Researchers Gary Mitchell and Hugh O'Donnell say that limited scientific evidence supports "doll therapy" for people with dementia. However, they assert that the therapy is being widely used. This would indicate that caregivers find that giving a baby doll to a person with dementia works well in reducing symptoms.
However, there are pros and cons to the use of dolls as therapy for people living with dementia. Let's look at some of these pros and cons.
Doll therapy allows people living with dementia to lower their distress levels and raise their quality of life. Dementia is often accompanied by distress. Distress takes many forms in dementia patients, ranging from withdrawal to agitation to outright aggression. Distress can also manifest as anxiety, depression, or fear and suspicion. Doll therapy helps.
Doll therapy probably works so well in part because the dolls help stir up happy memories of parenting; they bring the comfort of touch and holding; the elderly person is drawn out of him- or herself to nurture, talk to, and interact with the baby doll as well as to talk about the baby doll to others. This raises the quality of life for people living with dementia.
Pharmacological approaches nearly always include side effects. Sometimes, Mitchell and O'Donnell tell us, such drugs may even speed up cognitive decline and contribute to falls, the special bane of the elderly. Non-drug therapies are gaining in popularity, and some have been shown to be effective, such as aromatherapy, music therapy, reminiscence therapy, and doll therapy.
Caregivers love doll therapy. They find that doll therapy results in calmer, happier patients who smile and communicate more, sometimes expressing needs they have been silent about inside the shell of dementia. What is more, doll therapy is self-administered. Holding, cuddling, dressing, changing, and talking to a doll occupies and engages the person living with dementia.
A common objection to doll therapy comes from both scientists and family members of people living with dementia. They say that doll therapy treats such a person like a child. The elderly are not the same as little children to be comforted with a "lovey" when a caregiver can't be around. Objectors to doll therapy claim that it infantilizes people with dementia.
They also charge that doll therapy involves a certain amount of dishonesty, deception, and manipulation. As Mitchell and O'Donnell note, most dementia patients believe the dolls are real. (In fact, caregivers and doll manufacturers all seem to believe that the more life-like the doll, the better the result). Therefore, allowing the patient to believe something that is not true is being deceptive and disrespectful. What is more, objectors protest, the doll is used manipulatively from the first. In both private and institutional settings, caregivers find that it is best to arrange for the patient to find or discover the doll rather than giving the doll directly. The doll is strategically left around to be found. Thus, caregivers are said to be manipulating the dementia patient.
Other negative effects have been arguments among residents in institutional settings over ownership of dolls. Some residents also attempt to feed their dolls and may become agitated and confused when this does not "work," or when they are stopped from doing so. Also, if a doll accidentally gets lost or damaged in the institution, it can lead to distress in the patients.
"...human beings desperately need attachment to others in order to grow into normal and healthy human beings."
Clearly, people's attachments to their dolls are very real to them. Doll therapy's scientific roots are in the field of "attachment theory." Mitchell and O'Donnell trace the idea of "doll therapy" back to John Bowlby, who came up with "attachment theory"--the idea that human beings desperately need attachment to others in order to grow into normal and healthy human beings. Attachment theory holds that the quality of our early relationships with caregivers determines a great deal about our mental health for the rest of our lives.
People living with dementia long, as do all human beings, for significant and meaningful attachments to others. A surrogate "other" in the form of a doll fulfills some of these needs admirably.
Yet perhaps in societies where the extended family is the norm, or even in modern developed societies where the "sandwich" phenomenon of multigenerational homes becomes usual, such attachments may occur naturally. For example, a real grandchild or great grandchild might be placed in an elderly person's lap for short periods of time, providing the same benefits (and maybe more) as doll therapy. Such everyday occurrences in multigenerational homes may be the real clue as to how to help people living with dementia come out of their shells and their agitation. The answer to calming people living with dementia may be simply acknowledging that for them, like us, vital human relationships are a need from birth to death.
HealthDay (2011). Can "Doll Therapy" help put dementia patients at ease? U.S. News and World Report, May 6. Available online at http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2011/05/06/can-doll-therapy-help-put-dementia-patients-at-ease.
Mitchell, Gary & O'Donnell, Hugh. (2013). The Therapeutic Use of Doll Therapy in Dementia. British Journal of Nursing, (22)6. Available online at http://nptherapies.org/es/images/a/a2/Doll_therapy_2013.pdf.
Scott, Paula Spencer. (2009). Caring Currents: Baby Love: Therapy for Alzheimer's Sufferers. Caring.com, September 29. Available online at https://www.caring.com/blogs/caring-currents/alzheimers-baby-dolls.
Whitlock, Angela. (n.d.). Using Doll Therapy to Engage. Alzheimer's Society, United Kingdom. Available online at http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=2222.