[Reality approach in senile dementia. Fundamental methodologies of occupational therapy in psychogeriatrics]

Occupational therapy in psychogeriatrics has always been practiced empirically, aimed mainly at merely occupying patients. In the light of recent findings from the old age psychological research, a specific method should cope with certain forms of lost intellectual capacities. The purpose of this work is to define as accurately as possible the field of occupational therapy in psychogeriatrics. Three main concepts towards a systematic approach can be proposed: a) Those related to a careful observation of spontaneous activities dealing with the relationship between the patient and the world around him, and which lead to a classification of these activities. b) Concepts related to the most elementary level of intervention in occupational therapy termed as "objective relationship", in other words the construction of the external objective world as opposed to the world of phantasms or magical thought. c) Concepts, at a more sophisticated level, related to the instrumental aspects of traditional occupational therapy. An important distinction should thus be made between local and inclusive constituent parts of an activity.