Alzheimer's Disease, Spousal Caregiving Relationships, and Attachment

Alzheimer's disease is the most common cause of dementia in older adults. Due to increased life expectancy and the lack of a current effective treatment or prevention for this disease, a growing number of older couples will face the transition to a caregiving relationship in which one partner has dementia. Studies have shown that spousal caregivers experience a greater strain than adult children in the caregiving role, and that spousal caregivers who are providing care for Alzheimer's related dementia experience the greatest strain of any other caregiving group due to the nature of the Alzheimer's disease process. Studies also suggest that there is significant individual variation in the level of emotional support and distress experienced by the dementia spousal caregiver that can impact the health and well-being of each partner. The aim of this qualitative, exploratory study was to explore if and to what extent Master of Social Work professional use an attachment framework to guide and inform their practice when working with dementia caregiving spouses. Three primary findings resulted from this study. First, MSW professionals noted specific caregiving characteristics that enhanced responsive caregiving. Second, these professionals stated that they did not directly use Attachment Theory, but that components of this were built into their assessment process, thus, indirectly guiding their interventions. Third, MSW professionals felt that applying a more direct attachment lens could add additional dimensionality to inform and guide their practice at least in some situations. Implications for the broader practice of Social Work are discussed, as an attachment lens has the potential to help social workers proactively tailor their counseling or support recommendations for caregivers. Targeted support for caregivers has the potential to decrease caregiving burden and increase well-being. This in turn has the potential to decrease early institutionalization of the partner with dementia which places further burdens on the health care system.