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Gehechtheid als beïnvloedende factor van gedrags- en psychologische symptomen bij dementie

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Tijdschrift voor Gerontologie en Geriatrie

Abstract

Contemporary research has increasingly acknowledged the importance of attachment on stress-related processes in ageing. Congruent with this, there has been much research on attachment in older adults over the past three decades. In this article, the main findings of this research are summarized, with a focus on attachment and dementia. Results show that, in general, the number of attachment figures decreases in old age. Moreover, their identity changes as adult children, deceased loved ones and God become more prominent. With relation to the quality of attachment, anxiety in close relations appears to diminish as people age, while attachment avoidance remains relatively stable. Individuals with high levels of attachment security also report greater well-being and a more positive attitude towards ageing compared to persons with low levels of attachment security. Furthermore, individuals characterized by insecure attachment show more behavioral and psychological problems in dementia. Also, caregiver burden, depression, as well as the quality of care giving and future caregiver commitment differ depending on the quality of attachment of the caregiver. There is preliminary evidence for the efficacy of attachment-based interventions in dementia. Finally, there is a need for greater methodological uniformity and the use of measures that are validated for an older population.

Samenvatting

De laatste jaren wordt in toenemende mate het belang van hechting op oudere leeftijd erkend. Getuigen daarvan zijn vele onderzoekingen die gebeurden in de voorbije drie decennia. In dit artikel geven we een overzicht van de belangrijkste resultaten met speciale aandacht voor onderzoek naar hechting en dementie. Studies suggereren dat het aantal hechtingsfiguren afneemt op oudere leeftijd. Daarentegen wordt de plaats van volwassen kinderen, een overleden partner en God prominenter. Ook blijkt dat de hechtingsangst daalt naarmate mensen ouder worden, terwijl hechtingsvermijding relatief stabiel blijft. Veilige gehechtheid is verder positief gerelateerd met groter welzijn en een positievere visie op ouder worden in vergelijking met meer onveilig gehechte individuen. Onveilige gehechtheid hangt ook samen met een toename van gedrags- en psychologische problemen bij dementerende ouderen. Bij de zorgverlener zijn draaglast en depressiviteit, evenals de wijze waarop zorg opgenomen wordt en het engagement naar de toekomst toe, verschillend afhankelijk van de hechtingsstijl. Conform deze bevindingen lijken hechtingsgebaseerde interventies een positief effect op gedrags- en psychologische symptomen bij dementie te hebben, maar meer onderzoek is hier duidelijk nodig. Tot slot is er nog een weg af te leggen wat betreft uniformisering en validering van meetmethoden voor hechting op oudere leeftijd.

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Authors and Affiliations

  1. Klinisch ouderenpsycholoog, Cluster ouderenpsychiatrie van het Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Leuven, België

    L. Van Assche & L. Van de Ven

  2. Hoofddocent, Faculteit Psychologische en Pedagogische Wetenschappen (PPW), Klinische Psychologie, Katholieke Universiteit Leuven, Leuven, België

    P. Luyten

  3. Department of Clinical, Educational and Health Psychology, University College London, Groot-Brittannië, UK

    P. Luyten

  4. Universitair docent en ouderenpsychiater, Cluster ouderenpsychiatrie, Afdeling Psychiatrie van de Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, Leuven, België

    M. Vandenbulcke

  5. UZ St. Rafaël: Secretariaat Psychiatrie, Kapucijnenvoer 35, 3000, Leuven, België

    L. Van Assche

Authors
  1. L. Van Assche
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  2. P. Luyten
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  3. L. Van de Ven
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  4. M. Vandenbulcke
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Correspondence to L. Van Assche.

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Van Assche, L., Luyten, P., Van de Ven, L. et al. Gehechtheid als beïnvloedende factor van gedrags- en psychologische symptomen bij dementie. Tijdschr Gerontol Geriatr 44, 157–165 (2013). https://doi.org/10.1007/s12439-013-0029-1

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  • DOI: https://doi.org/10.1007/s12439-013-0029-1

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