Using attachment theory to improve the care of people with dementia

Abstract

Bowlby's attachment theory has been used to uncover the emotional meaning of behavioural responses to loss and abandonment in people with dementia caused by variant CJD. Insecure attachment behaviour, such as rocking and howling, was observed in the group when placed in unfamiliar surroundings with strangers and on departure of family members. This behaviour did not occur in familiar surroundings or in the presence of familiar people. Grieving behaviour in individuals, young or old, confronted with the (threatened) loss of an emotional link with people who are important to them, was fundamental to the experiences of these people with variant CJD. We suggest that attachment behaviour can be construed as a 'normal' response of humans in times of extreme distress, illness and loss and can be even more marked in the presence of cognitive impairment where there is reduced ability to adequately express emotion.