The Role of Doll Therapy in Dementia Care

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From life-like dolls to soft animal toys, therapy dolls are used to provide comfort and companionship to individuals with dementia. However, while research highlights their lasting positive impact, the practice remains a subject of debate, with critics raising concerns regarding ethics and dignity. So, can they be a compassionate addition to an individual’s care, or do they risk undermining their dignity and respect?

What Is Dementia?

Dementia is not a single condition but rather an umbrella term encompassing a range of medical disorders, including Alzheimer’s disease. The collection of symptoms such as memory loss, confusion and difficulty completing tasks cause significant damage to the brain, affecting all walks of life. Dementia is a progressive syndrome caused by diseases that deteriorate brain function over time. While behavioural changes can appear long before noticeable memory problems, symptoms typically worsen, eventually requiring individuals to rely on assistance in daily life. Currently, around 55 million people worldwide live with dementia, a number projected to rise to 139 million by 2050.

What Is Doll Therapy?

Doll therapy is a non-pharmacological approach designed to promote attachment, purpose, and collaboration in individuals with dementia. It has been shown to reduce agitation and challenging behaviours, offering a therapeutic alternative to medication. The practice is grounded in three key psychological theories:

Attachment Theory: This theory emphasises the human need to form close bonds, particularly in times of fear or uncertainty. For individuals with dementia, who often experience confusion and heightened anxiety, doll therapy can provide a comforting connection, easing stress and reducing agitation.
Transitional Object Theory: This theory suggests that specific objects, such as therapy dolls, can have a calming effect. By offering comfort and a sense of stability, these objects help individuals manage stressful situations.
Person-Centred Theory: Developed by American psychologist Carl Rogers in 1961, this theory focuses on placing the individual at the heart of their care. Doll therapy aligns with this approach by involving the person in meaningful decision-making and activities, which can foster social engagement and improve emotional well-being.

Benefits and Challenges of Doll Therapy

Therapy dolls have demonstrated significant positive effects for many dementia patients, but their use must be tailored to individual needs, as this is not a one-size-fits-all solution.

Benefits of Doll Therapy

Provides Purpose: Therapy dolls give individuals a renewed sense of purpose. Rather than solely being cared for, they have something to nurture, often forming deep emotional connections with their dolls, treating them as they would a child or pet.
Improves Social Skills: Skills developed through doll therapy, such as nurturing and interaction, can extend to other areas, enhancing social connections and overall engagement with others.
Reduces Medication Use: By alleviating symptoms such as stress, confusion, and agitation, doll therapy can lessen the need for medication, offering a gentle and non-invasive alternative to managing challenging behaviours.

Criticisms of Doll Therapy

Not Suitable for Everyone: While doll therapy has been proven effective, it doesn’t work for everyone with dementia. When deciding to implement it into an individual’s care plan, it must be done using a person-centred approach tailored to the individual.
Dignity Concerns: Critics argue that doll therapy risks infantilising adults with dementia, potentially compromising their dignity and leading to discomfort for both the individual and their loved ones.
Ethical Concerns About Deception: Some patients may come to believe the doll is real, raising questions about dishonesty in care. Additionally, when dolls are given directly rather than discovered and engaged with naturally, it may feel manipulative to caregivers.
Logistical Challenges: Emotional attachment to a doll can result in distress if the doll is lost or damaged. Caregivers must manage the practice carefully to avoid unnecessary heartache.

While doll therapy offers a low-cost, non-pharmacological method for improving the well-being of dementia patients, its implementation must always be sensitive and respectful of each individual’s unique needs and preferences.

Pearl's Memory Babies

Following research into the effects of doll therapy, numerous charities and organisations have been established worldwide, donating handmade or life-like dolls to nursing homes, hospitals, and families.

One such organisation, Pearl's Memory Babies, was founded in Kentucky after friends Sandy Cambron and Shannon Gray Blair observed the positive impact of doll therapy on their family members with dementia. Inspired by these experiences, Shannon, Sandy, and Sandy’s husband Wayne began visiting memory care facilities, sharing the benefits of doll therapy with residents. Their efforts gained widespread attention through a viral Facebook post, leading to an outpouring of media coverage and requests for support. This ultimately resulted in the creation of Pearl’s Memory Babies, a non-profit organisation dedicated to visiting nursing homes across Kentucky and donating life-like baby dolls to residents.

Final Thoughts

While doll therapy is still a relatively new practice in healthcare, and further research is needed, the early results are promising for individuals with dementia. As a non-pharmacological, low-cost intervention, the benefits of doll therapy have been clearly demonstrated despite ongoing ethical debates regarding dignity. It is important to note, however, that doll therapy should always be approached with a person-centred mindset, as not everyone will respond positively. Each individual is unique and should be treated accordingly.

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