Book Review: Supporting Older People Using Attachment-Informed and Strengths-Based Approaches

07 January 2019

Sanya Patel is a Foundation Trainee at Addenbrooke's Hospital who is interested in a career in geriatric medicine.

Working in the healthcare sector gives few opportunities to read a book front to cover. On the rare occasion I find myself in contact with a paperback, it is just to flick to the relevant page; more often I resort to searching for answers over the internet. It was therefore a pleasure to be given the chance to write a book review for the British Geriatrics Society, my thanks go to the team.

I am reviewing a book entitled “Supporting Older People Using Attachment-Informed and Strengths-Based Approaches”. The book explores two concepts. Attachment theory is a model of the way people connect, whilst strength-based approaches aim to fit services around the support already available from families and communities. The authors apply both principles to complex situations in geriatric care, including family dynamics, loneliness, risk taking and palliative care.

Attachment theory was initially developed after studying the way children react when their primary caregiver leaves the room. In dysfunctional attachments, children struggle to reform a stable relationship when the caregiver returns and this is thought to have implications on interactions in later life. One relatable vignette describes a lady who repetitively uses her call-bell for assistance in activities she could manage independently. The lady had become accustomed to an unpredictable frequency of human contact and adapted by finding ways to encourage staff to spend time with her.

Strength-based approaches describe strategies through which older people can be encouraged to use resources at hand to maintain as much independence as possible. There are seven principles that guide a strength-based approach and are shown in the diagram below.

The Seven Principles of Strength Based Approaches

1.    Collaboration and self-determination: work together to find a personalised solution
2.    Relationships are what matter most
3.    Everyone has strengths and everyone has something to contribute
4.    Stay curious about the individual
5.    Hope in the human capacity to change behaviour
6.    Permission to take risks
7.    Build resilience

(Adapted from: Supporting Older People Using Attachment-Informed and Strengths-Based Approaches, Blood et al 2018.)

Despite covering weighty conceptual material, the book was clear to follow - even for a junior doctor post-nights! Psycho-cognitive theory was supported with relatable character stories and a believable evidence base. The authors kindly included their own strength-based toolkit for practical guidance on a variety of strength-based approaches, which is invaluable for anyone working with older adults. A standout advantage of strength-based approach is that it can deliver personalised and high quality care, even in the face of current issues around resources and funding. The guidance offered in this book gives clear examples of how strength-based approach can be applied, without further stretching an overworked sector.

In summary, “Supporting Older People Using Attachment-Informed and Strengths-Based Approaches” was an enjoyable and practice-changing book - certainly worth putting at the top of your list, next time you have a chance to settle down and read.


Thank you to Sanya Patel and the team for such a positive review. Imogen and I are delighted that you found the book enjoyable to read, and useful for your practice.

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