A psychosocial model of parent fixation in people with dementia: The role of personality and attachment

Abstract

This study replicates and extends research into the occurrence of parent fixation in people with dementia by exploring the relationship between demographic, cognitive and psychological factors. Fifty-one people with dementia, living both in the community and in residential/nursing home settings, were interviewed about their parents and a relative of each completed measures assessing the person with dementia's demographic details, level of cognitive impairment/executive functioning, behavioural consequences of parent fixation and pre-morbid personality and attachment style. Results indicated that parent fixation can be viewed as a psychosocial phenomenon arising from the environment, pre-morbid personality and attachment style and that the behavioural consequences of parent fixation are maintained by the individual's level of executive functioning and gender. Findings and clinical implications are discussed in relation to Miesen's (1992, 1993, 1999) theoretical assumption that dementia is a loss process that activates the experience of feeling unsafe and the emotional need for the security of an attachment figure.

Emotional safety of people living with dementia: a systematic review

“…problems understanding several words (Sørensen et al, 2008). In addition, people living with dementia were reported to feel unsafe because things that previously created a feeling of safety, such as control and independence, are restricted in the course of dementia (Osborne et al, 2010). According to Osborne et al (2010), people who experience these restrictions are less able to cope with the disease.…”

“…In addition, people living with dementia were reported to feel unsafe because things that previously created a feeling of safety, such as control and independence, are restricted in the course of dementia (Osborne et al, 2010). According to Osborne et al (2010), people who experience these restrictions are less able to cope with the disease. Living in the present and following routines appear to be strategies for coping with dementia-related changes in the context of emotional safety (Panke-Kochinke, 2013; Yatczak, 2014).…”

“…Five studies of people living with dementia or family members reported that biographical, demographic and socioeconomic factors related to the emotional safety of people living with dementia should be considered in the context of emotional safety. Four studies concluded that past experiences without dementia may have an effect on the experience of emotional safety in the current situation (Mazaheri et al, 2014;Osborne et al, 2010;Wang et al, 2012;.…”

L’agitation chez les personnes atteintes de démence : examen de la portée des connaissances et mise en perspective du phénomène selon la théorie du confort et le concept de l’attachement

“…Ainsi, certaines des conséquences de l'agitation peuvent à leur tour avoir une incidence sur l'antécédent primaire « facteur relationnel » (Figure 1), connu comme précurseur des comportements agités (5,15 (33). Or, chez ces malades, les systèmes d'attachement sont souvent mobilisés (33)(34)(35) amenant le malade à rechercher une figure d'attachement souvent représentée par le soignant (35,36). Dans la relation soignant-soigné, la théorie de l'attachement est un modèle qui permet aux professionnels de compléter leur compréhension de l'origine de certains symptômes comportementaux relatifs aux modes relationnels des patients et d'y répondre de manière adaptée (38).…”

“…Ces connaissances renforcent la nécessité de tenir compte des modes d'attachement de ces patients et d'y répondre de manière appropriée lors de la réalisation d'approches non pharmacologiques. Elles corroborent les conclusions d'autres auteurs (36) qui soulignent la nécessité d'intégrer les caractéristiques individuelles de modes d'attachement des personnes atteintes de démence dans des démarches centrées sur le patient afin de développer des rapports de confiance (36). Ces auteurs appuient sur l'importance d'établir et de maintenir des relations d'attachement à travers les interventions de soins afin d'aider ces patients à se sentir émotionnellement en sécurité (36).…”