Disaffiliation/reaffiliation of people in case management

Résumé 0

The vulnerability of elderly people who require case management support in MAIA is identified in professional practice through an algorithm revealing the intrication of several parameters that indicate complexity: the presence of neurocognitive and/or psychiatric disorders, social difficulties, a situation aggravated by the absence or failure of coordination of assistance and care. This vulnerability, which corresponds to the analysis of a clinical state in an unfavorable social environment, could be apprehended from a sociological angle: as a process of “disaffiliation” marked by a breakdown in social ties. Their vulnerability is certainly functional, decisional, but also relational. If the fact of being helped by the intervention of a public system can be experienced by them as a feeling of social disqualification which could partly explain the refusal of help and care, some seem to make attempts to “reaffiliate” with different professionals, thanks to case management. The typology of these attempts is indicative of how they experience the helping relationship.