<\/strong>, les exercices peuvent \u00eatre programm\u00e9s aux plages horaires de meilleure vigilance, avec des sessions courtes (10-15 minutes) et une interface simple. La tablette g\u00e9n\u00e8re des donn\u00e9es de suivi qui permettent d&#8217;objectiver les fluctuations cognitives&nbsp;: un graphique de performance sur plusieurs semaines montre clairement les variations, ce qui aide le m\u00e9decin \u00e0 ajuster la prise en charge.<\/pee>\n<pee>Pour un r\u00e9sident <strong>DFT variante comportementale<\/strong>, les exercices centr\u00e9s sur les fonctions ex\u00e9cutives (classement, s\u00e9quen\u00e7age, cat\u00e9gorisation) sont plus pertinents que les exercices de m\u00e9moire \u00e9pisodique. Les activit\u00e9s courtes avec feedback imm\u00e9diat maintiennent l&#8217;attention mieux que les t\u00e2ches longues et ouvertes. La tablette offre \u00e9galement un cadre contenant qui structure la session et r\u00e9duit les comportements d&#8217;errance ou de distractibilit\u00e9.<\/pee>\n<pee>Pour un r\u00e9sident <strong>ACP<\/strong>, les exercices doivent minimiser les t\u00e2ches visuospatiales et valoriser la compr\u00e9hension verbale et le langage. Les exercices d&#8217;\u00e9coute, de compr\u00e9hension orale, de fluence verbale et d&#8217;\u00e9vocation s\u00e9mantique sont adapt\u00e9s. La taille des \u00e9l\u00e9ments visuels sur l&#8217;\u00e9cran doit \u00eatre maximis\u00e9e et les contrastes renforc\u00e9s.<\/pee>\n<p><a href=\"https:\/\/www.dynseo.com\/en\/courses\/diseases-related-to-alzheimers-disease-understanding-distinguishing-and-adapting-practices-in-medicalized-residences-en\/\" class=\"internal-link\"><\/p>\n<div class=\"internal-link-icon\">&#x1F393;<\/div>\n<div class=\"internal-link-content\">\n<div class=\"internal-link-label\">Formation certifiante<\/div>\n<div class=\"internal-link-title\">Maladies apparent\u00e9es \u00e0 Alzheimer&nbsp;: comprendre, distinguer et adapter ses pratiques<\/div>\n<div class=\"internal-link-desc\">Formation DYNSEO pour professionnels en r\u00e9sidence m\u00e9dicalis\u00e9e &mdash; programme complet, cas cliniques et outils pratiques.<\/div>\n<\/p><\/div>\n<div class=\"internal-link-arrow\">&#x2192;<\/div>\n<p><\/a><\/p>\n<div class=\"key-points\">\n<h3>&#x1F4F1; Stimulation num\u00e9rique&nbsp;: ce que l&#8217;on cible par pathologie<\/h3>\n<ul>\n<li><strong>Alzheimer&nbsp;:<\/strong> m\u00e9moire \u00e9pisodique, orientation, lexique, communication<\/li>\n<li><strong>DFT comportementale&nbsp;:<\/strong> fonctions ex\u00e9cutives, attention, activit\u00e9s proc\u00e9durales<\/li>\n<li><strong>DFT s\u00e9mantique&nbsp;:<\/strong> enrichissement s\u00e9mantique, \u00e9vocation, communication non verbale<\/li>\n<li><strong>DCL&nbsp;:<\/strong> attention, m\u00e9moire proc\u00e9durale, musicoth\u00e9rapie, sessions courtes \u00e0 horaires fixes<\/li>\n<li><strong>D\u00e9mence vasculaire&nbsp;:<\/strong> attention divis\u00e9e, fonctions ex\u00e9cutives, vitesse de traitement<\/li>\n<li><strong>ACP&nbsp;:<\/strong> langage oral, compr\u00e9hension auditive, \u00e9vocation, praxies simples<\/li>\n<li><strong>PSP&nbsp;:<\/strong> communication verbale, d\u00e9glutition (avec orthophoniste), mobilit\u00e9 douce<\/li>\n<\/ul>\n<\/div>\n<p><!-- SECTION 10 --><\/p>\n<h2 id=\"equipe\">10. Travailler en \u00e9quipe pluridisciplinaire autour du diagnostic diff\u00e9rentiel<\/h2>\n<pee>La reconnaissance et l&#8217;accompagnement diff\u00e9renci\u00e9 des maladies apparent\u00e9es \u00e0 Alzheimer ne peuvent pas reposer sur un seul professionnel. C&#8217;est un travail d&#8217;\u00e9quipe, structur\u00e9 autour d&#8217;une culture commune, d&#8217;outils de transmission partag\u00e9s et d&#8217;une organisation qui valorise et exploite les observations du terrain.<\/pee>\n<h3>Le r\u00f4le cl\u00e9 de l&#8217;observation quotidienne<\/h3>\n<pee>Les aides-soignants, les ASH, les animateurs et les aides m\u00e9dico-psychologiques sont en contact direct et prolong\u00e9 avec les r\u00e9sidents. Ils sont les premiers \u00e0 percevoir les signes d&#8217;alerte&nbsp;: fluctuations inhabituelles, comportements nouveaux, hallucinations, chutes atypiques. Mais cette observation ne vaut que si elle est <strong>transmise, formalis\u00e9e et prise en compte<\/strong>.<\/pee>\n<pee>Une grille d&#8217;observation simple et partag\u00e9e \u2014 listant les signes distinctifs des principales pathologies \u2014 permet \u00e0 tout soignant, quelle que soit sa qualification, de contribuer \u00e0 l&#8217;affinement du tableau clinique. Ces observations doivent \u00eatre not\u00e9es dans le dossier de soin avec la date, l&#8217;heure, le contexte et le comportement observ\u00e9 pr\u00e9cis\u00e9ment d\u00e9crit. \u00ab&nbsp;Agitation dans la soir\u00e9e&nbsp;\u00bb est insuffisant. \u00ab&nbsp;\u00c0 20h30, a interpell\u00e9 plusieurs fois des personnes absentes, semblait voir quelqu&#8217;un dans le couloir, a \u00e9t\u00e9 calm\u00e9 par la pr\u00e9sence silencieuse d&#8217;une soignante pendant 10 minutes&nbsp;\u00bb est exploitable cliniquement.<\/pee>\n<h3>La r\u00e9union de synth\u00e8se pluridisciplinaire<\/h3>\n<pee>La r\u00e9union de synth\u00e8se est le lieu o\u00f9 les observations du terrain deviennent des d\u00e9cisions th\u00e9rapeutiques. Pour qu&#8217;elle joue ce r\u00f4le dans le diagnostic diff\u00e9rentiel, elle doit int\u00e9grer un <strong>temps d\u00e9di\u00e9 \u00e0 la r\u00e9vision des hypoth\u00e8ses diagnostiques<\/strong>. Un r\u00e9sident admis avec un diagnostic d&#8217;Alzheimer pr\u00e9sum\u00e9 peut, au fil des mois, montrer des signes \u00e9vocateurs d&#8217;une DCL ou d&#8217;une DFT. La r\u00e9union de synth\u00e8se est l&#8217;occasion de formuler ces questions et d&#8217;en r\u00e9f\u00e9rer au m\u00e9decin coordonnateur ou de solliciter un avis neurologique.<\/pee>\n<pee>La formation continue de l&#8217;\u00e9quipe joue un r\u00f4le central. Une \u00e9quipe qui conna\u00eet les signes cliniques des principales pathologies observe diff\u00e9remment. Elle formule des hypoth\u00e8ses, pose des questions, et contribue \u00e0 un tableau clinique plus pr\u00e9cis. Cette comp\u00e9tence collective am\u00e9liore directement la qualit\u00e9 des soins et la s\u00e9curit\u00e9 des r\u00e9sidents.<\/pee>\n<h3>Le m\u00e9decin coordonnateur et le neurologue<\/h3>\n<pee>Le m\u00e9decin coordonnateur est la charni\u00e8re entre les observations de l&#8217;\u00e9quipe soignante et les d\u00e9cisions m\u00e9dicales. Son r\u00f4le est d&#8217;int\u00e9grer les donn\u00e9es cliniques, de solliciter des bilans compl\u00e9mentaires si n\u00e9cessaire, et d&#8217;informer l&#8217;\u00e9quipe des implications pratiques du diagnostic. Un diagnostic diff\u00e9rentiel formalis\u00e9 \u2014 \u00ab&nbsp;ce r\u00e9sident pr\u00e9sente une DCL, neuroleptiques formellement contre-indiqu\u00e9s, adapter les horaires d&#8217;activit\u00e9 aux fluctuations&nbsp;\u00bb \u2014 traduit la clinique en directives concr\u00e8tes pour l&#8217;\u00e9quipe.<\/pee>\n<pee>La t\u00e9l\u00e9m\u00e9decine permet d\u00e9sormais, dans certains territoires, d&#8217;obtenir un avis neurologique sp\u00e9cialis\u00e9 sans d\u00e9placer le r\u00e9sident. Ces dispositifs facilitent l&#8217;acc\u00e8s \u00e0 une expertise difficile \u00e0 obtenir en zone rurale et permettent une r\u00e9vision des diagnostics sans hospitalisation longue et d\u00e9stabilisante pour le r\u00e9sident.