Faire face aux comportements perturbants : le travail de contrainte en milieu hospitalier gériatrique

This article seeks to push beyond the catchphrase-laden vocabulary of “mistreatment” and “appropriate treatment” used by the media and professionals in order to qualify and discuss phenomena of violence in the care of vulnerable elderly people, and thus to shed new light on practices used by caregivers in geriatric hospitals from an angle that has been left in the shadows by the prescriptive terms evoked above. The use of restraint, as a working practice is an integral part of the daily activities of the long-term care unit team that was the subject of the ethnographic study mobilized here. The specific case of elderly patients whose behavior disrupts order in the hospital is examined here because it confronts caregivers with extreme cases where the use of restraint is not a clear-cut choice. The goal is to reveal the process of negotiation by which professionals create shared standards that draw boundaries between, on the one hand, controlled gestures of restraint that are accepted and adopted collectively; and, on the other, reckless and censurable misconduct.