Aesthetic care, prevention, bond of trust with patients… Alexandra Kerleau, psycho-socio-aesthetician in the Oncology department of the Avicenne hospital in Bobigny, talks about her job to Quelle Docteur.
According to the definition of CODES (ESthetics COURSE with humanitarian and social option), the pioneering school of the discipline located in Tours, socio-aesthetics is the professional practice of aesthetic care for suffering populations weakened by an attack on their physical integrity (illness, accident, old age, etc.), psychological (mental disorders, addictions, etc.) and/or in social distress.
Alexandra Kerleau is a psycho-socio-esthetician in the Oncology department of the Avicenne University Hospital, in Bobigny. His work is part of a program of “supportive care” intended for patients, which includes around twenty different workshops: physical activities (sports therapy, martial arts, etc.), art therapy (dance, music therapy, etc.), help with smoking cessation, nutrition, sophrology, Snoezelen approach. .. She tells us about her job.
Why Doctor: How did you get into socio-aesthetics?
Alexandra Kerleau: I started as a nursing assistant at the Avicenne hospital. I entered the neurology department, where I discovered brain tumors and glioblastomas. I realized that they took care of the patient, his pathology, but not really in a holistic way: the patient did his chemotherapy then left, he arrived with holes in his head because his hair was falling out, no one took care of it. of his skin… He was treated, followed by a dietician and a psychologist, but ultimately no one questioned him outside of the treatment. I discovered the profession of socio-aesthetics during a conference, and I immediately liked it. It’s been 13 years since I graduated from a psycho-socio-aesthetic school in Nanterre. I needed to have the “psycho” dimension of the job.
What does the job of psycho-socio-esthetician consist of?
The main tool is aesthetics: it is what allows us to relate to people. We go through aesthetic care, touch, so that there is a release of the patient’s speech. At the beginning, the teams (doctor, nurse, dietician, caregiver, etc.) detect a problem and refer the patient to me. It is not: “Alexandra, can you go give him a facial?” It is rather: “He’s starting to withdraw into himself, can you go see him?” With the patient, we will then work on isolation, entering into communication perhaps through treatment. Initially, it is a treatment, but the objective is to create a relationship of trust – thanks to kindness, voice intonation, touch – so that speech is freed and support is possible. Touch, through care, is the mediator. As a psycho-socio-esthetician, I must achieve “care objectives”. If a patient needs to start a new treatment, I may be asked, for example, to provide prevention of skin toxicities. Because if the patient benefits from the right recommendations and the right products (associated with hospital protocols) from the start of their treatment, they will limit the side effects on their skin, and therefore on the psychological level, of the link social, etc. It’s a snowball effect. By creating a bond with the patient, even if only by offering them a cream, support becomes easier.
Whatever the objective of care (reappropriation of the body, reconstruction of identity, management of stress and anxiety, etc.), it is always through the mediator of touch that we pass, by integrating the patient into the project.
Can you give an example of care-mediator?
A woman has just had a mastectomy. She no longer looks at herself, no longer touches herself, no longer wants her husband to touch her, she withdraws and isolates herself. In consultation, I put into words the treatment objective to be achieved: working on the reappropriation of one’s body. For example, I will offer her a back massage: she is on her stomach, arms dangling, which allows me to touch the tip of the scar on the side. This is a first contact to assess whether the patient has any startles, begins to move, shows discomfort, or if, on the contrary, she does not react. My work is not care, but exchange during care, to raise “awareness”: “Did you notice that I passed by your scar while massaging your body? It’s true that it is recent and fresh.” This allows you to imagine the scar on a body, alive and with sensations. We reintegrate the patient, with her emotions and feelings, into the care. “Do you find my touch pleasant?” We exchange, to bring awareness: “This is the first time someone has touched my scar, or touched it without disgust” – disgust or other which, often, is a representation linked to the patient’s life story, a projection that must be deconstructed. A mastectomy in a person who already lacks self-confidence, for example, can seriously increase their discomfort. This is why it is essential to know your patient to know where to refer them, to what care, what workshops, etc.
How does a session take place?
When I see a patient, I first carry out a bio-psycho-socio-aesthetic assessment. It is an exchange during which I find out about the patient’s environment and lifestyle: if he works, if he is supported by relatives, if he has children to pick up at home. school, if he has income – it would sometimes be inappropriate to offer cream if he is not able to buy it. Then, the treatment begins, depending on the problem. Whatever the objective of care (reappropriation of the body image, reconstruction of identity, management of stress and anxiety, etc.), it is always through the mediator of touch that we pass, by integrating the patient into the project, to be able to support it. The session lasts approximately one hour.
We use all the tools in the package of a beautician, except that we work on damaged skin, mutilations: facial treatments, hair removal, massages, manicures, hair prostheses…
What mediators do you use to communicate with the patient?
All the tools in the package of a beautician, except that we work on damaged skin, mutilations: facial treatments, hair removal, massages, manicures and pedicures, hair prostheses… I want the patient to be comfortable, it That is to say, he forgets his skin, because when we are well, we don’t think about it, whereas otherwise we scratch, we have redness, discomfort. I also run workshops to offer different tools: cosmetics, hand care, scars, correctors, relaxation, turban scarves… By doing different workshops with the same people, the idea is to create dynamics and cohesion group – we must not forget that there is always a goal of care. If I see a patient, it’s not a cosmetic procedure for the sake of a cosmetic procedure. For example, during the scar workshop, my job is above all to discuss the representation that the patient has of their scar – it is very subjective, very specific to each person. Or, during the corrective workshop: you can use therapeutic makeup to hide redness, breakouts, or to camouflage a problem, such as a PAC scar (the box implanted at the level of the collarbone to receive the correction treatment). chemotherapy), in order to be able to put on a neckline when summer comes. But my role is first to know what the patient is looking for in makeup: if she is used to wearing makeup or not, if she does it for herself or for others… Once again, it is necessary to take an interest in the patient’s journey.
Clichés die hard, and there is clearly a lack of recognition of the profession.
What are the profiles of socio-aesthetic patients?
We are here in 93, a department with high social insecurity. When people have difficulty feeding their children, and add cancer or OCD, some have difficulty absorbing everything that happens to them. In oncology, there is a budget to have aside. It is very difficult to get them to buy the products they need. Often, they wait for toxicity before asking and acting. We feel this concern, and there is a form of guilt: they are sick and cannot afford to buy cream (nothing effective is reimbursed), so they will not be able to compensate for the costs. deleterious effects of their pathology, which will create new problems. It’s a vicious circle. We try, with laboratories and associations, to give them products, but it is not enough.
Do you think the term “socio-aesthetic” is appropriate for your role?
I’m afraid that the term denigrates our profession a little. When I first started, passing through the corridors with my trolley, I was entitled to comments like “Ah, are you going to do your nails?”. Clichés die hard, and there is clearly a lack of recognition of the profession. But once people see the impact on patients and realize that it is comprehensive therapeutic care, they tend to quickly change their minds.
