Is Doll Therapy a Positive Approach to Dementia Care? Decide for Yourself

Lisa, hello everybody. Thanks for being here with me today for a new episode of the Truth Lies and Alzheimer's show. And I am Lisa Skinner, your host today, I want to tell you a real life story that happened when I was working as a community counselor in one of the elder care facilities that I worked in over the years, and it had a separate memory care wing to it, and my office was very close to the door of the memory care wing. And there was a resident who lived there, I'll call her Martha, who was what we call a screamer. And what would happen is, if she was unhappy about something, she would let out this blood curdling scream, and I could hear it in my office. You could hear it all over the memory care wing. It was pretty scary, and we all knew that she was trying to tell us something, but we really nobody was able to figure out what it was, and at any given time of the day or even at night, if she happened to be awake, she would let out this blood curdling scream. And I got to the point where I was really nervous to take anybody back there, like maybe a family member who was looking to place a loved one in our memory care wing, because we never knew when Martha was going to let out one of her screams. And, of course, you never know what people are thinking when one of the residents, I mean, you're trying to make a good impression, and one of the residents is screaming at the top of her lungs, and I would try to explain that, you know, Martha was what we call a screamer. And a lot of times they would just kind of look at me, and I would look at them, and to be honest with you, I never knew if they believed me or not, that you know, she wasn't being tortured or something going on, which, of course, was not. So I had recently attended a training on life skill stations, and I've talked about that with all of you in previous episodes. And so I brought the information back, and I decided to set up a couple of life stations in our memory care neighborhood based on the training that I had received. And of course, this is all part of person centered care approach to dementia care, which I am a firm advocate of and a firm believer of. So I set up a couple different life stations. I set up a baby themed life station with a crib and a bassinet and diapers and bottles and all the paraphernalia that a mother uses to take care of her baby, and then a couple other ones. But the point of this story is around the baby themed life station, Life Care station. So weeks went by and I noticed that I had not heard Martha scream for a while, and it was noticeable because you got so used to hearing it that when you didn't hear it, it was actually very noticeable. So I asked the caregivers in our memory care neighborhood, what's changed with Martha? And she said, Well, you can take the credit for that. And I said, I can't. They said, Yeah, she found your life skill station, the baby life skill station, and she has now adopted the baby doll that you put in there. She cares for it. She used a walker so she would put the baby in. The basket of her walker, and she would take it everywhere. So they just let her have the baby and take it to her room. And she cared for that baby, 24/7 and she was as happy as a lark. She showed everybody her baby, and she took it everywhere with her, and she cared for it very gently and lovingly. And the point to where I'm going with this story is, soon after she adopted the baby, she stopped screaming. And this all fits into how people with dementia find ways to communicate their wants and needs. And all that time, she was trying to tell us something which we knew, but nobody could figure out what that something was. And it just was a sure stroke of luck that she discovered the baby changing station, the baby station and adopt the baby. And that was exactly what her need was. She was looking for a purpose. She was looking for something to nurture. So the reason why I wanted to tell you this story was actually a prelude to what I'm going to discuss today, which is what is called doll therapy, using doll therapy for people living with dementia, especially when they're in the mid to ladder stages and they are no longer able to communicate their wants and their needs. And of course, we as loved ones and caregivers have that burden of trying to figure out what it is they're trying to tell us. So my true story of it's in my book. It's one of the chapters in my book, and it's called the changing station, and this was 100% true story that I witnessed when I was working in one of the elder care buildings, and there are still many pros and cons of giving baby dolls to people living with dementia. So I wanted to discuss that today, and then, based on the information I share with you, you can decide if the situation arose, if you would implement baby doll therapy into the world of Your loved one or the person that you care for. So one of the primary benefits of giving baby dolls to individuals with dementia is, of course, as you know, noted in Martha story, is the emotional comfort that the baby dolls can provide many people with dementia, experience feelings of loneliness, anxiety, agitation, so baby dolls have shown that they can evoke nurturing instincts, like we saw with Martha, allowing individuals to engage in caregiving behaviors, which can be comforting now, just so happens that Martha was a homemaker, and her job in the prime time of her life was to care for Her babies and her children and her home and her husband, so this was a driving need for her, and we figured out that perhaps that's why she was screaming before, because she was looking for her children. Because don't forget that short term memory is short circuiting for a long, long time, and when that happens, they're going back to a previous time in their life. And a lot of people, it's back when they were young mothers caring for their children. So this is kind of the conclusion we drew with Martha, because as soon as she adopted her baby, the behavior, the negative behaviors,

