On 14 December 2022, Aurélie Chopard-dit-Jean defended her doctoral thesis entitled "Talking about death in medico-social establishments (EMS) and residential establishments for dependent elderly people (EHPAD): towards a psychological understanding of residents' relationship with life and death".
When residents talk about their request to die and their move into an institution, they are talking above all about their experience of old age, dependency and death, and the physical, spiritual, identity, social and psychological issues involved. The request to die may reflect a difficulty in experiencing and psychologically processing one or more of these issues. In terms of attachment, the results show a significant avoidance of intimacy on the part of residents: they are painfully dependent on others and do not seek help to verbalise and become aware of what is difficult for them. This lack of elaboration can lead to psychological distress, resulting in a demand for death. The research provides the space that residents, their families and professionals sometimes lack to elaborate and become aware of the issues associated with old age, dependency and death.
The thesis emphasises the essential role of psychologists and thought spaces in geriatric institutions in supporting residents, their families and professionals. These spaces can take the form of individual interviews, discussion or mediation groups for residents and their relatives, and practice analysis groups for professionals.
Two studies were carried out jointly. The aim of the first was to use attachment to assess whether residents' request for death was a request for help, and to analyse the consequences of moving into an institution on this request for death. The second study had the same objective, but did not focus solely on the time of admission. Semi-structured interviews and an attachment assessment scale were conducted with the residents.
Based on an integrative approach mobilising concepts from social psychology (continuity and discontinuity of identity, social identity) and clinical psychology (psychic elaboration, function of containment) and attachment theory, this thesis proposes a psychological understanding of the relationship to life and death of residents of residential homes for the dependent elderly (EHPAD) in France and medical-social establishments (EMS) in Switzerland.