<\/pee>\n<div class=\"article-quote\">\n  <pee>\u00ab&nbsp;Depuis que nous avons int\u00e9gr\u00e9 une formation sur les maladies apparent\u00e9es \u00e0 Alzheimer, nos transmissions ont chang\u00e9 de qualit\u00e9. Les aides-soignantes d\u00e9crivent ce qu&#8217;elles voient avec beaucoup plus de pr\u00e9cision. Et quand le m\u00e9decin coordonnateur arrive \u00e0 la r\u00e9union de synth\u00e8se, il a d\u00e9j\u00e0 tous les \u00e9l\u00e9ments pour raisonner.&nbsp;\u00bb<\/pee>\n<div class=\"quote-author\">\u2014 Infirmi\u00e8re coordinatrice, EHPAD Seine-et-Marne<\/div>\n<\/div>\n<h3>Soutenir et former les \u00e9quipes en continu<\/h3>\n<pee>L&#8217;accompagnement de r\u00e9sidents atteints de DFT, de DCL ou de PSP est exigeant sur le plan \u00e9motionnel. Les comportements d\u00e9sinhib\u00e9s, les hallucinations, la lenteur extr\u00eame du r\u00e9sident PSP, les fluctuations d\u00e9concertantes de la DCL \u2014 tout cela sollicite des ressources psychologiques importantes chez les soignants. La formation ne suffit pas si elle n&#8217;est pas accompagn\u00e9e d&#8217;un <strong>espace de parole et d&#8217;analyse des pratiques<\/strong>.<\/pee>\n<pee>La supervision d&#8217;\u00e9quipe, les groupes de parole anim\u00e9s par un psychologue, et les formations courtes cibl\u00e9es sur des situations concr\u00e8tes permettent de transformer la connaissance th\u00e9orique en comp\u00e9tences pratiques solides et durables. Les soignants qui comprennent pourquoi un r\u00e9sident DFT se comporte ainsi ne vivent pas cet accompagnement de la m\u00eame fa\u00e7on que ceux qui l&#8217;interpr\u00e8tent comme de la mauvaise volont\u00e9.<\/pee>\n<div class=\"key-points\">\n<h3>&#x1F91D; Construire une \u00e9quipe comp\u00e9tente sur les maladies apparent\u00e9es<\/h3>\n<ul>\n<li>Former l&#8217;ensemble de l&#8217;\u00e9quipe aux signes d&#8217;alerte des principales pathologies (pas seulement les IDE)<\/li>\n<li>Mettre en place une grille d&#8217;observation partag\u00e9e et accessible dans le dossier de soin<\/li>\n<li>D\u00e9dier un temps en r\u00e9union de synth\u00e8se \u00e0 la r\u00e9vision des hypoth\u00e8ses diagnostiques<\/li>\n<li>Cr\u00e9er une proc\u00e9dure d&#8217;alerte \u00ab&nbsp;contre-indication m\u00e9dicamenteuse&nbsp;\u00bb dans le dossier de transfert<\/li>\n<li>Organiser des formations courtes sur des cas cliniques concrets (DFT, DCL, ACP)<\/li>\n<li>Proposer des espaces de parole pour les soignants qui accompagnent ces profils difficiles<\/li>\n<li>Int\u00e9grer les familles dans la compr\u00e9hension des sp\u00e9cificit\u00e9s de la pathologie<\/li>\n<li>Utiliser des outils num\u00e9riques de stimulation cognitive modulables et tra\u00e7ables<\/li>\n<\/ul>\n<\/div>\n<pee>Comprendre les maladies apparent\u00e9es \u00e0 Alzheimer dans leur singularit\u00e9 clinique, c&#8217;est redonner \u00e0 chaque r\u00e9sident l&#8217;accompagnement qui correspond pr\u00e9cis\u00e9ment \u00e0 ce qu&#8217;il vit dans son cerveau et dans son corps. C&#8217;est aussi redonner aux \u00e9quipes soignantes un cadre de compr\u00e9hension qui transforme des comportements perturbants en signes cliniques intelligibles &mdash; et les soignants d\u00e9munis en professionnels comp\u00e9tents et serein. Cette comp\u00e9tence s&#8217;acquiert, se partage et s&#8217;entretient. Elle est au c\u0153ur de la qualit\u00e9 de vie en EHPAD.<\/pee>\n<div class=\"cta-box\">\n<h3>&#x1F393; Approfondir avec la formation certifiante DYNSEO<\/h3>\n<pee>Formez votre \u00e9quipe \u00e0 distinguer et accompagner les maladies apparent\u00e9es \u00e0 Alzheimer&nbsp;: DFT, DCL, d\u00e9mence vasculaire, PSP, ACP. Programme certifi\u00e9 Qualiopi, cas cliniques r\u00e9els, outils pratiques directement applicables en r\u00e9sidence m\u00e9dicalis\u00e9e.<\/pee>\n<div class=\"cta-buttons\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/courses\/diseases-related-to-alzheimers-disease-understanding-distinguishing-and-adapting-practices-in-medicalized-residences-en\/\" class=\"btn-cta-white\">&#x1F4CB; Voir le programme<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/formations\/\" class=\"btn-cta-outline\">Toutes les formations &#x2192;<\/a>\n  <\/div>\n<\/div>\n<div class=\"article-tags\">\n  <a href=\"#\" class=\"article-tag\">maladies apparent\u00e9es Alzheimer<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">EHPAD<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">d\u00e9mence \u00e0 corps de Lewy<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">d\u00e9mence frontotemporale<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">d\u00e9mence vasculaire<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">PSP<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">formation soignants<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">DYNSEO<\/a>\n<\/div>\n<\/article>\n<\/div>\n<\/div>\n<p>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":116414,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"[et_pb_section fb_built=\"1\" admin_label=\"Article HTML\" _builder_version=\"4.16\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_row admin_label=\"Contenu\" _builder_version=\"4.16\" width=\"100%\" max_width=\"100%\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_column type=\"4_4\" _builder_version=\"4.16\" global_colors_info=\"{}\"][et_pb_code admin_label=\"HTML import\u00e9\" _builder_version=\"4.16\" 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.container {padding:0 16px;}\n.dbi-art-ae1838 .article-body p {font-size:14px;}\n.dbi-art-ae1838 .key-points, .dbi-art-ae1838 .info-box, .dbi-art-ae1838 .error-box, .dbi-art-ae1838 .error-fix {padding:24px 20px;}\n.dbi-art-ae1838 .article-quote {padding:24px 20px;}\n.dbi-art-ae1838 .case-study {padding:24px 20px;}\n.dbi-art-ae1838 .numbered-list li {padding:16px 16px 16px 60px;}\n.dbi-art-ae1838 .cta-box {padding:30px 20px;}\n.dbi-art-ae1838 .cta-box h3 {font-size:19px;}\n.dbi-art-ae1838 .cta-box .cta-buttons {flex-direction:column;max-width:260px;margin-left:auto;margin-right:auto;}\n.dbi-art-ae1838 .btn-cta-white, .dbi-art-ae1838 .btn-cta-outline {width:100%;text-align:center;padding:13px 24px;font-size:13px;}\n.dbi-art-ae1838 .internal-link {flex-direction:column;text-align:center;gap:12px;padding:22px 18px;}\n.dbi-art-ae1838 .internal-link-arrow {transform:rotate(90deg);}\n.dbi-art-ae1838 .internal-link:hover .internal-link-arrow {transform:rotate(90deg) translateX(4px);}\n.dbi-art-ae1838 .comparison-table {font-size:12px;}\n.dbi-art-ae1838 .comparison-table thead th, .dbi-art-ae1838 .comparison-table tbody td {padding:10px 12px;}\n.dbi-art-ae1838 .toc {padding:22px 20px;}\n}\n\n<\/style>\n<script type=\"application\/ld+json\">\n{\n  \"@context\":\"https:\/\/schema.org\",\n  \"@type\":\"Article\",\n  \"headline\":\"Maladies apparent\u00e9es \u00e0 la maladie d'Alzheimer : comprendre, distinguer et adapter ses pratiques en r\u00e9sidence m\u00e9dicalis\u00e9e\",\n  \"description\":\"Guide clinique pour professionnels en EHPAD : d\u00e9mence frontotemporale, corps de Lewy, vasculaire, PSP, ACP. Signes distinctifs, contre-indications m\u00e9dicamenteuses, stimulation adapt\u00e9e.