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Showing Compassion: Doll Therapy And Dementia

04/04/2016 12:03 EDT | Updated 04/05/2017 05:12 EDT
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porttrait of a 90 years old woman, with her handmade doll

Is doll therapy a compassionate or a childish way of addressing the needs of those living with dementia? Some people have the opinion that using dolls in dementia care is wrong (the term most often used is infantalization, where the belief is that dolls treat the person like a child). Let me convince you otherwise.

People of all ages collect things, including dolls, stuffed animals, stamps, toy trucks and model trains. Why then are there so many negative reactions to a doll, or stuffed animal, when it is in the hands of someone who has been diagnosed with dementia? Is it the term, "Doll Therapy"? If it is the term, then call it "Love and Comfort Therapy" or "Alternative Human Connection".

When these words are used it becomes clear why we would use a doll to address needs. The needs related to love; comfort and belonging are too often unmet in those living with dementia. A doll can provide comfort and an opportunity to nurture and love.

Boredom and loneliness contribute to many of the behaviours we see in dementia. These behaviours often arise when needs are not met. Dolls, and/or stuffed animals, can help to address these unmet needs, if the individual is interested and able. When considering whether a doll is appropriate, ask yourself, "Whose need is it anyway?"

If a doll addresses the need of a person who is seeking love, comfort and something purposeful to do (such as folding or changing the doll's clothes), perhaps the doll should be put into the arms of that individual. The decision to use a doll should not be based on how providers of care feel about dolls. The decision should be based on whether or not the doll, or stuffed animal, addresses the need of the person living with dementia.

So how do you implement doll therapy? The DementiAbility WOW Model helps you decide whether a person would benefit from doll therapy. Start with these questions:

- Who was this person in the past and who is this person in the present? (including needs, interests, abilities and skills):

- It is always important to rule out past trauma. Who was this person in the past? Are there any tragic events from the past related to children or babies that you need to be aware of?

- Did they like children in the past? Do they like them in the present? Don't assume you know the answer.

- Was this person loving, nurturing, caring, giving and the type of person that 'always wanted to help'?

- What is the current stage and type of dementia? Those with limited insight and few social controls are often well suited to doll therapy, and may refer to the doll as a baby.

- Would this person welcome a doll as a collector's item (perhaps earlier stage of dementia)? Would he/she enjoy it as a baby to nurture/care for and love (meeting needs for love and connection)? (Note: this person may be in later stages of dementia.)

Observations:

- What was the response when you offered the doll? When you said, 'Look what I have', what happened? Did he/she smile? Did he/she reach out for the doll? Did they call it a doll or do they call it a baby? How do they hold the doll? Do they talk to it like it's a baby? If they are not interested, dolls are not likely an option, at least at this time. (It could be that they are in pain or have to go to the toilet). If it doesn't work after a couple of attempts, doll therapy is not for this person.

What will you do?

- If doll therapy feels like a good fit for this person, provide opportunities for the person to hold and nurture the doll. Consider putting a crib for the doll in the person's room or in a themed area in the home. Provide opportunities to fold clothes. Consider finding a carriage/stroller and encourage the person with dementia to take the doll for a walk.

- Doll therapy can be used for men and for women. Dolls of all shapes and sizes have been successfully used in dementia care. Dolls that are about 18 inches with a soft body (with soft plastic face, hands and feet), secure parts (to avoid choking) and eyes that can open and close are recommended, but not always essential. For many the features of the doll will not seem to matter. Eyes that open and shut are important to some, but not all, as some individuals will not settle at night until the "baby" is asleep (and eyes are closed).

Dolls (or stuffed animals) can indeed address the needs of the person living with dementia. It is important for families to understand that a person with dementia has a brain that has changed and needs that are too often unmet. Visit our website to find our "Doll Therapy Guidelines" at www.dementiability.com.

Open up the lines of communication by encouraging all providers of care, including family, to talk about the doll, or stuffed animal. Knowing that persons with dementia live in the moment, we need to make every moment count.

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