stopped, so obviously, the interaction between the baby doll and the person living with dementia. So we've seen many, many times, many examples where it will reduce agitation and promote a sense of calm. It also stimulates memory and promote social interaction. Doll therapy can stimulate memories related to caregiving and parenting, encouraging those individuals to reminisce about their past experiences, whether they're cognizant of it or not, this can facilitate conversation and social interaction with caregivers and family members, which ultimately fosters connections and provides cognitive stimulation. Now, doll therapy has shown varying degrees of success for individuals with dementia. This therapeutic approach involves providing dolls to people, typically those in the later stages of dementia, to foster emotional connections and reduce their agitation. So here are some of the key points of its effectiveness. So we have emotional engagement. Many people respond positively to dolls, often treating them as real babies or companions, this can evoke nurturing behaviors and emotional responses, which can enhance mood and reduce feelings of loneliness. We've also identified a huge significant reduction of agitation. Studies have indicated that doll therapy can help decrease anxiety and agitation in some individuals with dementia, leading to a much calmer environment for them, it stimulates memories. For some people, interacting with dolls may stimulate past memories, like you know, if they happen to be a homemaker, related to caregiving or parenting, which can be comforting and help with cognitive engagement. Individual variability. The effectiveness of doll therapy can vary widely among individuals. Some may find great comfort, while others may not respond positively at all. So it's their personal history, their preferences and the stage of dementia that can influence the outcome of how effective doll therapy would be with any one individual complementary therapy. Is another one. Doll therapy is often used as part of a broader therapeutic approach, including music therapy, art therapy and other activities designed to engage people who live with dementia. So overall, while doll therapy can be beneficial for some, it's essential to tailor approaches to each individual's needs and preferences for optimal results all part of person centered care. It also improves communication. We have shown that interaction with dolls can encourage verbal expression and social interaction, helping to facilitate communication among the people living with the dementia and their caregivers, as I told you, Martha just loved showing off her baby and talking about her, and she named her, and she told everybody about her. She was very proud mama. It It allows an increased sense of purpose, and we never lose our need to feel that we always have a purpose in this life. Caring for a doll can provide a sense of purpose and responsibility, which may enhance self esteem and overall well being. It can reduce stress for caregivers, because when people living with dementia are calmer and more engaged with these dolls, caregivers may experience less stress and a more positive caregiving environment. It enhances moods many. People report feelings of happiness and contentment while engaging with dolls, which can contribute to improved all over overall moods. Now, Martha was not capable of expressing her emotions or her feelings, but just for the sheer fact that she stopped the screaming behavior was evidence enough to all of us that this is really meeting a desperate need that she had. Doll therapy can also help manage problematic behaviors, as in Martha's case, by redirecting attention and providing a focus for nurturing actions. Turns out that was very important for her, and it also facilitates connections. Dolls can serve as a conversation starter or a bridge for connection between the people that live with the dementia and their caregivers fostering meaningful interactions. Oh, how's Little Sarah doing today? What's she up to today? And you know, just just casual conversation points. It provides sensory stimulation. Engaging with dolls can provide sensory experiences such as touch and visual stimulation, which, of course, can be beneficial for cognitive engagement. We know this. So these particular benefits that I just shared with you highlight the potential of doll therapy as meaningful intervention in dementia care, promoting both emotional and social well being. So a couple other benefits that I'd like