How Can Individuals With Dementia Benefit From Doll Therapy?

Individuals living with dementia and Alzheimer's may benefit from "adopting" a doll. If you have been considering this coping mechanism for yourself or someone you love, it can be valuable to learn more about how doll therapy works, its benefits, and the controversy surrounding this practice. 

What is doll therapy?

The concept of DT is based on the idea that human beings instinctually attune themselves to babies, calming their behavior by gently rocking back and forth when holding an infant. Doll treatment may also be referred to as child representation therapy (CRT) or nurture counseling. This idea was popularized by British psychologist John Bowlby's attachment theory. 

The symptoms of cognitive decline in older adults can include high aggression, low food intake, and other behavioral and emotional symptoms that could impact overall health and wellness. Pairing dementia clients with dolls for them to care for may be beneficial for keeping these individuals calm and improving their emotional state. Studies have even found that doll treatment can improve food intake for individuals experiencing dementia. 

Initial research on doll therapy's benefits focused on treating childhood mental health conditions. Eventually, it expanded to include clients diagnosed with dementia. Dolls were distributed in mental health facilities, and research was conducted on their effectiveness. 

Symptoms of dementia

People with dementia may experience:

• Anxiety
• Depression
• Anger
• Suspicion 
• Confusion

When seniors with declining cognitive abilities are paired with a new, life-like baby doll that looks like a real baby, they may experience a reduction in the above symptoms. 

Benefits of dolls

"Adopting" a doll can have several benefits for those living with dementia. One of the benefits of doll therapy is that it can help calm agitated patients without using pharmaceuticals. Clients with dementia may become confused about their location and wander off. Doll therapy could reduce wandering to keep individuals safer.

Symptoms of agitation and aggression can negatively impact the health of individuals with dementia and their caretakers. These individuals may feel uncomfortable needing a caregiver after being independent throughout their life, which could increase their agitation. A doll can help them come to terms with this and feel like they are also a caregiver and give them a sense of purpose. 

Allowing clients to nurture a doll or stuffed animal can also increase self-esteem and calm negative emotions. This treatment can be used daily and may help those with dementia feel less alone in their experiences. For those that do not want a doll, robot pets or dolls made to look like animals may also be beneficial.  

The potential benefits of dolls include the following:

• Improving communication 
• Reducing aggression 
• Improving one's emotional state 
• Increasing food intake 
• Increasing self-esteem
• Lessening the need for medications 
• Reducing wandering behaviors
• Improving social behavior 
• Increasing interest in activities

Different types of dolls 

The two most common dolls are life-like doll babies and animals. A realistic stuffed animal can have similar benefits as other animal therapy interventions, such as therapy dogs but with increased safety. Some clients may have better results when paired with a stuffed animal instead of a baby doll. 

In addition, some companies create robot pets like dogs or cats that interact with the individual but do not require 24/7 care like a real pet. For those with dementia, having a robot pet that moves may remind them of the comforting feelings they may have had with a real pet in their past. 

Can dolls be an effective treatment option?

The effectiveness of dolls as a treatment for dementia and other patients has been a topic of debate. More research may need to be conducted on dolls as a treatment option for those with dementia and Alzheimer's. Still, current research shows that there could be significant benefits from baby doll therapy. However, try not to force doll treatment upon an individual. The individual's willful cooperation may be necessary in order for the treatment to work. 

A 2022 systematic review of the current details on the effectiveness of therapy dolls found that they could improve the emotional state of individuals and reduce negative behaviors like aggression. Therapy dolls could also be beneficial for improving communication. Around half of the studies in the systematic review concluded that therapy dolls positively affected people living with dementia and Alzheimer's disease.

Some experts believe that attachment behaviors are natural instincts and that tapping into them can benefit those with dementia and age-related cognitive conditions. People with dementia have been known to experience distress over their desire to be reunited with their parents or another family member. Doll treatment may help fill the instinctual need for attachment, thus lessening their distress. 

Below are a few options for increasing the odds that doll treatment is effective: 

• Use life-like baby dolls or stuffed animals 
• Provide props like clothes, blankets, and bottles
• Educate the individual about how doll treatment works 
• Talk to mental health professionals and nursing home staff about how to use doll therapy
• Combine doll treatment with talk therapy 

Who can benefit from this treatment?

Dolls were originally tested as a treatment tool for children with mental health conditions. Research expanded to include the elderly and patients with dementia. Current detail supports the idea that a doll can help reduce symptoms in individuals with dementia, Alzheimer's, and age-related cognitive disorders. Other mental health conditions may also benefit from DT, but more research is needed. 

Understanding this treatment's limitations

DT may not be right for every patient. For the treatment to be effective, it may be necessary for the individual to willingly "adopt" the doll or stuffed animal. Some people may assume that only women want to nurture baby dolls, but men can also benefit from DT. The best type of doll for the individual may depend on their preferences and budget, as some therapy dolls come at a high price. 

It may be recommended that caregivers allow the individual to voluntarily "adopt" the doll as their own. For example, it may be left on a table for them to find. Introducing the patient to the doll can be a natural process, with the goal of maintaining the client's dignity and avoiding infantilizing or demeaning them. 

Why is this controversial? 

Some mental health professionals have expressed ethical concerns about whether doll therapy is infantilizing or patronizing to older adults. However, DT is not designed to undermine the patient's dignity. Instead, it is a treatment option that can help reduce symptoms of dementia that could impact their health and wellness. 

Resistance to DT does exist, but it can be a beneficial tool for improving the cognitive and behavioral health of individuals with dementia and other age-related mental health conditions. However, DT may be unethical if forced upon an individual or used to neglect caregiving duties. 

Alternative treatment options 

One of the benefits of DT is that it can be administered individually without the oversight of a caregiver or mental health professional. However, talk counseling may be beneficial in conjunction with doll therapy for reducing symptoms of dementia. People with dementia may experience transportation limitations and other hurdles that prevent them from leaving home and attending appointments, so online counseling through a platform like BetterHelp may provide a solution. 

Online support

The convenience of online counseling may make it easier for individuals of all ages to avail of mental healthcare services. In addition to treating individuals with dementia, research has also found that online counseling can be beneficial for caregivers and family members who may experience anxiety or depression. For example, going to therapy can support the mental and emotional needs of caregivers. 

Clients with dementia may require assistance from a caregiver to use online counseling platforms. Still, by eliminating the need to travel, the process may be less time-consuming. Individuals with dementia may experience fear of leaving their homes or have physical disabilities that impede their ability to travel. Online counseling enables them to have care from home and reach professionals with a broader range of specialties.