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\n “text”: “La maladie d’Alzheimer est la plus connue des maladies neurocognitives, mais elle n’est pas la seule. Les maladies dites apparent\u00e9es regroupent notamment la d\u00e9mence vasculaire, la maladie \u00e0 corps de Lewy et la d\u00e9g\u00e9n\u00e9rescence frontotemporale. Elles partagent une atteinte progressive des fonctions cognitives, mais diff\u00e8rent par les zones du cerveau touch\u00e9es, l’\u00e9volution et les sympt\u00f4mes dominants : hallucinations et fluctuations pour les corps de Lewy, changements de comportement pour la frontotemporale, \u00e9volution par \u00e0-coups pour la forme vasculaire. Le diagnostic pr\u00e9cis rel\u00e8ve du m\u00e9decin : en \u00e9tablissement, l’enjeu est d’adapter l’accompagnement \u00e0 ces diff\u00e9rences.”
\n }
\n },
\n {
\n “@type”: “Question”,
\n “name”: “Que faire quand une personne voit ou entend des choses qui n’existent pas ?”,
\n “acceptedAnswer”: {
\n “@type”: “Answer”,
\n “text”: “On ne nie pas l’hallucination, car la personne la per\u00e7oit r\u00e9ellement, et on ne la valide pas non plus en jouant le jeu. On adopte une position neutre et rassurante, centr\u00e9e sur l’\u00e9motion : est-ce que ces images ou ces voix la d\u00e9rangent ou l’inqui\u00e8tent ? On agit ensuite sur l’environnement \u2014 lumi\u00e8re stable, retrait des reflets et des ombres. Toute hallucination nouvelle, soudaine ou angoissante se signale, car elle peut traduire une cause m\u00e9dicale aigu\u00eb ou un effet de traitement. Contredire ou raisonner ne fait jamais dispara\u00eetre l’hallucination et ab\u00eeme la confiance.”
\n }
\n },
\n {
\n “@type”: “Question”,
\n “name”: “Comment r\u00e9agir face \u00e0 des propos ou des gestes d\u00e9sinhib\u00e9s ?”,
\n “acceptedAnswer”: {
\n “@type”: “Answer”,
\n “text”: “La d\u00e9sinhibition, fr\u00e9quente dans la d\u00e9g\u00e9n\u00e9rescence frontotemporale, n’est pas un choix : le frein qui permettrait de se retenir est atteint. Sermonner ou humilier n’a donc aucune prise et blesse inutilement. On r\u00e9pond de fa\u00e7on br\u00e8ve et neutre, on d\u00e9tourne imm\u00e9diatement l’attention vers une action concr\u00e8te, et on prot\u00e8ge les personnes vis\u00e9es en rappelant \u00e0 l’\u00e9quipe qu’il s’agit d’un sympt\u00f4me. On anticipe aussi les contextes \u00e0 risque, par exemple un placement \u00e0 table plus calme. On note le fait et son contexte au dossier, jamais un jugement de valeur du type \u00ab vulgaire \u00bb.”
\n }
\n },
\n {
\n “@type”: “Question”,
\n “name”: “Pourquoi les capacit\u00e9s d’une personne changent-elles autant d’un moment \u00e0 l’autre ?”,
\n “acceptedAnswer”: {
\n “@type”: “Answer”,
\n “text”: “Ces variations importantes de la vigilance et de l’attention au fil de la journ\u00e9e s’appellent des fluctuations cognitives : elles sont particuli\u00e8rement caract\u00e9ristiques de la maladie \u00e0 corps de Lewy. La personne peut \u00eatre claire et autonome le matin, puis confuse ou somnolente quelques heures plus tard. Ce n’est ni de la simulation, ni forc\u00e9ment une aggravation. La bonne attitude consiste \u00e0 proposer les soins, les repas et les activit\u00e9s importantes pendant les fen\u00eatres de clart\u00e9, \u00e0 ne pas insister pendant les phases de retrait, et \u00e0 transmettre les horaires observ\u00e9s pour que toute l’\u00e9quipe organise la journ\u00e9e autour de ce rythme.”
\n }
\n },
\n {
\n “@type”: “Question”,
\n “name”: “Quels signes imposent d’alerter rapidement ?”,
\n “acceptedAnswer”: {
\n “@type”: “Answer”,
\n “text”: “Tout comportement nouveau et soudain \u2014 agitation, confusion, hallucinations d’apparition brutale \u2014 chez une personne jusque-l\u00e0 stable doit faire rechercher une cause m\u00e9dicale : douleur, infection, d\u00e9shydratation, effet d’un m\u00e9dicament. Dans la maladie \u00e0 corps de Lewy, une somnolence, une rigidit\u00e9 ou une confusion apparues apr\u00e8s l’introduction d’un traitement imposent un signalement sans d\u00e9lai en raison de la sensibilit\u00e9 aux neuroleptiques. S’y ajoutent les urgences habituelles : fausse route avec d\u00e9tresse respiratoire, chute avec traumatisme, malaise. En cas de d\u00e9tresse vitale, on contacte imm\u00e9diatement les services d’urgence de votre pays et on applique la proc\u00e9dure de l’\u00e9tablissement.”
\n }
\n }
\n ]
\n }
\n ]
\n}<\/p>\n

<\/p>\n
\n
\n Professionnels \u00b7 Alzheimer & troubles cognitifs<\/span><\/p>\n

Maladies apparent\u00e9es \u00e0 la maladie d\u2019Alzheimer : 10 situations difficiles du quotidien et comment y r\u00e9pondre<\/h1>\nFace aux maladies apparent\u00e9es \u00e0 la maladie d’Alzheimer<\/strong>, la question qui revient le plus souvent en \u00e9tablissement n’est pas \u00ab qu’est-ce que cette maladie ? \u00bb mais \u00ab que faire, l\u00e0, maintenant, quand la sc\u00e8ne se produit ? \u00bb. Un r\u00e9sident qui se l\u00e8ve habill\u00e9 \u00e0 trois heures du matin, une r\u00e9sidente qui d\u00e9crit des enfants dans sa chambre, un homme qui tient des propos crus \u00e0 table : ce sont ces moments ordinaires, et non la th\u00e9orie, qui mettent les \u00e9quipes en difficult\u00e9.<\/pee>\n