\",\n  \"author\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\",\"url\":\"https:\/\/www.dynseo.com\"},\n  \"publisher\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\",\"logo\":{\"@type\":\"ImageObject\",\"url\":\"https:\/\/www.dynseo.com\/wp-content\/uploads\/2021\/03\/logo-dynseo.png\"}},\n  \"datePublished\":\"2026-03-05\",\n  \"dateModified\":\"2026-03-05\",\n  \"mainEntityOfPage\":\"https:\/\/www.dynseo.com\/maladies-apparentees-alzheimer-ehpad\/\"\n}\n<\/script>\n<div class=\"dbi-art-ae1838\">\n<header class=\"article-hero\">\n  <div class=\"article-hero-inner\">\n    <nav class=\"article-breadcrumb\">\n      <a href=\"https:\/\/www.dynseo.com\/\">Home<\/a> &rsaquo;\n      <a href=\"https:\/\/www.dynseo.com\/professionnels-de-sante\/\">Professionals<\/a> &rsaquo;\n      Alzheimer's-related diseases\n    <\/nav>\n    <span class=\"article-category\">&#x1F9E0; CLINICAL GUIDE<\/span>\n    <h1>Alzheimer's-related diseases: understanding, distinguishing and <span class=\"hl\">adapting practices<\/span> in nursing home<\/h1>\n    <div class=\"article-meta\">\n      <span>&#x1F4C5; March 2026<\/span>\n      <span>&#x23F1; 18 min read<\/span>\n      <span>&#x1F9D1;&#x200D;&#x2695;&#xFE0F; By the DYNSEO team<\/span>\n    <\/div>\n  <\/div>\n  <div class=\"article-hero-curve\"><\/div>\n<\/header>\n\n<div class=\"container\">\n<article class=\"article-body\">\n\n<div class=\"toc\">\n  <h4>&#x1F4D1; Summary<\/h4>\n  <ol>\n    <li><a href=\"#panorama\">Overview of Alzheimer's-related diseases<\/a><\/li>\n    <li><a href=\"#distinguer\">Why distinguishing these pathologies is essential in nursing homes<\/a><\/li>\n    <li><a href=\"#dft\">Frontotemporal dementia (FTD): when behavior takes precedence<\/a><\/li>\n    <li><a href=\"#dcl\">Lewy body dementia (LBD): caution regarding treatments<\/a><\/li>\n    <li><a href=\"#vasculaire\">Vascular dementia: a progression with ups and downs<\/a><\/li>\n    <li><a href=\"#psp-acm\">PSP, MSA and other Parkinson-plus syndromes<\/a><\/li>\n    <li><a href=\"#tableau-comparatif\">Comparative table: distinctive signs by pathology<\/a><\/li>\n    <li><a href=\"#adapter-soins\">Concretely adapting care practices<\/a><\/li>\n    <li><a href=\"#stimulation\">Cognitive stimulation: which tools for which profiles?<\/a><\/li>\n    <li><a href=\"#equipe\">Working in a multidisciplinary team around differential diagnosis<\/a><\/li>\n  <\/ol>\n<\/div>\n\n<p>In nursing homes and EHPADs, Alzheimer's disease occupies a central place in the training of care teams. This is legitimate: it accounts for 60 to 70% of dementia cases in France. However, this omnipresence sometimes creates a clinical blind spot: the <strong>Alzheimer's-related diseases<\/strong> \u2014 Lewy body dementia, frontotemporal dementia, vascular dementia, progressive supranuclear palsy, posterior cortical atrophy \u2014 are frequently underdiagnosed or wrongly assimilated to \"classic\" Alzheimer's disease.<\/p>\n\n<p>This confusion is not without consequences. Adapting practices to Alzheimer's disease when actually accompanying someone with Lewy body dementia risks inappropriate medication, poorly targeted stimulation, and a misunderstanding of behaviors that exhausts the team and increases the suffering of the resident. Conversely, recognizing the specificity of each pathology allows for <strong>personalized support<\/strong>, prevents avoidable complications, and better supports families.<\/p>\n\n<p>This guide is aimed at care professionals in nursing homes: nursing assistants, nurses, activity coordinators, psychologists, occupational therapists, care coordinators. It does not replace a medical diagnosis but provides you with the keys to <strong>observe, alert, and adapt<\/strong> appropriately on a daily basis.<\/p>\n\n<!-- SECTION 1 -->\n<h2 id=\"panorama\">1. Overview of Alzheimer's-related diseases<\/h2>\n\n<p>The term \"dementia\" refers to a clinical syndrome characterized by a cognitive decline severe enough to impact daily life. This syndrome can be caused by many different pathologies. Alzheimer's disease is the most common form, but it is far from the only one.<\/p>\n\n<p>The World Health Organization estimates that around 55 million people live with dementia worldwide, and this number will double by 2050. In France, there are approximately 1.2 million affected individuals. Among them, 30 to 40% have a pathology other than Alzheimer's or a mixed form combining several pathological mechanisms.<\/p>\n\n<p>The main pathologies grouped under the term \"Alzheimer's-related diseases\" are as follows:<\/p>\n\n<ol class=\"numbered-list\">\n  <li><strong>Frontotemporal dementia (FTD)<\/strong> \u2014 preferential involvement of the frontal and temporal lobes, often with early onset (50-65 years), marked by behavioral or language disturbances at the forefront.<\/li>\n  <li><strong>Lewy body dementia (LBD)<\/strong> \u2014 the second leading cause of degenerative dementia after Alzheimer's, characterized by a triad: cognitive fluctuations, early visual hallucinations, and parkinsonian syndrome.<\/li>\n  <li><strong>Vascular dementia<\/strong> \u2014 a consequence of cerebrovascular damage (Stroke, lacunes, leukoaraiosis), with a progression often marked by ups and downs and a relative preservation of episodic memory in the early stages.<\/li>\n  <li><strong>Progressive supranuclear palsy (PSP)<\/strong> \u2014 atypical parkinsonian syndrome with vertical oculomotor dysfunction, early postural instability, and frontal dysexecutive syndrome.<\/li>\n  <li><strong>Posterior cortical atrophy (PCA)<\/strong> \u2014 a variant of Alzheimer's with visual onset, spatial disorientation, early praxic disturbances, and agnosia, but with memory preserved for a long time.<\/li>\n  <li><strong>Creutzfeldt-Jakob disease (CJD)<\/strong> \u2014 a rare spongiform encephalopathy, with very rapid progression (weeks to months), presenting polymorphically with cognitive disturbances, myoclonus, and diffuse neurological signs.<\/li>\n  <li><strong>Mixed forms<\/strong> \u2014 very common in the elderly, combining an Alzheimer's component with a vascular or Lewy body component. These forms make differential diagnosis particularly complex.<\/li>\n<\/ol>\n<div class=\"info-box\">\n  <p><strong>&#x1F4A1; Key figure.<\/strong> According to a study by Inserm published in 2023, more than one third of people diagnosed with \"Alzheimer's disease\" in geriatric practices actually present a mixed form or an alternative pathology. This figure rises to 50% in cohorts of autopsied patients. The improvement of diagnostic tools (biomarkers, advanced neuroimaging) is gradually allowing better identification of these forms, but daily clinical observation in nursing homes remains a valuable detection tool.<\/p>\n<\/div>\n\n<!-- SECTION 2 -->\n<h2 id=\"distinguer\">2. Why distinguishing these pathologies is essential in nursing homes<\/h2>\n\n<p>One might be tempted to think that, faced with a resident in a nursing home whose dementia is advanced, the distinction between Alzheimer's and a related disease matters little: support will anyway be focused on comfort, safety, and quality of life. This reasoning, although intuitively appealing, is erroneous for at least four major reasons.<\/p>\n\n<h3>Vital medication contraindications<\/h3>\n\n<p>Lewy body dementia perfectly illustrates this issue. Classic neuroleptics (haloperidol, chlorpromazine) are frequently prescribed to manage behavioral disorders in Alzheimer's disease. In LBD, they cause severe hypersensitivity reactions, potentially fatal: extreme rigidity, coma, malignant hyperthermia. A hospitalized LBD resident for agitation treated with neuroleptics may not survive. The vigilance of the care team regarding signs indicative of LBD can literally save a life.