Dementia, Attachment, and Unrelated Questions

“Can I ask an unrelated question?”

I often get this question as an appointment with a college student is wrapping up. It is one of my favorite questions.

It’s like that Forrest Gump box of chocolates deal. You never know what you’re going to get.

Sometimes students want to know where I get my hair cut in our college town (and I’m flattered for days). Sometimes they want to talk to me about whether they should make an appointment at our counseling center. Sometimes they have seen pictures of my dogs on Twitter and want to know what vet we use (Den Herder in Waterloo, IA…this is not a paid ad but they are great). Sometimes they want to know who to contact in Financial Aid if your parents got laid off due to COVID and you can’t pay your U-bill.

Here is her unrelated question: “How do I keep from getting attached to all the people while I work in memory care?”

She is a freshmen and just moved into her residence hall a couple weeks ago. She applied at a local memory care community and got the job. She’s only worked a few shifts in training. She tells me she’s already attached to the residents. (As a side note, she’s not a Gerontology major now…but I hope she is soon.)

I was startled by how difficult it was for me to answer this question. I don’t know how you keep from getting attached. I had no tips or expert advice to offer.

I am attached to the adults with dementia that I’ve gotten to work. For that matter, I have an attachment to students I get to work with.

I don’t cross boundaries, but I’m a human being. And I care. I think’s probably hard to care and not become attached.

Then it occurred to me that maybe I should think about the question. Maybe we should ask whether or not it’s okay to get attached to the residents.

I starting thinking about family members who have loved ones in facilities and cannot visit due to COVID. I realized that many of those families are surviving only because they know there is an employee in the facility who is attached to their loved one.

Imagine if you couldn’t see your mom, dad, grandparent, spouse, sibling, or friend for months and you felt that no one was attached to them during that timeframe.

I understand professional boundaries. I understand burnout. I understand that you should be able to let go after your shift. I know that professional caregiving is stressful and you need to step away, relax, and regenerate. I encourage you do all these things and understand you are only one person who can only do so much.

But I’d worry about a professional caregiver who wasn’t attached to residents.

And I have a suspicion that professional caregivers are even more attached now that family visitation is limited.

As a director of nursing at a nursing home recently told me, “It’s the residents and employees against COVID. We are all on the same team, and we’re in this together.”

Whenever I post something positive about nursing home employees, I get some messages from you all to remind me that not all nursing home employees are great. Before you email me, know that I get it. If you’ve had a loved one in a nursing home or assisted living, you’ve likely run into caregivers who weren’t up to par. You have every right to speak up and voice concerns. We have to advocate for our loved ones and I support you in doing so.

But, please, if there is a nursing home employee who takes good care of your loved one, mention them to management as well.

Many of the gerontology majors that I work with are employed at nursing homes. You know those pictures you see of college students out at bars and parties without masks…you won’t see them in those pictures. They sacrifice parts of college life because they can’t get COVID. They’d be devastated if they infected nursing home residents.

As for my college freshmen, she had some great questions about how communicate with her residents. She wanted to know if it was okay to imply that someone’s loved one was still alive when they were wandering around looking for them. She wanted to how to calm someone down when they were agitated. She wanted to know what to tell residents who wanted to go home.

She’s going to be great.

11 thoughts on “Dementia, Attachment, and Unrelated Questions

  1. Awesome post! You need to be an “attached” professional when working with a person living with dementia. In the words of David Sheard, “Feelings matter most in dementia care”. The centre of the Kitwood Flower is Love, and one of the petals is Attachment. You can’t meet the 6 psychological needs of a person living with dementia by being a “detached” professional. This student is going to be great. I hope she becomes a Gerontology major.


  2. Having a loved one with dementia living in a care facility is difficult enough, but couple it with COVID and it becomes far more cruel. Bad enough that the loved one will ultimately be unable to recognize their family/friends, but not being able to see/talk to them anymore would, IMHO, hastens the time when this happens. COVID is cheating all of us in different ways, but for some, the loss is greater.


  3. I’m with you, Elaine. If you don’t have a degree of attachment, then you don’t really care. Of course personal boundaries need to be maintained for the carers’ own self care. I was a clinical psychologist before retirement, and a nurse when I was much much younger, so I get it.

    As for your student, please God she goes into gerontology – we need people like her, she sounds great.


  4. I have been a nurse looking after people with dementia, a social worker in older people’s care and cared for my parents. Now I have dementia myself and have run my own young onset support group. I think it’s essential to become involved as this means you care about a fellow human being.

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  5. For sure, I’m praying every single day that someone in the care home is attached to my spouse, that someone’s attention warms her spirit, that someone gets her sense of humor, that someone CARES for her – now that I can’t.
    There’s no way to know – which is very weird.
    There’s a related problem that I’d love to see more discussion on: When the doors closed at the beginning of Covid, my 3-4 visits every other day suddenly stopped. Those visits were filled with activities – going out to lunch, out for a drive, participating in Bingo and art classes at the residence, etc. – because conversation was nearly impossible.
    Covid restrictions initially allowed only brief phone calls – well, we had very seldom talked on the phone in all our 25 years, and when I tried it she became upset and confused. Later, video chat was allowed for short periods every other week, but she’d never been able to deal with it even with family overseas, so that wasn’t a good option either.
    It turns out that our lively, action-filled visiting style worked because it allowed us to be close, in the car, at the table, during a walk, etc, which was really the only thing getting through. It also lifted the need for much conversation, which was harder and harder for either of us to sustain or respond to.
    I can’t imagine how 20 minutes every 2 weeks, gowned and masked, across a large table, would allow for anything but waking up her very vague memory of who I am and our life together, only to have to say goodbye, I can’t hug you, and disappear for another eternity.
    So, I haven’t had direct contact in months. It tears me up inside, even though I think it’s the better option. I’d appreciate hearing more about this dilemma, if you are interested in writing about it.
    Thanks, and welcome back!

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