Doll Therapy for People with Alzheimer’s Disease is Not Always a Good Idea

I recently commented on a post at Alzheimer’s Reading Room about the use of dolls for people with Alzheimer’s Disease and related dementias. If you conduct an internet search on the subject you’ll find articles where nursing home staff and caregivers tout the benefits and pleasure of giving dolls to the individuals. The benefits they state can be summarized as improved communication, happier individuals and sense of purpose. I don’t see anyone discussing the negative aspects some people find with doll therapy. Instead I continue to read about more people using it.

Individuals have even begun marketing dolls to caregivers of people with Alzheimer’s Disease. The Alzheimer’s Store sells Someone to Care For dolls for $99.95. Their site states one family wrote:

My mother has had a baby doll for two years now. She loves that doll with a passion you would not believe. She kisses it, tells it how much she loves it, and keeps it with her all the time. At first she told me she knew it wasn’t real, but with it, she never feels alone. This was the best thing we ever did for her.

Dolls4alzheimers.com markets lifelike dolls to people with Alzheimer’s for $65.00 each. Two women even caught media attention as they began collecting used dolls for people with AD to ease the suffering and bring joy. The article states:

“It was like a miracle,” Dugan said of her mother’s initial reaction to the life-like baby she received for Christmas in 2007. “She looked at that baby, stared at it lovingly and kissed it.”

Instead of playing with the doll, the mother of seven and grandmother of 15 seemed to be caring for it as if it were a live baby of her own, according to family members.

“She held onto it all the time,” said Dugan, who took comfort in seeing her mother so apparently happy.

The BBC News even reported on a research study, albeit a small one (14 residents in one nursing home), that concluded dolls can help people with Alzheimer’s Disease interact and communicate with others.

I’m here to tell you that, though doll therapy may work for some, it is actually a bad idea for many, particularly in institutional settings. This is based on my experience as a Licensed Social Working in a nursing home and as Director of Adult Day Services at an assisted living facility. The problem starts with why the individual enjoys the doll so much. People with Alzheimer’s Disease tend to move back in time as their disease progresses, meaning they think they are younger and living a different life/reality than what they are. This is why they may not recognize themselves in the mirror or why they look for long lost loved ones. Those that become attached to the dolls often do so, because they think it’s their own – real – child.

The doll can become a source of great anxiety. For example:

• Imagine if you became attached to the doll (your child) and then you couldn’t find it. You would become worry filled, anxious and angry if people couldn’t find your child.
• Imagine if you set the doll down, forgot about it, then saw another resident walking around with your child. Then that resident thinks it’s his/her child! These turn of events do happen, and staff must run to break up the fight.
• While it may help some focus their attention on the doll (child), it may also focus their attention too greatly. Bringing the individual to a meal or the bathroom cannot be done without serious effort as the individual becomes fixated on the doll.
• In some cases, when the doll doesn’t respond as the individual expects a child should, they become worry filled that the child has died.

These experiences are real and widespread with dolls and people with Alzheimer’s Disease in institutional settings. Of course, the positive outcomes are also real. It gave me great joy to see the smile on someone’s face when I gave them a doll and talked with them about it, but that temporary joy can lead to anxiety and stress. The only true way to find out if a doll will benefit someone is to try giving them one, but what other articles aren’t telling you that I am, is to be aware that the experience may not turn out as you had hoped.