In the 1990’s, long-term care institutions were introduced to doll therapy with the aim of reducing behavioural and psychological disorders in people with dementia. Doll therapy is a non-pharmacological intervention suitable to some people living with dementia.
The rationale was inspired British Psychologist John Bowlby’s ‘Attachment Theory’. Although Bowlby’s work focused on children, his theoretical explanation for attachment was thought helpful to apply in people with dementia to ease emotional problems and anxiety.
Doll Therapy is also known as Child Representation Therapy and Nurture Therapy.
Attachment behaviours can be observed in people with dementia. Parent fixation (searching for long deceased parents) is said to be an expression of an attachment need. This searching behaviour indicates that the person is insecure and seeking to be reunited with or attached to a familiar figure in order to find safety.
Doll therapy can meet this attachment need in some people with dementia. Although conclusive research data has not yet been produced, positive anecdotal and empirical studies are gathering momentum.
Doll therapy as a care tool is similar to other therapeutic interventions including music therapy, aromatherapy, art therapy and other sensory pursuits. As the number of people affected by dementia dramatically increases, more research into nonpharmacological interventions like doll therapy is taking place. This is fueled by concerns about the effectiveness and side effects of pharmacological treatments to manage the challenging behaviours of people with dementia.
The introduction of Doll Therapy to treat people with dementia was met with much controversy and strong resistance from some staff and healthcare professionals which continues to this day. The therapeutic use of dolls for people with dementia can be a contentious issue for numerous reasons including an absence of clinical guidelines and misconceptions about the doll therapy as a demeaning practice. Those critical to the practice argue that:
For those in favor of doll therapy, the empirical evidence supporting its use is compelling. Research in various countries including the United States, England, Australia and Canada indicate that there are strong benefits to the use of doll therapy including:
There are a growing number of care facilities embracing doll therapy as an effective intervention for people with dementia.
Before implementing a doll therapy program, time and resources need to be allocated to the following:
Doll therapy is not for everyone and candidates should be carefully chosen. People who may benefit from doll therapy include those with Alzheimer’s Disease. More women than men will choose a doll to nurture, but some men do benefit greatly from holding a doll, so don’t rule them out.
Assist residents with dementia to make their own choices by having them ‘find’ the doll rather than giving it to them. Leave it in a cot or lying on a table where it will be easily found.
Standard guidelines are not yet available and every facility implements their own procedures which leisure staff must comply with. Here are some general guidelines that may be helpful:
Doll Therapy can be considered an appropriate therapeutic intervention by care staff when the person caring for the doll displays any of the following:
I have witnessed the positive effects of doll therapy as an intervention numerous times in my working life. In my experience, the use of doll therapy promotes feelings of contentment in the person with dementia and improves their social rapport with staff.
Doll Therapy can provide satisfaction and comfort to people with dementia. It provides them with the opportunity to nurture and satisfy an emotional need that wouldn’t be fulfilled otherwise.
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