Doll Therapy for Alzheimer’s Disease
Pros and Cons of this controversial therapy
Anyone who has seen it happen knows that a doll has the power to soothe and comfort people with Alzheimer’s disease. Formal investigation of the effects that dolls can have on people who have Alzheimer’s disease is in the early stages, but talk to caregivers who have participated in doll therapy for dementia and most of them will speak positively about the experience. Dolls have been shown repeatedly to soothe and comfort people with Alzheimer’s. Although it can be discomforting to see an adult hold a doll, we need to acknowledge the benefit that doll therapy can provide.
We probably get more feedback from customers concerning doll therapy for Alzheimer’s disease (and doll therapy for dementia) than any other category of care. Elaine (below) shared the cost of one of our Serenity Babies with her brothers and sisters so they could give this beautiful doll to their mother.
Research | Doll Therapy for Alzheimer’s
Much of the research involving doll therapy for Alzheimer’s disease has been carried out at Newcastle General Hospital in England and in care facilities in the area of Newcastle. Clinical Psychologist Ian James and nursing specialist Lorna Mackenzie, with others, reported significant improvement in the behavior of nursing home residents with dementia when dolls were introduced to the residents as a choice.
Various studies done by this group, all observing the effect of baby doll therapy on people with dementia, all reached similar conclusions. Using dolls to alter behavior in patients with dementia, Nursing Times VOL: 103, ISSUE: 5, PAGE NO: 36-37, (a British journal, which explains the funny spelling) summed it up like this:
The results of the study provide support for the hypotheses that after the introduction of dolls, doll-users showed an increase in positive behaviour and a decrease in negative behaviour and incidents of aggression compared with before the dolls were introduced. These results support previous attitudinal studies, which have reported doll therapy to be an effective approach in reducing negative and challenging behaviours, and promoting more positive behaviours and mood.
These conclusions are in agreement with so much anecdotal evidence reported by caregivers that credit doll therapy for Alzheimer’s with increasing quality of life for people with dementia. Some have even reported that they were able to reduce medications as a direct result of doll therapy.
doll therapy for Alzheimer’s? It is important that carers be onboard…
A study³ published in the journal Age and Ageing concentrated, in part, on caregiver reaction to the introduction of dolls into the care environment. Residents with dementia in two facilities in England were introduced to dolls. All of the caregivers in the facility were given surveys before and after the study. Although nine of the 46 staff members voiced some initial concern, mostly centering on the idea that the dolls would be ‘babyish’, ‘ totally demeaning’, ‘ patronizing’, or otherwise ‘inappropriate’. In the interview that followed the conclusion of the study, only one caregiver retained this concern. All of the others “felt that there were clear benefits of using the dolls. . . . 14 carers felt that residents’ lives were a little better, and 32 felt that their lives were much better.
Benefits of doll therapy for Alzheimer’s
- Reduces aggression and anxiety
- Improves communication
- Reduces wandering and agitated behavior
- May reduce or even eliminate the need for certain medications
Benefits reported by the staff included a calming effect, reduction in wandering, increased communication and improved speech. Many of them expressed the opinion that the effect was the result of the individual now having a sense of purpose or focus. One caregiver said of a resident, “He’s a different man with a doll in his hand. I found out more about him—the tender side”.
Doll Therapy for Alzheimer’s — Not for Everyone
The nurturing instinct is strong. This instinct is a big part of the reason that doll therapy is so effective. On the other hand, it can lead to some problems that should be watched for when introducing dolls as therapy. In community settings, ownership issues have led to arguments between residents. Anxiety can result from dolls being mislaid. Redirecting attention until the lost doll is found will usually defuse this potential calamity.
Family members of caregivers sometimes see the use of dolls as demeaning. From the study in Age and Aging cited above:
A question concerning the carers’ ‘initial impression of the use of dolls when they first heard about them’ had intended to capture staff’s misgivings. Three staff reported major concerns, six had minor concerns, 16 were neutral, six were mildly positive and 15 were very positive from the outset. .. 13% of carers recorded that they had misgivings—carer quotes included: ‘Thought it was babyish’; ‘. . . totally demeaning’; ‘. . . patronising’; ‘inappropriate . . ., thought it would confuse residents further..
These concerns can be even more pronounced when trying to convince family care partners that their loved one might benefit from a doll. Another study² reported, “there had been some problems using the dolls, such as arguments between residents over ownership of dolls, residents trying to feed their dolls, and dolls being mislaid leading to distress. In addition, some staff working in homes felt that the dolls may be infantilising residents.”
but having seen the way residents react when using the doll opinion has changed’.