<\/p>\n\n<h3>Different cognitive stimulation modalities<\/h3>\n\n<p>Standard cognitive stimulation in nursing homes is often modeled on the needs of Alzheimer's disease: episodic memory exercises, fact recall, temporal orientation. This approach is counterproductive, even painful, for a resident with frontotemporal dementia whose episodic memory is long preserved but who presents severe apathy or disinhibition. It is unsuitable for a patient with primary progressive aphasia who can no longer perceive space correctly. <strong>Adapting cognitive stimulation to the resident's actual neuropsychological profile<\/strong> is a condition for its effectiveness.<\/p>\n\n<h3>A better understanding of disruptive behaviors<\/h3>\n\n<p>Aggression, disinhibition, and aberrant eating behaviors of a frontotemporal dementia resident are sometimes interpreted as \"Alzheimer's agitation\" and managed by inappropriate behavioral measures. Understanding that these behaviors are the direct consequence of frontal damage \u2014 and not of bad will or anxiety \u2014 radically changes the approach. The team can anticipate, structure the environment, and de-dramatize rather than react in urgency.<\/p>\n\n<h3>Better support for families<\/h3>\n\n<p>Families of residents with frontotemporal dementia or LBD are often bewildered by symptoms they had not anticipated. LBD, in particular, affects relatively young people and often presents with personality changes that those around interpret as a \"change in character\" or a psychiatric problem. A trained team can help the family recontextualize these behaviors within the framework of the disease, which reduces guilt and improves the quality of visits.<\/p>\n<div class=\"article-quote\">\n  <p>\u00ab&nbsp;When I understood that my husband's aggression was not directed at me but was a neurological consequence of his illness, something was released in me. I was able to start visiting him again peacefully.&nbsp;\u00bb<\/p>\n  <div class=\"quote-author\">\u2014 Testimony from a wife of a resident with FTD, Nursing home Loire-Atlantique<\/div>\n<\/div>\n\n<!-- SECTION 3 -->\n<h2 id=\"dft\">3. Frontotemporal dementia (FTD)&nbsp;: when behavior takes precedence<\/h2>\n\n<p>Frontotemporal dementia is a group of degenerative pathologies characterized by a preferential impairment of the frontal and anterior temporal lobes. It differs from Alzheimer's disease by several major clinical features.<\/p>\n\n<h3>An earlier onset<\/h3>\n\n<p>The average onset age of FTD is 58 years, compared to 73 years for Alzheimer's. This difference is fundamental in a Nursing home&nbsp;: a 60-year-old resident with severe behavioral disorders, whose episodic memory remains relatively preserved, should be directed towards FTD rather than atypical Alzheimer's. Care in a traditional geriatric facility is often unsuitable for these younger, more active profiles, with different social needs.<\/p>\n\n<h3>Three main clinical variants<\/h3>\n\n<p>FTD has three main presentations. The <strong>behavioral variant (bvFTD)<\/strong> is the most common (50&nbsp;% of cases). It manifests as disinhibition, apathy, loss of empathy, stereotyped behaviors, changes in eating habits (hyperphagia, preference for sweets). Episodic memory is initially preserved, but executive functions are severely impaired.<\/p>\n\n<p>The <strong>semantic aphasia variant (SV)<\/strong> is characterized by a progressive loss of meaning of words and concepts. The resident speaks fluently but empties their sentences of semantic content (\u201c&nbsp;thing&nbsp;\u201d, \u201c&nbsp;stuff&nbsp;\u201d, descriptions instead of names). They may no longer recognize famous faces or common objects. The <strong>non-fluent primary progressive aphasia (NFPA)<\/strong>, the third variant, is characterized by significant speech effort, apraxia of speech, progressive dysarthria with language comprehension preserved for a long time.<\/p>\n\n<h3>What this changes for the caregiving team<\/h3>\n\n<p>When faced with a bvFTD resident, the team should expect disconcerting behaviors&nbsp;: lack of modesty, inappropriate comments, excessive food consumption, rigidity regarding daily rituals. These behaviors are neither malice nor a refusal of authority&nbsp;: they are the direct consequence of frontal disinhibition. The strategy is not confrontation but <strong>reorientation and structuring<\/strong>.<\/p>\n<div class=\"key-points\">\n  <h3>&#x1F9E0; Warning signs of DFT to monitor in Nursing home<\/h3>\n  <ul>\n    <li>Onset age between 50 and 65 years<\/li>\n    <li>Marked personality changes before memory disorders<\/li>\n    <li>Social disinhibition (inappropriate remarks, inappropriate sexual behaviors)<\/li>\n    <li>Profound apathy without sadness or depressive mood<\/li>\n    <li>Hyperphagia, sudden preference for sweet foods<\/li>\n    <li>Repetitive or ritualized behaviors (counting, organizing, stamping)<\/li>\n    <li>Loss of empathy and interest in others<\/li>\n    <li>Relatively preserved episodic memory at the beginning of evolution<\/li>\n  <\/ul>\n<\/div>\n\n<!-- SECTION 4 -->\n<h2 id=\"dcl\">4. Lewy body dementia (LBD)&nbsp;: vigilance on treatments<\/h2>\n\n<p>Lewy body dementia is the second leading cause of degenerative dementia, accounting for about 15 to 20&nbsp;% of cases. It is caused by the accumulation of alpha-synuclein protein in neurons in the form of Lewy bodies, affecting the cerebral cortices and subcortical structures.<\/p>\n\n<h3>The characteristic clinical triad<\/h3>\n\n<p>The diagnosis of LBD is based on three cardinal symptoms. <strong>Cognitive fluctuations<\/strong> are significant variations in attention and alertness throughout the day or from day to day&nbsp;: the resident may be clearly awake and communicative in the morning, then prostrate and confused in the afternoon, without apparent reason. These fluctuations are often mistakenly interpreted as simulation or depression.<\/p>\n\n<p><strong>Early and recurrent visual hallucinations<\/strong> are almost pathognomonic of LBD. They typically involve images of animals, children, or unknown people, often described accurately and relatively calmly by the resident. They may precede cognitive decline by several years. The <strong>spontaneous parkinsonian syndrome<\/strong> \u2014 rigidity, bradykinesia, postural instability, sometimes tremor \u2014 completes the triad.<\/p>\n\n<h3>Major medication risks<\/h3>\n\n<p>One of the most critical issues of LBD in Nursing homes is the <strong>extreme sensitivity to neuroleptics<\/strong>. Classic antipsychotics (haloperidol, chlorpromazine) as well as some atypicals (risperidone, olanzapine) can cause in LBD a syndrome of severe sensitivity&nbsp;: abrupt worsening of cognitive disorders, massive rigidity, hyperthermia, stuporous state that can be fatal. This reaction occurs in 30 to 50&nbsp;% of LBD cases exposed to neuroleptics.<\/p>\n\n<p>Equally problematic&nbsp;: <strong>anticholinergic effect medications<\/strong> (certain antihistamines, tricyclic antidepressants, urinary antispasmodics) are poorly tolerated in LBD and worsen confusion. The care team must systematically alert the coordinating physician before introducing any new treatment for a resident suspected of having LBD.