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La peinture en gérontologie et alzheimer

La peinture en gérontologie. Cet article est issu de mon expérience d'intervention en maison de retraite. Je suis confronté aux malades atteints de la maladie Alzheimer et dans mes interventions artistiques, je suis obligée de me remettre en question et de chercher des solutions pour ne pas mettre de côté ces personnes que j'encadre depuis plusieurs années et dont la dégénérescence bloque l'expression. Je n'ai pas encore la réponse absolue mais mon cheminement commence à m'amener vers des actions positives.    
Difficultés rencontrées dans la pratique de l’activité  
Les personnes âgées subissent plusieurs dégénérescences qui peuvent engendrer des difficultés plus ou moins handicapantes à la pratique d’une activité artistique Les difficultés les plus courantes sont :
  • La perte visuelle.
  • La perte de force gestuelle
  • La fatigue
  • Les handicaps associés (hémiplégie)
  • La perte d’autonomie
  D’autre part, la personne âgée, placée en établissement, subit un univers restreint qui inhibe son imaginaire et la prive donc de capacité d’expression personnelle. Cet état de fait oblige l’intervenant à proposer une bibliothèque culturelle élargit afin de couvrir les différentes personnalités et permettre à chacun de se retrouver au travers d’une œuvre connue ou non.   Une autre difficulté est la perte de confiance en soi et en ses capacités. La personne âgée à souvent ce sentiment de ne plus être capable de produire quelque chose qui puisse intéresser, questionner ou surprendre. Elle éprouve ce sentiment d’inutilité et il est toujours très long et délicat de transformer cette idée en désir de reconnaissance.       

Peinture et maladie   
Difficultés rencontrées dans la pratique de l’activité   Les malades atteints de la maladie d’aheizemer sont confrontés à la perte de la notion d’espace. De ce fait, il leur devient très difficile voir impossible de coloriser une zone cloisonnée d’un trait. La reproduction d’œuvre devient alors totalement inadaptée. Au-delà de ce constat, il semble même que la personne ne discerne plus les couleurs. Ce que je veux dire c’est que la personne n’est plus capable de penser : blanc = non colorisé. Alors elle va appliquer de la couleur n’importe où et, sur ce qu’elle avait déjà colorisé. L’œuvre va alors perdre toute sa logique de couleur mais aussi tout son sens, en tout cas pour le lecteur car, rien ne nous dit que cette œuvre n’a pas de sens pour la personne qui la réalise. En tout état de cause, lorsque cette personne est contente de son travail c’est que celui-ci à du sens pour elle alors il n’y a pas à intervenir, c’est le principe de l’œuvre abstraite. La perte de sens se retrouve sur la relation entre le mot et l’objet. Là nous sommes dans une réalité compliquée à prendre en charge. Comment représenter quelque chose que l’on n’identifie plus réellement. Le décalage entre la pensée et la représentation devient un véritable frein à l’expression. Il semble que seul le plaisir de la couleur attise l’esprit. Ce plaisir est à exploiter mais de manière à ne pas frustrer la personne qui garde la conscience et une certaine notion du beau. Cette notion du beau n’est pas franchement consciente, elle semble se caler sur une comparaison avec les autres productions ou par rapport au modèle. Intentionnellement, je ne dit pas modèle choisit car, la personne atteinte de ce syndrome n’exprime plus de désir de choix. Elle ne sait pas se décider car, encore une fois, elle est dans l’incompréhension. Elle ne sait pas quel est le plus beau pour elle entre tel ou tel modèle proposé, elle ne sait pas celui qu’elle préfère, elle ne sait pas ce qu’elle fait là ! Elle doute de ses capacités à faire les choses, elle s’angoisse, elle veut partir, fuir, se réfugier dans quelque endroit qui lui semble familier. Ces personnes ont besoin de repères. Dans ce contexte, il est très important de :
  • Garder les mêmes lieux d’intervention ou de pratiquer celle-ci dans un lieu qui est utilisé régulièrement pour les animations.
  • Prévenir les personnes de l’activité bien avant qu’elle ne commence.
  • Remettre les personnes à leur place précédemment  occupée et ceci à chaque intervention.
  • Maintenir un groupe « souche », rassurant.
  • Maintenir un rythme d’atelier régulier.
  • Respecter les réalisations.
  • Respecter l’intimité du groupe sans en faire une attraction d’établissement qui perturbe.
  • Instaurer une ambiance rassurante et paisible.
Intervention en gérontologie   

Proposition et adaptation   Le choix des sujets : La personne âgée est un individu avec tout ce que cela implique : son histoire, son vécu, sa vie sociale, familiale et professionnelle. A partir de là, tout est dit. On ne peut pas décemment proposer à cette personne des reproductions infantilisantes et donc dégradantes. Même si la mémoire et les capacités semblent défaillantes, le respect de la personne nous oblige à réfléchir nos propositions de manière à ce quelles soient appropriées à leur identité et tout simplement à leur âge ! Pour les personnes ayant gardé une bonne capacité intellectuelle, il est intéressant de pratiquer la reproduction ou l’inspiration d’œuvre. Il ne faut pas s’attendre à des reproductions à l’identique, qui n’ont en soi aucun intérêt autre qu’une prouesse technique. Non, l’important est de permettre l’initiative picturale. Donner l’envie de peindre. La correction du dessin par l’animateur n’est judicieuse que lorsque la personne le demande. Corriger systématiquement est castrateur. C’est imposer sa propre perception du monde à l’autre. C’est le priver de l’expression de sa personnalité, de son moi intérieur. Van Gogh ne faisait absolument rien de conforme et c’est ce qui a fait son art unique et si reconnaissable. Nous avons trop tendance à vouloir tout standardiser, stigmatiser, conformer. Il faut que ce soit beau ! Mais, le beau est une vu de l’esprit. Le beau en soi n’existe pas. C’est une référence à des critères qui permet de classer les choses dans un registre de beau ou de laid. Il ne nous est pas autorisé de juger une réalisation qui ne nous semble pas esthétique. Les réalisations sont construites en fonction de critères tout à fait uniques et personnels.  
Pour arriver à répondre à toutes les demandes, toutes les personnalités et toutes les difficultés liées à l’âge, il faut se munir de matériel. Du matériel peu onéreux mais de qualité La gouache est à déconseiller car trop associée à un statut scolaire qui infantilise On se tournera donc vers des techniques plus nobles Les aquarelles Les pastels secs ou gras, Le fusain et la pierre noire La sanguine Les encres colorées (légèrement plus onéreuses) mais qui permettent des effets (cire et sel) La peinture acrylique (plus délicate à nettoyer sur les vêtements) La peinture à l’huile mais les produits de dilution sont toxiques ce qui est plus délicat à gérer. Les techniques de cerne et de cire : drawin-gum, cire liquide, bougie, cerne relief. 
Pour aider à la réalisation des personnes malades, il est possible d'utiliser des caches afin de préserver les parties déjà colorisées ou de faire des séparation de couleurs. Les pochoirs restent très stéréotypés et sont à proscrire si l'on veut conserver un travail de création personnelle.
La connaissance et la maîtrise d'un éventail suffisant de techniques est indispensable à l'intervention en atelier thérapeutique, ce qui est le cas en gérontologie. Il est important de pouvoir rebondir d'une technique à une autre afin d'amener la personne vers la réussite. En art thérapie, l’échec n'est pas permit. 


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