chapter  21
16 Pages

Care-giving in dementia: the challenge of attachment

Today, most researchers and care-givers all around the world agree about one common goal in dementia. All methods, approaches, techniques or interventions are meant to improve the quality of inter-personal interaction with the sufferer in order to counteract the impending isolation of the sufferer and his family, as the dementia process progresses. They can now be elaborated without becoming competitive, demagogic or religious. The realization that many roads lead to the same goal represents valuable progress. Yet, there is no magic formula for working with the dementing elderly. At the moment we acknowledge that in modelling individual caregiving in whatever setting, we have to consider the aetiology of the disease, the stage of the process, the life-span and the personality of the sufferer, and his or her family system. However, that knowledge and expertise was addressed mainly to care-givers; which implies that the patient is still often considered as an object of the dementia disease. Fortunately, the individual perspective of the sufferer has recently been stressed more and more by many authors. This new view means that the patient is becoming the subject of his or her disease. This changing perspective is enabling us to see, on the one side, the rich panorama of experiences and emotional needs of the patient; and on the other, it has enabled us to enter and discuss the experiences and (un)conscious needs of the care-givers themselves, be they relatives or professionals. In a broader context, the foundations on which care-giving in dementia is grounded, implicitly reflect the basic values and beliefs of our culture and society.