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What Margaret's situation illustrates is that a trauma-informed, holistic

assessment serves not only as a useful aid to the selection of an appropriate

residential placement, but also provides valuable insights for her future care

management.

Understanding attachment seeking behaviour helps those working in care

homes to better understand and respond to expressions of loss and need. As

the case with good quality foster placements, where the understanding of the

importance of a secure base to support care is advanced, so too good

dementia care is based upon building relationships.

It recognises that people with strong social connections built from secure

attachments in early life, that they are able to maintain when they develop

dementia, are best placed to live well (Magai and Cohen, 1998). Supporting

people as their cognitive ability declines to stay connected to the people and

environments that matter to them can be very positive, but regrettably this

experience is not universal. It is crucial, therefore, that reminiscence tools are

used with care and intelligence, taking account of family patterns and

attachment histories (Sabir and colleagues, 2016).

Summary points for practice

Understanding people's experience of attachment, as someone requiring

support or as a family carer, is an important element in a person-centred

approach to assessing need and planning for care.

Supporting a person to reflect on their experience of attachment contributes to

their capacity to build resilience and maintain their rights and choices through

their dementia.

Understanding attachment complements a rights-based approach by

recognising the need for love and care throughout life.

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