Therapeutic use of dolls for people living with dementia: A critical review of the literature

Abstract

BackgroundThere are a number of therapies currently available to assist health professionals and carers with non-pharmacological treatment for people living with dementia. One such therapy that has been growing in clinical practice is doll therapy. Providing dolls to some people living with dementia has the potential to enhance personal well-being through increased levels of communication and engagement with others. Despite its potential for benefits, the practice is currently under-developed in healthcare literature, probably due to varied ethical interpretations of its practice. AimTo undertake a critical review of the published literature on doll therapy, using the CASP tool, in order to determine the potential benefits and barriers of this therapy for people living with dementia. DesignA comprehensive literature search, incorporating the CINAHL, Medline, Embase, PubMed, Joanna Briggs, Cochrane Library and PsycINFO data bases, was conducted. ConclusionsDespite many commentaries and anecdotal accounts of the practice, this review identified only 11 empirical studies that were eligible. The majority of studies found that the use of dolls could be therapeutic for some people living with dementia by reporting increased levels of engagement, communication and reduction in episodes of distress. Some studies identified limitations to the therapy including; confusion over the ownership of the doll and healthcare professional uncertainty about issues pertaining to autonomy. Relevance to Clinical PracticeAccording to this review, doll therapy has the potential to increase the well-being of some people living with dementia. This review illuminates that some health professionals feel 2 | P a g e uncomfortable about its use in clinical practice. The operationalisation of doll therapy in clinical practice has been shown to be inconsistent with different approaches to the practice being advocated. This highlights the need for further empirical research to identify best practice and education to increase awareness in both health professional and carer populations.

Using dolls for therapeutic purposes: A study on nursing home residents with severe dementia

“…To date, 17 studies (see Table ) have been published on DT for older adults with dementia. Since the literature review on this topic by Mitchell, McCormack, and McCance (2016), 6 more recently published studies clearly confirmed that, after DT, people with dementia were more engaged in proposed activities, and more communicative with their caregivers . A reduction in wandering and in the need for neuroleptics has also been demonstrated …”

Implementing the Namaste Care Program for residents with advanced dementia: exploring the perceptions of families and staff in UK care homes

“…Namaste residents are assessed for pain and discomfort, and treated if necessary. The Namaste Care worker offers personal care as meaningful activity alongside individualised interventions, e.g., rummage boxes, or doll therapy if judged appropriate (24). Fluids are offered frequently during Namaste along with high caloric food treats.…”

Comparison of the efficacy of gesture‐verbal treatment and doll therapy for managing neuropsychiatric symptoms in older patients with dementia

“…Existing pharmacological options in NPS treatment include atypical antipsychotics, benzodiazepines, and other drugs (eg, mood stabilizers), which may, however, increase the risk of cognitive decline, cerebrovascular events, or mortality . Differently, systematic reviews have demonstrated the effectiveness of nonpharmacological treatments (NPTs) for NPS as well as the increase in perceived quality of life in PwD and their caregivers . Consequently, the National Institute for Health and Care Excellence dementia guidelines recommend NPTs as first‐line treatments in the management of noncognitive behavioral disturbances in PwD.…”

“…[15][16][17] Differently, systematic reviews have demonstrated the effectiveness of nonpharmacological treatments (NPTs) for NPS as well as the increase in perceived quality of life in PwD and their caregivers. 14,[18][19][20] Consequently, the National Institute for Health and Care Excellence dementia guidelines 21 focused on NPTs such as cognitive stimulation, pet therapy, doll therapy, and caregiver training in problem solving 18,22,23 to reduce NPS.…”