handicap, autonomy and dependence:
is not a devalued state but a function which varies
throughout our life.
It gives place
to constant refittings.
framework of WHO:
the existence of a physical, psychic or sensory
disturbance compared to the biomedical standards.
charge for a reduction in the functions.
the importance of the disturbance.
how the incapacity is compensated or not. These concepts
make it possible to define the physical
“dependere comes”: to be suspended with
of dependence physical implies the incapacity to achieve
without the assistance of a third person three acts of
the everyday life.
also define an emotional dependence.
framework of normality, it can get along like a need to
communicate and a refusal of loneliness.
speaks about psychological dependence: incapacity to
also often an economic dependence.
forms of dependence imply the intervention of a
an individual to control itself; including managing its
It is an
independence compared to a decision, and not compared to
It is to be
opposed to heteronomy: another person manages what
arrives, without referring about it to the needs and
desires of the person concerned.
It is the
law of others.
measures the degree of autonomy using scales:
Physiological ageing is responsible for a fall of
the performances of the various bodies.
It does not
involve a fall of the functions being able to be
responsible for a physical dependence.
physical dependence is the consequence of diseases whose
frequency increases with the age.
It is more
difficult to adapt to a brutal modification of its
capacities than to their progressive reduction.
dependence returns to a loss of autonomy imposed of
outside for good reasons that the patient does not
measure completely or any more.
attitude of looking after will be determining in the
maintenance of a certain degree of autonomy.
The sexuality of the old
Old age is
associated the fall of all the powers:
• Sexual In
any event, lowers power does not mean impotence.
does not indicate only the activities and the pleasure
which depend on the operation of the genital apparatus,
but a whole series of excitations and activities present
as of the childhood, which presents an irreducible
pleasure at the satisfaction of a fundamental
physiological need and which is found as component in
the form known as “normal” of the sexual love.
(Laplanche and Fontalis: dictionary of the
psychoanalysis uses also the concept of impulse:
can be intended like the expression of an internal
impulse to appease.
At the woman:
Physiological ageing does not involve
modifications likely to block the sexual intercourse and
to prevent from reaching the orgasm.
menopause decreases secretions ovariennes and can
• Of the
urinary disorders: cause painful reports/ratios.
• A bad
menopause can involve, because of incapacity to give
birth to, can generate psychic disturbances:
image of oneself
Intensification of the desires
are more numerous from the point of view of the sexual
reduction in the hormones is translated by a slower
erection to come and on a later ejaculation.
also problems of prostate which have psychological
of the male partners:
disease can influence the sexual behavior:
of the sexuality of the old people belongs to a cultural
people are perceived like ugly, sick, impotent.
sexuality of the old men is accepted better than that of
the old women.
the old people like our parents.
imagine a sexuality is unbearable for us.
Complaints calling palpation
around the anal zone
• More or
less controlled Exhibitionnisme: possibly search of
Sublimation of sexual behaviors: expression of desires
and impulses on an intellectualized mode
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