Dementia : an exploration of the effectiveness and value of support groups

This study considers the problem of dementia from the perspective of the person with dementia. Treatment and attitudes to the disease have changed considerably in recent years but to what extent are interventions meeting the needs of the person with dementia? The person of the person with dementia is increasingly considered in the treatment of the disease as well as growing consideration of how attachment style and attachment behaviours feature in the experience of a person with dementia. The aim of this study was to follow twenty six participants and their carers over a series of four occurrences of consecutive psychosocial group interventions with the aim of identifying changes in peoples' perception of their quality of life as well as investigating whether a person's attachment style affects their perception of the helpfulness of a psychosocial group intervention. Participants were visited in their homes on a pre and post basis. Attachment style was calculated, using a revised form of the Adult Attachment Interview questions in a semi-structured interview setting. Observations were made of relational interactions during the home visits as well as engagement and involvement with others in the group setting. A quality of life measure (DEMQoL) was used to measure changes in peoples' experience of their quality of life before and after the group intervention. Results were analysed using mixed methodology within a case-study approach, which was informed by thematic analysis of the complete data set, out of which arose three main themes: the person's relationship with their carer, the group experience and childhood experiences. The AAI questions were scored using Gricean principles to establish attachment style and identify associations between attachment style and perceived helpfulness of a psychosocial group intervention. Findings suggest a significant difference in the pre and post group scores on the quality of life measure. There was no significant difference for the perceived helpfulness of the group. The most significant finding was the importance of the relationship the person with dementia has with their principal carer. Verbatim notes provide examples of relational exchanges and suggest an association between attachment style and quality of relationship.