to mention of implementing doll therapy is maintaining routine and structure very important. We've talked about that on previous episodes. Engaging with dolls can help establish a consistent routine. Oh, it's time to change Little Sarah. It's time to feed Little Sarah. I think I'll take little Sarah for her walk in her stroller. So these things do become routine for the people that really are engaged with doll therapy. I've seen it over and over and over again. It reduces some behavioral issues for some people, doll therapy can help mitigate aggressive or disruptive behaviors by providing a calming focus and of course, there's cognitive stimulation. The act of caring for a doll can stimulate cognitive functions, encouraging reminiscence and recall of past experiences, social interaction again, group activities involving dolls can promote socialization among residents and care facilities, enhancing community and connection. And of course, this is huge. It's a non pharmacological intervention or approach to dementia care. Doll therapy provides an alternative to medicating people for managing dementia related symptoms, and this is aligned with a more holistic approach to care. And this one is kind of unique. It helps facilitate the grief processing for some individuals, dolls can represent lost loved ones or relationships that they had in their past a lifetime, helping them process feelings of loss, but in a safe way and a very personalized experience. Dolls can be customized to reflect an individual's preferences, for example, choosing clothes to dress them in, or other features or bottles, things like that, which may enhance their emotional connection with one another,

a couple other potential benefits of doll therapy, just to be aware of is helping to foster creativity, because engaging with dolls can inspire creative play and imaginative scenarios providing mental stimulation and. A sheer enjoyment, encouraging physical activity. Caring for a doll may involve gentle movements, such as rocking or holding the baby, which can promote physical engagement, or, as I just said, taking them for a walk, promoting relaxation, the soothing nature of doll therapy can create a calming atmosphere, building trust. Consistent interactions with dolls can help build trust between individuals and their caregivers, facilitating a more supportive care, environment, triggering memories, precious memories, dolls can act as prompts for memories related to caregiving, parenting or childhood, encouraging storytelling and reminiscence. Then there's a cultural connection. Dolls that reflect cultural backgrounds can help people connect with their heritage, fostering a sense of identity and belonging, encouraging routine activities. Doll therapy can be integrated into a person's daily routines, encouraging regular engagement and structure in care settings and facilitating transitions for people experiencing transmission transitions, excuse me, and one example is moving into a care facility. Dolls can provide comfort and a sense of continuity. There are also animals like dogs and cats that look very real, that people adopt, and one of the things I want to emphasize is don't force any of these therapies onto people you want to allow them an opportunity to discover the dog or the cat or the baby doll. What had happened with Martha is I had left the doll at the life station that I created, and she found it. She saw, Oh, this is looks like something noon. She went, you know, wandering in there, and she discovered the doll. And she just immediately took it, took the the baby doll under her wing, and adopted it. Do the same with a stuffed cat or a dog, and let the individual decide whether or not it's a right fit for them. If they if it is, they will adopt it and care for it, but don't push it on them. That's one thing that I really just want to make sure that is understood, because it's very important to approach it in that manner. So over the three decades that I've been working with people living with Alzheimer's disease and related dementia, doll therapy has sparked a lot of controversy for several reasons, so I'm going to go over those with you, and then I think that just to emphasize all of the benefits that I just shared with you, I have seen actually come into play with doll therapy. But again, it's not for everybody. There are people, and I see men adopt dolls, Girl dolls, boy dolls. So it's not unheard of that a gentleman who perhaps was a dad and helped raise children, won't adopt a doll or a dog or a cat. But here are the controversial issues that have come up about using doll therapy for some people, and I've seen this, especially with the adult children of the person living with Alzheimer's disease and related dementia that They perceive it to be representative of info telesation, infant, infantilization, critics argue that giving dolls to adults comes across as being patronizing, reducing their dignity, treating them like children, rather than respecting their autonomy and. There's, you know, other varied responses. Not all individuals with dementia respond positively to doll therapy. Some do a lot do, but not everybody remember. Every single person who lives with dementia lives with it differently. Some may find it confusing or distressing, leading to concerns