The socio-health geriatricization of disability: institutional power struggles and clash of categorical representations. La gériatrisation socio-sanitaire du handicap : luttes de pouvoir institutionnelles et choc de représentations catégorielles

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Fougeyrollas, Patrick | Grenier, Yan | Andrien, Loïc | Sarrazin, Coralie

Edité par HAL CCSD

International audience. Through a socio-historical anthropological approach and a focus on technics and devices for the evaluation and management of access to home services and long-term accommodation duration, this article retraces a persistant trend towards the medically centered geriatricization of the assessment and management of disability. This geriatricization tends to assimilate and equate people with disabil- ities and the elderly with a loss of autonomy as dependent populations to be supported within the Quebec socio-health system. The management of the socio-health crisis of COVID 19 by Quebec’s public administration in 2020 was marked by the invisibilization of the pandemic’s consequences on people with disabilities. The attention was focused on the dramatic and deadly outbreaks of elderly people with a geriatric profile in elderly home care facilities (CHSLD). The astonishment of those working in the field of disability caused by this blind spot in public health reached its peak with the unveiling of triage protocols designed on the basis of geriatric scales of fragility and dependency in- compatible with the social and human rights models of disability, which have inspired Quebec policies in this area for over three decades. . Soutenu par une approche anthropologique socio-historique et un examen des dispositifs techniques d’évaluation et de gestion de l’accès aux services à domicile et à l’hébergement de longue durée, cet article illustre une tendance persistante à la gériatrisation médicalo-centrée de l’évaluation et de la prise en charge du handicap. Cette gériatrisation assimile les personnes en situations de handicap et les personnes âgées en perte d’autonomie à des populations dépendantes, à prendre en charge par le système socio-sanitaire québécois. Cette tendance a particulièrement été mise en évidence par la gestion publique de la crise socio-sanitaire du COVID 19 en 2020. Cette crise a été marquée par une invisibilisation de ses conséquences sur les personnes en situations de handicap. L’attention s’est concentrée sur les éclosions dramatiques et meurtrières de personnes âgées dans les Centre d’hébergement et de soins de longue durée (CHSLD). L’absence de considération des personnes en situations de handicap a sidéré les acteurs de ce champ. Cette sidération, provoquée par ce point aveugle de la santé publique, a atteint son comble avec le dévoilement de protocoles de triage conçus sur la base d’échelles gériatriques de fragilité et de dépendance incompatibles avec le modèle social et de droits humains du handicap inspirant les politiques québécoises dans ce domaine depuis plus de trois décennies.

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