<\/p>\n\n<h3>Appropriate support in Nursing homes<\/h3>\n\n<p>Hallucinations in LBD are rarely anxiety-provoking if one does not seek to \"correct\" them. The most effective strategy is to <strong>not confront the resident<\/strong> about the reality of their visions, but to accompany them in their experience (\u201cDo these people scare you? Would you like us to stay with you?\u201d). Activities should take into account cognitive fluctuations&nbsp;: plan stimulation workshops at times of better alertness, usually in the morning.<\/p>\n\n<div class=\"error-box\">\n<div class=\"error-box-title\">&#x26A0;&#xFE0F; Frequent and dangerous error<\/div>\n  <p>Prescribing or administering a classic neuroleptic to \"calm\" an agitated resident presenting visual hallucinations without having excluded a DCL. This error typically occurs during an emergency hospitalization when the diagnosis of DCL is not mentioned in the transfer record.<\/p>\n<\/div>\n<div class=\"error-fix\">\n  <div class=\"error-fix-title\">&#x2705; Good practice<\/div>\n  <p>Explicitly mention \"suspicion or diagnosis of DCL \u2014 neuroleptics contraindicated\" in any transfer document, discharge prescription, and shared care record. Some nursing homes place a specific alert in the computerized record.<\/p>\n<\/div>\n\n<!-- SECTION 5 -->\n<h2 id=\"vasculaire\">5. Vascular dementia: a stepwise progression<\/h2>\n\n<p>Vascular dementia is the consequence of brain damage of vascular origin: multiple infarcts, diffuse subcortical lesions (leukoaraiosis), or sequelae of a strategic stroke affecting a key brain area. It represents about 15% of dementias, but this proportion is likely underestimated due to the frequency of mixed forms.<\/p>\n\n<h3>A clinical presentation distinct from Alzheimer's<\/h3>\n\n<p>Unlike Alzheimer's, whose decline is progressive and regular, vascular dementia often evolves in a <strong>stepwise manner<\/strong>: the patient experiences a sudden deterioration at the time of a new vascular event, followed by a period of relative stability, then another decline. This discontinuous progression is an important warning sign.<\/p>\n\n<p>Episodic memory is often relatively preserved at the onset, unlike in Alzheimer's. It is the <strong>executive and attentional functions<\/strong> that are affected first: slow processing, planning difficulties, concentration problems, psychomotor slowing. Associated neurological signs are common: gait disturbances, early urinary incontinence, pseudobulbar syndrome (spasmodic laughter and crying).<\/p>\n\n<h3>Vascular risk factors at the heart of prevention<\/h3>\n\n<p>Vascular dementia is the only form of dementia for which preventive action remains effective even after the first symptoms. <strong>Control of vascular risk factors<\/strong> \u2014 high blood pressure, diabetes, atrial fibrillation, dyslipidemia, smoking \u2014 slows the onset of new lesions and stabilizes the clinical picture. In nursing homes, vigilance regarding blood pressure, anticoagulant treatment in case of fibrillation, and overall therapeutic adherence are integral to care.<\/p>\n\n<h3>Adapting support to the vascular profile<\/h3>\n\n<p>The vascular resident tires quickly and shows great variability in performance depending on the time and conditions. Activities should be short, well-structured, with simple and clear instructions. Stimulation of executive functions \u2014 sorting, organizing a task sequentially \u2014 is more relevant than episodic memory exercises. Attention to <strong>gait disturbances and fall risks<\/strong> is also crucial.<\/p>\n\n<!-- SECTION 6 -->\n<h2 id=\"psp-acm\">6. PSP, ACM, and other Parkinson-plus syndromes<\/h2>\n\n<h3>Progressive supranuclear palsy (PSP)<\/h3>\n\n<p>PSP is an atypical parkinsonian syndrome caused by the accumulation of tau protein in the neurons of the brainstem and basal ganglia. It is distinguished from Parkinson's disease by <strong>early and severe postural instability<\/strong> (falls in the early years), a <strong>disorder of gaze verticality<\/strong> (difficulty looking down, a nearly pathognomonic sign), and <strong>marked dysarthria<\/strong>.<\/p>\n\n<p>Cognitive disorders in PSP are of the fronto-subcortical type: ideomotor slowing, dysexecutive syndrome, apathy. Episodic memory is initially preserved. Swallowing impairment is a severe and early complication, warranting careful monitoring and rapid adaptation of food texture.<\/p>\n\n<h3>Posterior cortical atrophy (PCA)<\/h3>\n\n<p>PCA is a variant of Alzheimer's in which lesions predominate in the parietal and occipital cortices. The clinical picture is dominated by <strong>early and severe visuospatial disorders<\/strong>: inability to locate objects in space, to read, to recognize faces or objects (visual agnosia), to perform complex gestures (apraxia). Memory and language are preserved for a long time, creating a disconcerting gap between the resident's verbal abilities and their functional incapacities.<\/p>\n\n<p>In nursing homes, the PCA resident is often perceived as \"strange\" or \"a simulator\" because they can hold a coherent conversation but are unable to find their room, recognize their plate, or use a spoon. Understanding this neuropsychological profile by the team is essential to adapt the environment (strong visual signage, uncluttered environment, assistance with daily gestures) and avoid paradoxical injunctions.<\/p>\n<div class=\"info-box\">\n  <p><strong>&#x1F4A1; Posterior cortical atrophy and reading.<\/strong> ACP residents often lose the ability to read long before they lose the ability to speak. If a resident expresses frustration with newspapers or books brought to them, they are not \"refusing to engage\": they may genuinely no longer see letters as meaningful units. Audiobooks, podcasts, and radio shows are valuable alternatives.<\/p>\n<\/div>\n\n<!-- SECTION 7 -->\n<h2 id=\"tableau-comparatif\">7. Comparative table: distinctive signs by pathology<\/h2>\n\n<table class=\"comparison-table\">\n  <thead>\n    <tr>\n      <th>Pathology<\/th>\n      <th>Onset age<\/th>\n      <th>First symptom<\/th>\n      <th>Episodic memory<\/th>\n      <th>Medication alert<\/th>\n    <\/tr>\n  <\/thead>\n  <tbody>\n    <tr>\n      <td>Typical Alzheimer's<\/td>\n      <td>70-80 years<\/td>\n      <td>Recent forgetfulness, disorientation<\/td>\n      <td>Early and severe impairment<\/td>\n      <td>Anticholinergics discouraged<\/td>\n    <\/tr>\n    <tr>\n      <td>Behavioral variant FTD<\/td>\n      <td>50-65 years<\/td>\n      <td>Personality change, disinhibition<\/td>\n      <td>Long preserved<\/td>\n      <td>Risky neuroleptics<\/td>\n    <\/tr>\n    <tr>\n      <td>Semantic variant FTD<\/td>\n      <td>55-70 years<\/td>\n      <td>Loss of meaning of words<\/td>\n      <td>Long preserved<\/td>\n      <td>Little specificity<\/td>\n    <\/tr>\n    <tr>\n      <td>Lewy body dementia<\/td>\n      <td>65-80 years<\/td>\n      <td>Visual hallucinations, fluctuations<\/td>\n      <td>Moderate early impairment<\/td>\n      <td>CONTRAINDICATED neuroleptics<\/td>\n    <\/tr>\n    <tr>\n      <td>Vascular dementia<\/td>\n      <td>65-80 years<\/td>\n      <td>Slowing, executive disorders<\/td>\n      <td>Relatively preserved<\/td>\n      <td>Adjust antihypertensives<\/td>\n    <\/tr>\n    <tr>\n      <td>PSP<\/td>\n      <td>60-70 years<\/td>\n      <td>Falls, downward gaze disorder<\/td>\n      <td>Long preserved<\/td>\n      <td>L-Dopa minimally effective<\/td>\n    <\/tr>\n    <tr>\n      <td>Posterior cortical atrophy<\/td>\n      <td>55-65 years<\/td>\n      <td>Visuospatial disorders, apraxia<\/td>\n      <td>Long preserved<\/td>\n      <td>Anticholinergics discouraged<\/td>\n    <\/tr>\n  <\/tbody>\n<\/table>\n\n<p>This table is a clinical orientation tool, not a diagnostic one. It serves to structure observation and formulate relevant questions for the coordinating physician or neurologist. The formal differential diagnosis relies on a comprehensive neuropsychological examination, neuroimaging (brain MRI), and increasingly, on biomarkers in the CSF or through amyloid PET.