Attachment, loss and coping in caring for a dementing spouse
The burden of caring for a dementing spouse is well documented. Changes in the marital relationship, such as loss of the dementing person as he or she used to be, are part of the burden. The history of the relationship and the attachment between spouses are crucial in understanding the individual burden and adaptation to changes. John Bowlby describes three kinds of insecure attachment, which tend to increase proneness to loss: (i) anxious attachment, (ii) compulsive care-giving and (iii) strenuous attempts to claim emotional self-sufficiency and independence. Insecure attachment is seen in relationships between care-givers and dementing spouses, reflecting problems of dependency and of regulating the relational dynamics of closeness and distance. Attachment behaviour is often overtly expressed by the dementing person. For spouses insecure attachment may cause reluctance to accept that changes are in conflict with their basic needs of stability and security.