Menu Expand
Supporting Older People Using Attachment-Informed and Strengths-Based Approaches

Supporting Older People Using Attachment-Informed and Strengths-Based Approaches

Lydia Guthrie | Imogen Blood

(2018)

Abstract

The significance of attachment theory for working with older people has been overlooked, and yet its importance is clear - evident in the experiences of people who struggle to adapt to new ways of living, to life with limiting health conditions, or to new social networks.

This book explains how an understanding of attachment theory can empower health and social care staff, and improve the care of older people. It also serves as an accessible introduction to strengths-based working, covering principles and practice as well as key practice issues such as positive risk-taking, supporting people with dementia, working in end of life settings and working with whole families.

With in-depth case studies depicting a broad span of experiences and easy to use tools for practice, this practical guide serves as an essential guide for all staff supporting older adults.

This hands-on guide will help frontline workers convert this policy vision into practice.


This is a really important and timely book. It's essential that we inject the humanity back into our caring relationships, formal and informal. Too much attention is given to the architecture of care; rules regulations, protocols. Too little is done to support carers and care workers to foster the essential and deeply human relationships we'd like to see. Far to little understanding and recognition about how we as humans can be best engaged to bring our empathy, humanity and kindness to the fore. Blood and Guthrie draw on solid evidence to demonstrate why we have to change our culture around care, it's not about 'them' it's about all of 'us'. If we want care to be kind we have to make the system around it kind. Until we fully recognise the relational and human aspect to care we will continue to fail to create the conditions for kind of care we want for our loved ones and indeed ourselves. Bravo!
John Kennedy, Independent Consultant and Commentator in Adult Social Care
Applying attachment theory to close relationships in later life is still a neglected topic (I say that with some experience because it was the subject of my PhD, and it was just as neglected then). This book goes a long way to stress the importance of recognising that attachment processes carry on until the end of life, when the loss of key attachment figures is more and more frequent. By introducing 'strength-based' and other contemporary ideas closely connected with attachment theory and research the authors have produced a very relevant and readable volume for practitioners from all disciplines.
Professor David Shemmings OBE PhD, Director of the Attachment and Relationship-Based Practice Project
This book is an essential read for practitioners, supervisors, researchers and educators concerned with working with older adults. Attachment theory is about all of us, across the whole of our lives. Imogen Blood and Lydia Guthrie have written a richly rewarding and comprehensive volume, providing profound and useful insights and ideas for working systemically, holistically and humanely with older people.
Clark Baim, Senior Trainer, Supervisor and Psychotherapist

Imogen Blood is a qualified social worker with experience in research and policy on older people's housing, care and support. She is the Director of Imogen Blood & Associates Ltd., in Manchester, UK.

Lydia Guthrie is a qualified social worker and systemic practitioner who specialises in applying attachment theory in social work and mental health settings. She is Co-Director at Change Point Learning Ltd., and is based in Oxford, UK.

Table of Contents

Section Title Page Action Price
Supporting Older People Using Attachment-Informed and Strengths-Based Approached by Imogen Blood and Lydia Guthrie 3
Acknowledgements 9
Preface 11
Attachment-based practice and strengths-based practice: the ethos of this book 11
Do we need a book about ‘older people’? 12
The organisation of this book 13
1. An Introduction to Strengths-Based Practice with Older People 15
Jakob’s story 15
Policy and legal context for a strengths-based approach 17
Principles of strengths-based practice 19
Conclusion 32
2. Introduction to Attachment Theory 34
The Dynamic-Maturational Model of attachment and adaptation (DMM) 34
How babies develop attachment strategies 39
The development of attachment strategies 42
The development of attachment strategies beyond infancy 45
How can attachment theory be useful when working with older people? 48
Further reading 54
3. Working with the Whole Family 55
Caregiving and family relationships 57
Attachment patterns within families 58
Interactional patterns within families 59
Attachment and caregiving 62
Practical ideas for supporting families using attachment and strengths-based approaches 73
4. A Good Life in Care 76
What does a ‘good life in care’ mean to older people living in care homes? 77
How can we apply the seven principles of strengths-based practice in care home settings? 83
How do good homes create a good life? 88
5. Maintaining Connections and Interests 100
Introduction 100
Loneliness: an overview 101
Identifying lonely individuals 102
Understanding an individual’s loneliness 104
Supporting older people out of loneliness using strengths-based approaches 106
Supporting access to mainstream clubs and activities 114
6. Positive Risk-Taking 117
Introduction 117
Older people and risk-taking 121
Family members’ attitudes to risk 124
Professionals, risk and older people 127
Conclusion 144
7. End of Life and Bereavement 148
The ‘medicalisation’ of end of life 148
What do we know about what matters most to people at end of life? 149
How can attachment theory help us to support people at the end of life? 150
Attachment-informed care at the end of life 153
Supporting families and individuals through bereavement: an attachment-informed approach 156
A strengths-based approach to end of life care 159
Using attachment- and strengths-based approaches to support people with dementia at the end of life 163
Supporting families through bereavement 166
Considering the needs of staff members 167
Resources 168
8. Reflective Supervision, Staff Wellbeing, and Strengths-Based Leadership 169
Introduction 169
Low pay in the care sector 170
Emotional labour, relationship-based practice and ‘burnout’ 172
Supporting relationships at an organisational level 174
Supporting relationships at a personal level: attachment theory and wellbeing 179
Supervision 182
Strengths-based leadership 187
Reviewing assessment processes in an adult social care team 188
Resources 192
9. Tools 193
Tool 1: Using the resilience wheel 193
Tool 2: The art of asking questions 195
A problem-/deficit-focused conversation 198
A strengths-based/solution-focused version of the conversation 199
Tool 3: The behaviour, pattern and function triangle 200
Tool 4: Family tree 202
Tool 5: My world 204
Tool 6: Life story work 206
Tool 7: Motivational interviewing 210
Tool 8: Circles of support 217
Tool 9: Positive Risk-Taking 220
Tool 10: Tools to support supervision: writing a contract and setting the agenda 224
Tool 11: Tools to support supervision: promoting reflection in supervision and team meetings 226
References 230
Subject Index 240
Author Index 244
Blank Page