Attachment behaviours and parent fixation in people with dementia: The role of cognitive functioning and pre-morbid attachment style

Abstract

This study replicates and extends exploratory research into the occurrence of attachment behaviours and parent fixation amongst people with dementia. Relationships between cognitive functioning, pre-morbid attachment style, attachment behaviours and parent fixation were examined. Fifty-three people with dementia, living in residential or nursing homes, completed the Standardised Mini-Mental State Examination and were interviewed about their parents. A family member or friend rated pre-morbid attachment style and care staff made observations of attachment behaviour. Results indicated that parent fixation occurred more often in participants with lower levels of cognitive functioning. Parent fixation was not related to pre-morbid attachment style. The occurrence of overt attachment behaviour was inconsistently associated with both high and low levels of cognitive functioning, at different times of the day. Participants with an avoidant attachment style exhibited more overt attachment behaviour than participants with a secure attachment style. Findings are interpreted in terms of attachment theory and the clinical and research implications of the study are discussed.

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

“…On this basis he suggested that progressive short-term memory failure causes people to become disorientated to their surroundings, and also to the presence of, and emotional response from, attachment figures (Miesen & Jones, 1997). As a consequence, overt attachment behaviours become less useful and symbolic attachment (Cicirelli, 1991), in the form of thinking about the parents as if they were still alive, provides the person with a sense of emotional security (Browne & Schlosberg, 2005).…”

“…More recently, Browne and Schlosberg (2005) hypothesized that invoking the presence of parents may not be as comforting for all individuals as it would depend on their pre-morbid attachment style (anxious-ambivalent, avoidant or secure). Their study showed support for Miesen's (1993) finding that parent fixation was associated with individuals with lower levels of cognitive functioning.…”

“…It often results in individuals calling out or searching for their parents, asking how their parents are or wanting to be allowed home to see their parents (Browne & Schlosberg, 2005). This can be particularly challenging to work with as exposing a person to the reality of a present which is characterized by loss and the death of parents can result in emotional distress for the individual and increased attempts to search for or find the parents (Miesen & Jones, 1997;Stokes, 2000).…”

“…This can be particularly challenging to work with as exposing a person to the reality of a present which is characterized by loss and the death of parents can result in emotional distress for the individual and increased attempts to search for or find the parents (Miesen & Jones, 1997;Stokes, 2000). Nursing home prevalence rates of parent fixation range between 54% and 60% (Browne & Schlosberg, 2005;Miesen, 1993) and despite this phenomenon being widely observed and accepted in clinical practice, the nature of its occurrence and its psychological/biological underpinning has been the focus of limited exploratory research (Miesen & Jones, 1997). However, attempts have been made to develop a theoretical explanation.…”

Designing for Dementia: Iterative Grief and Transitional Objects

“…Winnicott's theory of transitional objects suggests that children form attachments with objects that offer security and comfort as they transition through individuation. 16 Inverse parallels have been drawn between the development of people in later stages of dementia and early childhood development. This move is intended not to infantilize or to ignore their wealth of life experiences, but to provide a framework to comprehend the normal attachment to objects and the relevance of transitional objects throughout the lifespan.…”