[Management of patients and their families]

The management of Alzheimer's disease is currently undergoing profound upheavals. The advent of specific treatments for the disease is largely responsible for those changes. Psychiatrists are directly involved in that approach. They play a very important role in the pluridisciplinary approach to patients and their families. The management of the disease shows, in fact, that management consists in long-term accompaniment of the patient, of course, but also of the family, qualified as the "natural caregiver", and that the two are indissociable. A review of the natural course of the disease enables restitution of the concomitant progress of the entourage's experience and the problems encountered by the family. The various studies on caregivers stress the importance of the psychological burden, the risk of depression and, above all, the position of behavioral symptoms in their quality of life. WHO has formulated recommendations concerning caregivers, and while they are simply common sense, they deserve to be restated: carefully evaluating their capacities and work load and informing them on the disease may enable them to benefit from support and, above all, enable periods of respite to be arranged. Lastly, the resources available for management need to be understood, even though the list is far from complete and a certain number of resources have yet to be fully evaluated and defined.