An attempt to deconstruct the French concept of “syndrome de glissement”

Résumé 0

Syndrome de glissement is a French term used to describe end-of-life situations whereby an older person becomes adynamic and any therapeutic intervention seems ineffective until the patient dies. It is close to failure to thrive. Although its use, which is widespread, seems appropriate to briefly describe a complex situation, it has the major disadvantage of leading to the absence of a clinical or therapeutic approach, which represents a loss of chance for the patient. In clinical practice, we consider that this “sliding syndrome” is actually a situation of apathy associated with a deterioration in general condition. A diagnostic approach should therefore examine all organic pathologies that associate deterioration in general condition with apathy, as well as neuropsychiatric situations, such as a major depressive episode, that cause such symptoms. Once these diagnoses have been ruled out, the person should be considered for palliative care and benefit from the expertise that goes with this practice. Any older person in a condition resembling syndrome de glissement should therefore benefit from a rigorous clinical approach, and not be considered beyond therapeutic treatment. It is a matter of dignity and quality of care.