Other considerations: “Despite these positive findings,
* We should repeat here that doll therapy is not for everyone. If you see that it is more problematic than beneficial, discontinue it in favor of some alternate non-pharmacological therapy.
Guidelines for Doll Therapy For Alzheimer’s Disease
Doll therapy (also known as baby doll therapy) is not for everyone. More women than men will choose a doll to nurture, but some men do benefit greatly from holding a doll, so don’t rule out doll therapy for the man or men in your care. Another option to the doll is a Teddy Bear or other stuffed animal. We have a selection of bears and other animals that provide aromatherapy and heat and cold therapy as well as the therapy provided by the act of nurturing. Our best-selling Twiddle Pup and Twiddle Cats, in certain cases, would even qualify for doll therapy.
Providing doll therapy for Alzheimer’s disease
Choose a doll that is lifelike. One that looks like a real baby, is 15 – 20 inches long, and weighs 3 – 6 pounds will get a much better response and result than one that is smaller or unrealistic looking, or one that looks like an older child. This is not to say that other dolls can’t be effective, but our recommendation is evidence based¹.
- We recommend a doll that represents an age from newborn to a year or so in age. Dolls that look like toddlers may work for some, but most people with dementia will connect better with a younger looking doll.
- Do not hand a person a doll – people don’t like responsibility imposed upon them. Place the doll where it can be discovered, or hold it yourself. Allow the individual to choose the responsibility of caring for the baby.
- Some people with dementia will think that the doll is a real baby. Others will know that it is just a doll, but love it just the same. Some will think it is alive one day, and know it is a doll the next. Be careful how you refer to the doll. If it has a name, refer to it by that name.
- There are potential drawbacks to doll therapy. It is not for everyone with dementia. Until a bond is created between the individual and his or her doll, be alert to behaviors that may indicate that a connection will likely not happen. There are other therapies and activities that may suit that person better.
Introducing the therapy doll
[pullquote]He’s a different man with a doll in his hand. I found out more about him—the tender side.
~ Caregiver[/pullquote]It is important that a doll not be given directly to the person with Alzheimer’s disease. Rather it should be left somewhere, on a table or sitting in a chair, for example, somewhere that she will easily find it. This way the individual can make the choice to provide care for the doll, not feel that they are being given the responsibility to do so, which could cause anxiety or result in the doll being rejected.
For Doll Therapy to be effective, it is recommended that you use a doll that is as lifelike as possible. Introduce the doll in the middle stages of Alzheimer’s, or even in an earlier stage, depending on the individual. Often when introduced later, the person fails to or has a more difficult time making a connection with the doll. Once the connection has been made, the rest is easy. It’s a self-administering therapy
Doll Therapy for Alzheimer’s
- Baby dolls as therapeutic tools for severe dementia patients; (2001).T. Tamura, K. Nakajima, M. Nambu, K. Nakamura, S. Yonemitsu, A. Itoh, Y. Higashi, T. Fujimoto, H. Uno; Gerontechnology Vol 1, No 2 (2001)
- Using dolls to alter behaviour in patients with dementia: (2007). Jenny Ellingford, BSc,; Ian James, PhD, MSc, BSc, C.Psychol; Lorna Mackenzie, RMN; Lisa Marsland, BSc, MSc. University.VOL: 103, ISSUE: 5, PAGE NO: 36-37
- A pilot study on the use of dolls for people with dementia; Lorna Mackenzie Ian Andrew James Rachel Morse Elizabeta Mukaetova-LadinskaF. Katharina Reichelt. Age and Ageing, Volume 35, Issue 4, 1 July 2006, Pages 441–444.
Related Research: Doll Therapy for Alzheimer’s
A study¹ reported in the Journal of Gerontechnology in 2001 actually used one of the Cuddle Baby dolls (pictured above). The study reported on the effects that dolls had on a group of people in a long-term care facility in Japan, most whom had dementia, and all who suffered from Sundowners syndrome. For the most part the dolls influenced behavior in a significant way; behavior classified as: “no reaction, close observation (of the doll), care giving, and communication with other patients.” There was a small group that seemed to be completely uninterested in the dolls, which reinforces our point that doll therapy is not for everyone.
The researchers described the affect caring for a doll had on one subject of the study:
We monitored the activities of an individual patient with and without intervention with (a doll). She took extensive care of the baby doll during the intervention period. However, in the absence of the doll, she became agitated and tended to wander around, while during doll intervention she was calm and gentle.
The study reinforces what we know, that for many people with dementia, doll therapy is a meaningful and effective intervention. A bonus is their finding that more realistic looking and feeling dolls were significantly better at soliciting positive responses, and our Cuddle Baby performed the best of three dolls used in the study!
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