<\/p>\n\n<!-- SECTION 8 -->\n<h2 id=\"adapter-soins\">8. Concrete adaptation of care practices<\/h2>\n\n<p>Knowing the different pathologies is necessary but insufficient. The added value of this knowledge is measured in the concrete adjustments it allows on a daily basis. Here is how the specificities of each pathology translate into adapted care practices.<\/p>\n\n<h3>Communication and caregiver-resident relationship<\/h3>\n\n<p>In <strong>FTD<\/strong>, the relationship must be firm without being confrontational. The resident is unaware of their inappropriate behaviors (frontal anosognosia): arguing is pointless. The technique of diversion and proposing an alternative activity is more effective. The team must be prepared not to take inappropriate remarks personally.<\/p>\n\n<p>In <strong>AD<\/strong>, cognitive fluctuations make exchanges very variable. The caregiver must adapt to the resident's level of alertness in the moment, not insist during phases of confusion, and resume communication during phases of better clarity. Hallucinations deserve an empathetic, not corrective response (\"I don't see the same things you do, but I hear you\").<\/p>\n\n<p>In <strong>ACP<\/strong>, verbal comprehension being long preserved, the resident understands what is said to them. However, visual information reaches them distorted. The caregiver must <strong>verbally guide<\/strong> each gesture, orally describe what they are going to do, and avoid solely gestural instructions.<\/p>\n\n<h3>Environmental adjustments<\/h3>\n\n<p>For the <strong>FTD<\/strong> resident, structuring the environment means reducing uncontrolled stimuli (access to food, freedom to wander in unsuitable areas) while maintaining marked spaces of freedom. Rituals and routines are resources, not constraints: rely on them rather than breaking them.<\/p>\n\n<p>For the <strong>ACP<\/strong> resident, the environment must be visually uncluttered and well marked. Bright color cues on the bedroom door, a clearly defined path to the dining room, contrasting dishware with the tablecloth: these simple adjustments significantly reduce functional disorientation and situations of failure.<\/p>\n\n<p>For the <strong>PSP<\/strong> resident, fall prevention is a priority. The bed must be at a minimum height, the chair must provide good back support to compensate for postural instability, and thick-soled shoes should be avoided. The bedside table and elements of the room must be accessible without the resident having to lower their gaze.<\/p>\n\n<h3>Nutrition and nursing care<\/h3>\n\n<p>Swallowing disorders are early in <strong>PSP<\/strong> and late in Alzheimer's. A speech therapy evaluation of swallowing should be anticipated well before the onset of significant aspiration. The texture and consistency of meals must be gradually adapted. Mealtime is also a risk moment for falls in PSP: the resident may tip backward while trying to look at their plate.<\/p>\n\n<p>In <strong>FTD<\/strong>, hyperphagia can be managed in small portions (several small servings) and by offering healthy alternatives freely accessible. Total removal of access to food leads to great agitation; it is better to channel than to prohibit.<\/p>\n<div class=\"case-study\">\n  <div class=\"case-study-header\">\n    <div class=\"case-study-emoji\">&#x1F469;&#x200D;&#x2695;&#xFE0F;<\/div>\n    <div>\n      <div class=\"case-study-label\">\u00c9tude de cas &mdash; DCL<\/div>\n      <div class=\"case-study-title\">Monsieur R., 76 ans, chutes inexpliqu\u00e9es et \u00ab&nbsp;visions&nbsp;\u00bb<\/div>\n    <\/div>\n  <\/div>\n  <p>Monsieur R. est admis en EHPAD pour des chutes \u00e0 r\u00e9p\u00e9tition et une d\u00e9sorientation progressive. L'\u00e9quipe note rapidement qu'il \u00ab&nbsp;parle \u00e0 des gens qui n'existent pas&nbsp;\u00bb et que ses capacit\u00e9s varient fortement selon les jours. Le m\u00e9decin coordonnateur prescrit un bilan neuropsychologique complet qui oriente vers une DCL. Une alerte \u00ab&nbsp;neuroleptiques contre-indiqu\u00e9s&nbsp;\u00bb est imm\u00e9diatement int\u00e9gr\u00e9e \u00e0 son dossier.<\/p>\n  <p>L'\u00e9quipe adapte le planning des ateliers aux cr\u00e9neaux de meilleure vigilance (10h-12h). Les hallucinations \u2014 des enfants jouant dans la chambre \u2014 sont g\u00e9r\u00e9es par validation \u00e9motionnelle sans confrontation. La famille est inform\u00e9e de la sp\u00e9cificit\u00e9 de la DCL et form\u00e9e \u00e0 r\u00e9pondre aux hallucinations de fa\u00e7on non anxiog\u00e8ne.<\/p>\n  <div class=\"case-study-result\">\n    <p>&#x2705; <strong>R\u00e9sultat&nbsp;:<\/strong> Apr\u00e8s 3 mois, les \u00e9pisodes d'agitation nocturne ont diminu\u00e9 de fa\u00e7on significative. La famille rapporte des visites plus apais\u00e9es. Deux hospitalisations aux urgences ont \u00e9t\u00e9 \u00e9vit\u00e9es gr\u00e2ce \u00e0 l'alerte m\u00e9dicamenteuse dans le dossier de transfert.<\/p>\n  <\/div>\n<\/div>\n\n<div class=\"case-study\">\n  <div class=\"case-study-header\">\n    <div class=\"case-study-emoji\">&#x1F9D3;<\/div>\n    <div>\n      <div class=\"case-study-label\">\u00c9tude de cas &mdash; DFT<\/div>\n      <div class=\"case-study-title\">Madame C., 62 ans, \u00ab&nbsp;chang\u00e9e&nbsp;\u00bb depuis 2 ans<\/div>\n    <\/div>\n  <\/div>\n  <p>Madame C. est admise \u00e0 62 ans pour \u00ab&nbsp;troubles du comportement s\u00e9v\u00e8res&nbsp;\u00bb apr\u00e8s une p\u00e9riode de deux ans pendant laquelle sa famille a observ\u00e9 une d\u00e9sinhibition croissante, un d\u00e9sint\u00e9r\u00eat pour ses proches et des comportements alimentaires aberrants. Le diagnostic de DFT variante comportementale est pos\u00e9 par le neurologue au terme d'une IRM et d'un bilan neuropsychologique.<\/p>\n  <p>En EHPAD, les comportements d\u00e9sinhib\u00e9s cr\u00e9ent des tensions avec les autres r\u00e9sidents. L'\u00e9quipe met en place un environnement structur\u00e9 avec des rituels fixes (promenades \u00e0 heure r\u00e9guli\u00e8re, ateliers de cuisine adapt\u00e9e). Les soignants sont form\u00e9s \u00e0 la r\u00e9ponse non confrontationnelle. Un espace de d\u00e9ambulation s\u00e9curis\u00e9 lui est d\u00e9di\u00e9.<\/p>\n  \n<div class=\"case-study-result\">\n    <p>&#x2705; <strong>R\u00e9sultat&nbsp;:<\/strong> La compr\u00e9hension de la nature neurologique des comportements a transform\u00e9 l'approche de l'\u00e9quipe. La charge \u00e9motionnelle des soignants a diminu\u00e9. La famille a pu reprendre des visites qu'elle avait espac\u00e9es faute de comprendre ce qui se passait.<\/p>\n  <\/div>\n<\/div>\n\n<!-- SECTION 9 -->\n<h2 id=\"stimulation\">9. Stimulation cognitive&nbsp;: quels outils pour quels profils&nbsp;?