Attachment theory, ageing and dementia : a review of the literature.

The following review draws together recent theoretical contributions and research findings highlighting the pertinence of attachment issues for older adults. Beginning with a brief overview of the principles of attachment theory, the paper proceeds to illustrate that attachment remains a key feature of relationships throughout the life cycle. Research findings suggest that past and present secure attachment relationships function as a protective resource in later life and preliminary studies highlight the continuing salience of parents as attachment figures for older adults. Particular attention is given to the significance of attachment theory in thinking about the subjective experiences of people with dementia, for whom unwilling separation and disruption of attachment bonds can be common themes. Research indicates the frequent occurrence of attachment behaviours and parent fixation amongst people with dementia living in residential care. Pre-morbid attachment style has been shown to interact with emotional and behavioural expression during the course of dementia. Clinical applications of attachment theory in dementia care are discussed and initial evidence for the effectiveness of Simulated Presence Therapy is provided. Methodological issues raised by the review are considered, together with suggestions for future research