Doll therapy for those with dementia

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Spark of Life

Written by Jane Verity

Although Doll Therapy has been around for well over 20 years, the debate on using dolls in dementia care can still tend to provoke strong opposing responses that sometimes lead to a division between staff in aged care facilities.

This précis is not about the ‘how to'. Instead, it aims to help build a bridge between the two opposing views and show how dolls can be used for their symbolic significance, with tremendous positive outcomes.

If you support the use of doll therapy, you are likely to have had positive, personal experience that dolls have strong symbolic meaning and provide purpose, nurture and healing for people with dementia. As a result you are most likely passionate about these outcomes and will fight for Doll Therapy to be an integral part of the therapy program.

On the opposite side, you may have thoughts such as: I'd rather die than imagine myself as an old person in a nursing home, walking around with a doll. You are genuinely concerned that introducing dolls can be childish, demeaning, maybe even patronising and often feel so strongly about your point of view that you ensure dolls are not permitted in your facility.

If you belong to this side, undoubtedly, you genuinely want the best for people with dementia and respect and dignity are high on your agenda. The way you assess whether Doll Therapy is acceptable or not is based on the thinking: Do unto others as you would like done unto you. This is a perfectly logical and rational conclusion.

This same logical, rational thinking is still active in most people in the early stages of dementia. However there is a distinct difference in the way a person who has moved beyond the early stages of dementia thinks. T his person may now have lost much of their memory and their logical, rational thinking as well as their social inhibitions. The beliefs and values they used to uphold are no longer important to them. They live in the moment - and that is all that matters!

When you care for a person in the later stages of dementia, it can serve you both well to consider a change of thinking from: How will the person respond to this activity? To: What activity will this person respond to?

We believe you can draw your best answer in deciding if doll therapy is appropriate by seeking input directly from the person with dementia. Let them show you whether or not they enjoy a particular activity.

Simply read their eyes. People with dementia will give you immediate feedback on what you do and say. You either rekindle "the spark" or you extinguish it. So focus your attention on their eyes for a genuine indicator and response.

People with dementia have some universal emotional needs that are often not fulfilled.

The five most significant universal emotional needs are:

To feel needed and useful
To have opportunity to care
To have self-esteem boosted
To love and be loved
To express emotions freely
When these needs are not fulfilled in this reality they tend to go back into their memories and recreate significant people, places, objects or situations where those needs were fulfilled. Often they relive these in this reality, such as Eva who is standing at the door, vigorously shaking the door handle, calling out: Let me out, I want to go home. My babies are crying.

This is not a crazy action but a perfectly meaningful way of seeking to fulfil these four needs. Eva is most likely feeling isolated because she is no longer involved. So she recreates a time when she was a mother taking care of her children. She is longing to feel needed and useful, to still be able to care, to have her self esteem boosted and to give and receive love.

Freud spoke about the Eternal Eros - the ever constant love - innate in us all, and the ability to display this nurturing love naturally, which women may return to and some men may discover for the first time. The need exists strongly but what is often missing is a natural way to fulfil it. This is where a doll with its powerful symbolic significance can be of incredible positive value.

From a wide range of documented stories we know that Doll Therapy offers many and varied benefits that reach far beyond providing the purpose and healing described so far. Doll Therapy can help improve the overall well-being of the person with dementia.

Doll Therapy has never been defined in a short, clear and precise way but rather through anecdotes and benefits. It has been the aim of this article to offer a definition of Doll Therapy as the wise and mindful use of dolls for their symbolic significance to help improve the well-being of people with dementia