<\/h2>\n\n<p>La stimulation cognitive en EHPAD est souvent pens\u00e9e comme un bloc homog\u00e8ne d'activit\u00e9s b\u00e9n\u00e9fiques pour \u00ab&nbsp;les personnes d\u00e9mentes&nbsp;\u00bb. La r\u00e9alit\u00e9 neuropsychologique est bien plus nuanc\u00e9e. <strong>Stimuler de fa\u00e7on inadapt\u00e9e peut \u00eatre aussi d\u00e9l\u00e9t\u00e8re qu'une absence de stimulation<\/strong>&nbsp;: une activit\u00e9 de rem\u00e9moration pour un r\u00e9sident DFT dont la m\u00e9moire est pr\u00e9serv\u00e9e mais dont le comportement est d\u00e9sorganis\u00e9 aggrave l'agitation sans apporter de b\u00e9n\u00e9fice cognitif. Un exercice de lecture pour un r\u00e9sident ACP sans adaptation sensorielle est une source d'\u00e9chec et de frustration.<\/p>\n\n<h3>Principes g\u00e9n\u00e9raux de la stimulation diff\u00e9renci\u00e9e<\/h3>\n\n<p>Le premier principe est de <strong>partir du profil neuropsychologique r\u00e9el<\/strong> du r\u00e9sident et non du diagnostic seul. Deux r\u00e9sidents DFT peuvent avoir des profils tr\u00e8s diff\u00e9rents selon la variante et le stade de la maladie. Une \u00e9valuation neuropsychologique actualis\u00e9e, m\u00eame sommaire, guide plus efficacement le choix des activit\u00e9s qu'un diagnostic de cinq lettres.<\/p>\n\n<p>Le deuxi\u00e8me principe est de <strong>cibler les fonctions pr\u00e9serv\u00e9es<\/strong> autant que les fonctions d\u00e9ficitaires. La stimulation des capacit\u00e9s r\u00e9siduelles maintient l'estime de soi et l'engagement motivationnel. Un r\u00e9sident DCL peut avoir des capacit\u00e9s musicales longtemps pr\u00e9serv\u00e9es (m\u00e9moire proc\u00e9durale musicale)&nbsp;: la musicoth\u00e9rapie est un levier puissant. Un r\u00e9sident DFT variante s\u00e9mantique peut b\u00e9n\u00e9ficier de travaux manuels qui font appel \u00e0 la m\u00e9moire proc\u00e9durale plut\u00f4t qu'au langage.<\/p>\n\n<h3>Le num\u00e9rique comme outil de stimulation adaptable<\/h3>\n\n<p>Les outils num\u00e9riques de stimulation cognitive pr\u00e9sentent un avantage consid\u00e9rable pour les maladies apparent\u00e9es \u00e0 Alzheimer&nbsp;: la <strong>modularit\u00e9 fine des exercices<\/strong>. L\u00e0 o\u00f9 un atelier papier-crayon propose un niveau de difficult\u00e9 fixe, une application sur tablette peut adapter en temps r\u00e9el la complexit\u00e9, le nombre de distracteurs, le temps de r\u00e9ponse autoris\u00e9 et la modalit\u00e9 de pr\u00e9sentation (visuelle, auditive, combin\u00e9e).<\/p>\n\n<p>Pour un r\u00e9sident <strong>DCL<\/strong>, les exercices peuvent \u00eatre programm\u00e9s aux plages horaires de meilleure vigilance, avec des sessions courtes (10-15 minutes) et une interface simple. La tablette g\u00e9n\u00e8re des donn\u00e9es de suivi qui permettent d'objectiver les fluctuations cognitives&nbsp;: un graphique de performance sur plusieurs semaines montre clairement les variations, ce qui aide le m\u00e9decin \u00e0 ajuster la prise en charge.<\/p>\n\n<p>Pour un r\u00e9sident <strong>DFT variante comportementale<\/strong>, les exercices centr\u00e9s sur les fonctions ex\u00e9cutives (classement, s\u00e9quen\u00e7age, cat\u00e9gorisation) sont plus pertinents que les exercices de m\u00e9moire \u00e9pisodique. Les activit\u00e9s courtes avec feedback imm\u00e9diat maintiennent l'attention mieux que les t\u00e2ches longues et ouvertes. La tablette offre \u00e9galement un cadre contenant qui structure la session et r\u00e9duit les comportements d'errance ou de distractibilit\u00e9.<\/p>\n\n<p>Pour un r\u00e9sident <strong>ACP<\/strong>, les exercices doivent minimiser les t\u00e2ches visuospatiales et valoriser la compr\u00e9hension verbale et le langage. Les exercices d'\u00e9coute, de compr\u00e9hension orale, de fluence verbale et d'\u00e9vocation s\u00e9mantique sont adapt\u00e9s. La taille des \u00e9l\u00e9ments visuels sur l'\u00e9cran doit \u00eatre maximis\u00e9e et les contrastes renforc\u00e9s.<\/p>\n\n<a href=\"https:\/\/www.dynseo.com\/courses\/maladies-apparentees-a-la-maladie-dalzheimer-comprendre-distinguer-et-adapter-ses-pratiques\/\" class=\"internal-link\">\n  \n<div class=\"internal-link-icon\">&#x1F393;<\/div>\n  <div class=\"internal-link-content\">\n    <div class=\"internal-link-label\">Formation certifiante<\/div>\n    <div class=\"internal-link-title\">Maladies apparent\u00e9es \u00e0 Alzheimer&nbsp;: comprendre, distinguer et adapter ses pratiques<\/div>\n    <div class=\"internal-link-desc\">Formation DYNSEO pour professionnels en r\u00e9sidence m\u00e9dicalis\u00e9e &mdash; programme complet, cas cliniques et outils pratiques.<\/div>\n  <\/div>\n  <div class=\"internal-link-arrow\">&#x2192;<\/div>\n<\/a>\n\n<div class=\"key-points\">\n  <h3>&#x1F4F1; Stimulation num\u00e9rique&nbsp;: ce que l'on cible par pathologie<\/h3>\n  <ul>\n    <li><strong>Alzheimer&nbsp;:<\/strong> m\u00e9moire \u00e9pisodique, orientation, lexique, communication<\/li>\n    <li><strong>DFT comportementale&nbsp;:<\/strong> fonctions ex\u00e9cutives, attention, activit\u00e9s proc\u00e9durales<\/li>\n    <li><strong>DFT s\u00e9mantique&nbsp;:<\/strong> enrichissement s\u00e9mantique, \u00e9vocation, communication non verbale<\/li>\n    <li><strong>DCL&nbsp;:<\/strong> attention, m\u00e9moire proc\u00e9durale, musicoth\u00e9rapie, sessions courtes \u00e0 horaires fixes<\/li>\n    <li><strong>D\u00e9mence vasculaire&nbsp;:<\/strong> attention divis\u00e9e, fonctions ex\u00e9cutives, vitesse de traitement<\/li>\n    <li><strong>ACP&nbsp;:<\/strong> langage oral, compr\u00e9hension auditive, \u00e9vocation, praxies simples<\/li>\n    <li><strong>PSP&nbsp;:<\/strong> communication verbale, d\u00e9glutition (avec orthophoniste), mobilit\u00e9 douce<\/li>\n  <\/ul>\n<\/div>\n\n<!-- SECTION 10 -->\n<h2 id=\"equipe\">10. Travailler en \u00e9quipe pluridisciplinaire autour du diagnostic diff\u00e9rentiel<\/h2>\n\n<p>La reconnaissance et l'accompagnement diff\u00e9renci\u00e9 des maladies apparent\u00e9es \u00e0 Alzheimer ne peuvent pas reposer sur un seul professionnel. C'est un travail d'\u00e9quipe, structur\u00e9 autour d'une culture commune, d'outils de transmission partag\u00e9s et d'une organisation qui valorise et exploite les observations du terrain.<\/p>\n\n<h3>Le r\u00f4le cl\u00e9 de l'observation quotidienne<\/h3>\n\n<p>Les aides-soignants, les ASH, les animateurs et les aides m\u00e9dico-psychologiques sont en contact direct et prolong\u00e9 avec les r\u00e9sidents. Ils sont les premiers \u00e0 percevoir les signes d'alerte&nbsp;: fluctuations inhabituelles, comportements nouveaux, hallucinations, chutes atypiques. Mais cette observation ne vaut que si elle est <strong>transmise, formalis\u00e9e et prise en compte<\/strong>.<\/p>\n\n<p>Une grille d'observation simple et partag\u00e9e \u2014 listant les signes distinctifs des principales pathologies \u2014 permet \u00e0 tout soignant, quelle que soit sa qualification, de contribuer \u00e0 l'affinement du tableau clinique. Ces observations doivent \u00eatre not\u00e9es dans le dossier de soin avec la date, l'heure, le contexte et le comportement observ\u00e9 pr\u00e9cis\u00e9ment d\u00e9crit. \u00ab&nbsp;Agitation dans la soir\u00e9e&nbsp;\u00bb est insuffisant. \u00ab&nbsp;\u00c0 20h30, a interpell\u00e9 plusieurs fois des personnes absentes, semblait voir quelqu'un dans le couloir, a \u00e9t\u00e9 calm\u00e9 par la pr\u00e9sence silencieuse d'une soignante pendant 10 minutes&nbsp;\u00bb est exploitable cliniquement.