about its appropriateness for certain people, there have been ethical concerns regarding consent and the use of dolls, particularly in terms of ensuring that individuals are comfortable with this type of therapy. Again, another reason why you don't want to push doll or animal therapy onto any individual. Let them discover it themselves, and if they take take it under their wing, then obviously it's appropriate for them. There's always been cultural sensitivity in our world. Dolls may not resonate culturally with all individuals, and their use may be seen as inappropriate or disrespectful in certain contexts. There's, of course, the emotional attachment. And a lot of the individuals do become very emotionally attached to their baby dolls or their their adopted pets. And some caregivers worry about emotional attachments to the the dolls and the pets, fearing it could complicate relationships with real people or lead to dependency. I personally have not seen a lot of that, but I'm not just completely erasing the fact that it's a possibility. So these controversies highlight the need for careful consideration and individualized approaches when implementing doll or pet therapy in dementia care. A few other negative beliefs, stigmatizations and concerns about doll therapy include reinforcing negative stereotypes about aging and dementia, suggesting that individuals are incapable of adult interactions, misinterpretation of their needs. Critics argue that using dolls may overlook underlying emotional or psychological needs, potentially leading to inadequate care. Conversely, it can be what they're desperate for, as we saw in Martha's case, inconsistency with person centered care. I personally think it is completely aligned with person centered care. But some people believe that doll therapy can detract from personalized care approaches by focusing too much on the doll rather than the individual's unique preferences and history. Well, this is totally related to their history. There could be dependency issues. There are concerns that individuals may become overly reliant on dolls for comfort, which could interfere with their ability to engage with caregivers or their peers. Potential for negative emotions. For some individuals, dolls may evoke feelings of sadness or loss, particularly if they remind them of deceased loved ones or past experiences. So I'm not really going to force my opinion on anybody about doll therapy. I'm an advocate for it. I've seen it just provide wonderful miracles and joy for people who adopt the doll or the pet. But there, you know, there, there are some valid concerns about it, and I think that's changing. And the more it's used, the more it, you know, the general shifts in attitude,

increased focus on quality of life, which we've seen it provide. So the changing attitudes towards doll therapy in dementia care reflect a broader cultural shift towards compassion, understanding and innovation in addressing the needs of individuals with dementia. Data. As awareness grows and more evidence supports the therapeutic benefit of doll therapy, it is likely to become an increasingly accepted and valued practice within the field of dementia care. I've actually seen it come a long way. I introduced the life skill station to the memory care that I was at in the mid 90s. So what was that 20 years ago? And there's definitely been a pivot and a shift in being more accepting of using these types of therapies to enhance and improve the quality of life of people living with dementia. This, to me, this evolution underscores the importance of being flexible, keeping up with the latest information in education and also the ever changing, individualized approaches in enhancing the quality of life for those affected by dementia. I mean, since my grandmother was diagnosed with what they called senile dementia back in the 70s, when I was a teenager, I was what 50 years ago, we've come a long way in understanding how people live with dementia, what it's doing to their brains, how it's changing their brains, and through that better understanding process that we've all experienced in 50 years and 30 years, in the last 10 years, we're just realizing that some of these therapies that we have tried or are still trying, to introduce into the lives of people living with dementia are definitely beneficial due to their circumstances and the cognitive functions that they have lost due to the illness. So I hope that this is giving you a dual perspective on whether or not implementing doll therapy or stuffed pet therapy would be appropriate for you. I really think probably one of the only ways you're going to know if you're open to it is to see if it resonates with the person living with the brain disease. Because, like I said, some people it will and some people it won't, but the people that I've seen it be positive for is very positive, so that'll do it. That's a wrap for our episode today. I'll bring you another brand new episode next week. Thank you so much for taking the time to be here with me today. I appreciate everybody, and I look forward to having you back next week for another episode of the Truth Lies and Alzheimer's show with Lisa Skinner, your host. Hope you all have a wonderful week and take good care of yourselves and your loved ones. Bye, bye.