By Jane Verity
To implement Dementia Care Australia’s definition of Doll Therapy as the mindful use of dolls for their symbolic significance to help improve the wellbeing of people with dementia:
- Develop a doll therapy policy.
- Create doll therapy consent forms.
- Obtain family consent.
- Establish and follow individual doll therapy care plans.
- Educate staff and families on how to use doll therapy. Ensure that all involved know that doll therapy is not a cure. (Provide copies of Jane Verity’s The Great Doll Therapy Debate editorial for full explanation.)
- Choose the right doll. We recommend Lee Middleton Original Dolls, which often elicit a compassionate response due to their lifelike look and feel. They are weighted as a 6-month-old baby with floppy heads and soft cuddly bodies.
- Dress the doll in old-style baby clothes – avoid stretch or modern growsuits.
- Provide cuddly wraps and blankets to wrap dolls in.
- Provide a cot or bassinet. Many people with dementia take great pride in remaking the bassinet as they see best for their ‘baby’.
- Provide a stable pram, which can also be used as a walking frame.
- Avoid debating whether to address the doll as the doll or the baby by simply asking the person with dementia, ‘What’s its name?’
- Only give the doll to residents who show interest and wish to hold it. Remember that people who have not had children may benefit tremendously from doll therapy as caring for the doll can sometimes make up for a need they have not had fulfilled in life.
- Provide a ‘nursery’ area where dolls can be placed and collected. This helps if the person tires of looking after the doll and needs a break.
- Always show respect for the doll and hold or carry it as you would a real child.
- Support and validate the feelings of a person with dementia if they believe the doll is a real baby.
- Keep an open mind until you have had an opportunity to experience the positive and joyful results doll therapy can achieve.
- Force a doll on a person with dementia. Not everyone will like or want a doll.
- Avoid sleeping dolls with their eyes permanently closed. Although some may be incredibly beautiful, they may prove upsetting for some people with dementia who become upset if they can’t wake the doll.
- Avoid dolls that cry as the crying may cause the resident distress when they cannot work out how to ‘stop’ it crying.
- Don’t call it a doll or a baby – instead say – ‘Look what I have here.’ Or, ‘Look who is visiting.’
- Leave the doll on the floor, on a shelf, or in an ‘unsafe’ place. Leave it wrapped in a basket.
- The occupational or diversional therapist assesses whether doll therapy is a suitable intervention for each resident and this is documented in individual care plans. There needs to be a specific care plan for doll therapy.
- All families are given information on doll therapy and a permission form to sign when residents are admitted.
- Doll therapy will only be used with a resident upon the family’s consent.
- Staff members are educated on how to use doll therapy during ongoing education, and by following individual care plans.
- The effectiveness of doll therapy is regularly reviewed and evaluated in care plans, and progress is recorded in the integrated progress notes.
Reference sources: Hilary Lee Doll Therapy Policy