<\/p>\n\n<h3>La r\u00e9union de synth\u00e8se pluridisciplinaire<\/h3>\n\n<p>La r\u00e9union de synth\u00e8se est le lieu o\u00f9 les observations du terrain deviennent des d\u00e9cisions th\u00e9rapeutiques. Pour qu'elle joue ce r\u00f4le dans le diagnostic diff\u00e9rentiel, elle doit int\u00e9grer un <strong>temps d\u00e9di\u00e9 \u00e0 la r\u00e9vision des hypoth\u00e8ses diagnostiques<\/strong>. Un r\u00e9sident admis avec un diagnostic d'Alzheimer pr\u00e9sum\u00e9 peut, au fil des mois, montrer des signes \u00e9vocateurs d'une DCL ou d'une DFT. La r\u00e9union de synth\u00e8se est l'occasion de formuler ces questions et d'en r\u00e9f\u00e9rer au m\u00e9decin coordonnateur ou de solliciter un avis neurologique.<\/p>\n\n<p>La formation continue de l'\u00e9quipe joue un r\u00f4le central. Une \u00e9quipe qui conna\u00eet les signes cliniques des principales pathologies observe diff\u00e9remment. Elle formule des hypoth\u00e8ses, pose des questions, et contribue \u00e0 un tableau clinique plus pr\u00e9cis. Cette comp\u00e9tence collective am\u00e9liore directement la qualit\u00e9 des soins et la s\u00e9curit\u00e9 des r\u00e9sidents.<\/p>\n\n<h3>Le m\u00e9decin coordonnateur et le neurologue<\/h3>\n\n<p>Le m\u00e9decin coordonnateur est la charni\u00e8re entre les observations de l'\u00e9quipe soignante et les d\u00e9cisions m\u00e9dicales. Son r\u00f4le est d'int\u00e9grer les donn\u00e9es cliniques, de solliciter des bilans compl\u00e9mentaires si n\u00e9cessaire, et d'informer l'\u00e9quipe des implications pratiques du diagnostic. Un diagnostic diff\u00e9rentiel formalis\u00e9 \u2014 \u00ab&nbsp;ce r\u00e9sident pr\u00e9sente une DCL, neuroleptiques formellement contre-indiqu\u00e9s, adapter les horaires d'activit\u00e9 aux fluctuations&nbsp;\u00bb \u2014 traduit la clinique en directives concr\u00e8tes pour l'\u00e9quipe.<\/p>\n\n<p>La t\u00e9l\u00e9m\u00e9decine permet d\u00e9sormais, dans certains territoires, d'obtenir un avis neurologique sp\u00e9cialis\u00e9 sans d\u00e9placer le r\u00e9sident. Ces dispositifs facilitent l'acc\u00e8s \u00e0 une expertise difficile \u00e0 obtenir en zone rurale et permettent une r\u00e9vision des diagnostics sans hospitalisation longue et d\u00e9stabilisante pour le r\u00e9sident.<\/p>\n\n\n<div class=\"article-quote\">\n  <p>\u00ab&nbsp;Depuis que nous avons int\u00e9gr\u00e9 une formation sur les maladies apparent\u00e9es \u00e0 Alzheimer, nos transmissions ont chang\u00e9 de qualit\u00e9. Les aides-soignantes d\u00e9crivent ce qu'elles voient avec beaucoup plus de pr\u00e9cision. Et quand le m\u00e9decin coordonnateur arrive \u00e0 la r\u00e9union de synth\u00e8se, il a d\u00e9j\u00e0 tous les \u00e9l\u00e9ments pour raisonner.&nbsp;\u00bb<\/p>\n  <div class=\"quote-author\">\u2014 Infirmi\u00e8re coordinatrice, EHPAD Seine-et-Marne<\/div>\n<\/div>\n\n<h3>Soutenir et former les \u00e9quipes en continu<\/h3>\n\n<p>L'accompagnement de r\u00e9sidents atteints de DFT, de DCL ou de PSP est exigeant sur le plan \u00e9motionnel. Les comportements d\u00e9sinhib\u00e9s, les hallucinations, la lenteur extr\u00eame du r\u00e9sident PSP, les fluctuations d\u00e9concertantes de la DCL \u2014 tout cela sollicite des ressources psychologiques importantes chez les soignants. La formation ne suffit pas si elle n'est pas accompagn\u00e9e d'un <strong>espace de parole et d'analyse des pratiques<\/strong>.<\/p>\n\n<p>La supervision d'\u00e9quipe, les groupes de parole anim\u00e9s par un psychologue, et les formations courtes cibl\u00e9es sur des situations concr\u00e8tes permettent de transformer la connaissance th\u00e9orique en comp\u00e9tences pratiques solides et durables. Les soignants qui comprennent pourquoi un r\u00e9sident DFT se comporte ainsi ne vivent pas cet accompagnement de la m\u00eame fa\u00e7on que ceux qui l'interpr\u00e8tent comme de la mauvaise volont\u00e9.<\/p>\n\n<div class=\"key-points\">\n  <h3>&#x1F91D; Construire une \u00e9quipe comp\u00e9tente sur les maladies apparent\u00e9es<\/h3>\n  <ul>\n    <li>Former l'ensemble de l'\u00e9quipe aux signes d'alerte des principales pathologies (pas seulement les IDE)<\/li>\n    <li>Mettre en place une grille d'observation partag\u00e9e et accessible dans le dossier de soin<\/li>\n    <li>D\u00e9dier un temps en r\u00e9union de synth\u00e8se \u00e0 la r\u00e9vision des hypoth\u00e8ses diagnostiques<\/li>\n    <li>Cr\u00e9er une proc\u00e9dure d'alerte \u00ab&nbsp;contre-indication m\u00e9dicamenteuse&nbsp;\u00bb dans le dossier de transfert<\/li>\n    <li>Organiser des formations courtes sur des cas cliniques concrets (DFT, DCL, ACP)<\/li>\n    <li>Proposer des espaces de parole pour les soignants qui accompagnent ces profils difficiles<\/li>\n    <li>Int\u00e9grer les familles dans la compr\u00e9hension des sp\u00e9cificit\u00e9s de la pathologie<\/li>\n    <li>Utiliser des outils num\u00e9riques de stimulation cognitive modulables et tra\u00e7ables<\/li>\n  <\/ul>\n<\/div>\n\n<p>Comprendre les maladies apparent\u00e9es \u00e0 Alzheimer dans leur singularit\u00e9 clinique, c'est redonner \u00e0 chaque r\u00e9sident l'accompagnement qui correspond pr\u00e9cis\u00e9ment \u00e0 ce qu'il vit dans son cerveau et dans son corps. C'est aussi redonner aux \u00e9quipes soignantes un cadre de compr\u00e9hension qui transforme des comportements perturbants en signes cliniques intelligibles &mdash; et les soignants d\u00e9munis en professionnels comp\u00e9tents et serein. Cette comp\u00e9tence s'acquiert, se partage et s'entretient. Elle est au c\u0153ur de la qualit\u00e9 de vie en EHPAD.<\/p>\n\n<div class=\"cta-box\">\n  <h3>&#x1F393; Approfondir avec la formation certifiante DYNSEO<\/h3>\n  <p>Formez votre \u00e9quipe \u00e0 distinguer et accompagner les maladies apparent\u00e9es \u00e0 Alzheimer&nbsp;: DFT, DCL, d\u00e9mence vasculaire, PSP, ACP. Programme certifi\u00e9 Qualiopi, cas cliniques r\u00e9els, outils pratiques directement applicables en r\u00e9sidence m\u00e9dicalis\u00e9e.<\/p>\n  <div class=\"cta-buttons\">\n    <a href=\"https:\/\/www.dynseo.com\/courses\/maladies-apparentees-a-la-maladie-dalzheimer-comprendre-distinguer-et-adapter-ses-pratiques\/\" class=\"btn-cta-white\">&#x1F4CB; Voir le programme<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/formations\/\" class=\"btn-cta-outline\">Toutes les formations &#x2192;<\/a>\n  <\/div>\n<\/div>\n\n<div class=\"article-tags\">\n  <a href=\"#\" class=\"article-tag\">maladies apparent\u00e9es Alzheimer<\/a>\n  <a href=\"#\" class=\"article-tag\">EHPAD<\/a>\n  <a href=\"#\" class=\"article-tag\">d\u00e9mence \u00e0 corps de Lewy<\/a>\n  <a href=\"#\" class=\"article-tag\">d\u00e9mence frontotemporale<\/a>\n  <a href=\"#\" class=\"article-tag\">d\u00e9mence vasculaire<\/a>\n  <a href=\"#\" class=\"article-tag\">PSP<\/a>\n  <a href=\"#\" class=\"article-tag\">formation soignants<\/a>\n  <a href=\"#\" class=\"article-tag\">DYNSEO<\/a>\n<\/div>\n\n<\/article>\n<\/div>\n\n\n<\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]","_et_gb_content_width":"","footnotes":""},"categories":[3582],"tags":[],"class_list":["post-510170","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-advice-from-our-coaches"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Maladies apparent\u00e9es \u00e0 la maladie d&#039;Alzheimer : comprendre, distinguer et adapter ses pratiques en r\u00e9sidence m\u00e9dicalis\u00e9e | DYNSEO - DYNSEO - Educational apps &amp; 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