Monday, December 7, 2015

Dementia, Alzheimer’s Doll Therapy: Beneficial or Demeaning? (Research, Story)

More and more people with dementia are being gifted with dolls and stuffed animals. While some caregivers find doll therapy rewarding for those with dementia and helpful in making positive connections, others say it is demeaning because it treats adults like children or overshadows real issues that need to be addressed.

Scientific research on doll therapy can put these worries to rest. People with dementia, like most of us, display a wide range of emotions. Through the years, caregivers have used a variety of ways, including chemical restraints, to channel agitated behaviors of persons with dementia. But baby doll therapy has proven to be one way that receives a lot of attention.

For too long, there was no protocol or official record of scientific experimentation on the success of doll therapy. That’s how the implementation of research protocol of doll therapy began for 16 residents at a dementia care center. Researchers measured the impact of the dolls on six areas of each resident’s behavior and their reactions to the doll. These are the results:

1)  Participants had an increase in level of happiness,
     activity/liveliness, interaction with staff and others, and ease of giving care.
2)  There was a reduction in the level of anxiety.
3)  The increase in happiness was a statistically significant outcome.  Baby doll therapy is an effective nonpharmacological approach  for improving the well-being of patients with moderate to  severe dementia.

As a hospice volunteer I had observed these positive results many times in various Detroit nursing homes. Here’s a true story (I couldn't make this stuff up if I tried) about an experience with a resident named Susan and her baby doll:

“Hi, Susan, I see you’re taking your baby with you to dinner,” I said to a woman wearing a high wattage smile that her baldheaded “baby” inherited.
“Well, I want to take my baby out more. Everybody likes her, you know, especially me. She told me she was hungry,” she responded.
“What’s your baby’s name?” I asked, exploring her reality.
She and the doll stared at each other, grinning as if they shared secrets from ancient times. And maybe they did. Susan looked at me, pointed to her doll baby and said, “She’ll tell you her name tomorrow when you come back with cookies.”

© Excerpt above from Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.


  1. I conducted a very successful research project which was published in 2012 on the use of dolls for some individuals living with dementia. I wanted to dispel the myth and also prove to the doubters that their rigid and judgemental viewpoints were based purely on a cognitive viewpoint, which is more disrespectful and dehumanising to the people they are caring for.

    Imagine for a moment, searching for a distinct space in the world— the harder you search for that space to connect your need for inclusion— the tougher and more confused it becomes. Those around you just don’t seem to enter your reality, or provide you with the joy of companionship you crave and desire— you feel utterly alone. All you feel is a sense of core suffering and misery— you withdraw into yourself. It is as if you have lost your humanity in the eyes of those who look through you, do for you and leave. This is the experience of many in our care who live with dementia.

    An opportunity is presented to you to regenerate past relationships and to regain the space you hold in the world, with the assistance of those who care about maintaining your personhood. A doll is given to you as a gift and that faltering spark that keeps you alive begins to burn again. You embrace the doll and long term memories, like the scattered pieces of a jigsaw and it becomes your present. Delight, pleasure, enchantment, feelings of self-worth and attachment, as well as stimulation of long forgotten nurturing instincts precipitously flash through you.

    As professionals, our long term experience of people living with dementia and their ever changing reality is that they can feel completely alone unless we, as caregivers, establish links through the complex maze of fractured memories that make up a long lived life. It is in the unravelling of these memories that enable us to participate in their journey and provide them with companionship and support to preserve their personhood. My research project aimed at unravelling some of these links with the past through the use of dolls and was titled, Doll therapy: A therapeutic means to past attachment needs and diminish behaviours of concern in a person living with dementia - a case study approach.

    There is evidence that a person in the moderate-to-advanced stages of dementia may respond favourably to familiar attachments related to long term memories and this can then provide meaning to their present (Kitwood 1997). I utilised Miesen’s (1992) expansion of Bowlby’s (1969) theories of attachment in children, where the author adapted this theory to people living with dementia; and suggested that those who cling to dolls and soft toys appear to be using these objects as a representation of the personal support that they yearn for.

    to be continued

  2. Part 2.
    Basically I was guided by the view that the way in which we evaluate whether doll therapy is suitable for people living with dementia, or not, should not be based on our preconceived assumptions; and to avoid judgment on what we think is right for us or on how we would feel if given a doll. If a doll is of benefit to the lifestyle of a person living with dementia, does not distress that person emotionally, provides solace and joy, a sense of calm, improves communication, and reduces behaviours of concern, then there is a place for doll therapy, to be examined as a form of therapeutic encounter (Bisiani, 2010).

    It is also a reminder to us that we cannot constrain ourselves and those we care for, by ignoring the simplest answers  the responses of the people living with dementia are our answers.

    Crucially, my study advanced an understanding of a) the use of a doll as a therapeutic tool on the behavioural expression of a person living with dementia; b) the long term attachment needs of the participant to reduce or prevent behaviours reflective of other needs; and c) the effect therapeutic interventions on the well-being of the participant. It also extends our understanding of the use of complementary therapies to inform professional practice; to promote opportunities for the exchange of knowledge; and to stimulate research and promote best practice (Bisiani & Angus, 2012). Further, the benefits of this research will, hopefully, encourage a change in attitude to one of the many alternative therapeutic ways of meeting the specific requirements of a person living with dementia. As professionals we need to build upon this evidence to promote therapeutic interventions that demonstrate another valuable way forward in the provision of person-centred dementia care.

    I have over the last few years been lecturing on the success of this research here and internationally and changed the title to “Dementia gets Dolled Up”.

    If you would like further information please contact me through my website:

    1. Good article. The bottom line really is that if the doll or the stuffed animal brings joy and/or comfort to someone, regardless of their mental health status, the debate is over. The person with the toy wins because happiness is the goal.

  3. I agree with Kim. Improving mental health and having them interact with the toy is important.