Utilising dolls in dementia care: A literature review

The next fifteen years will see the number of people with dementia double in the UK. The use of pharmacological interventions has been implicated in not only falls but also increased cognitive decline in older people. As a result, health professionals have developed a range of non-pharmacological therapies that seek not only to minimize distress but also increase the social functioning of those with dementia. The use of doll therapy has been shown to alleviate distress and promote comfort in some people with dementia.
The rationale for providing a doll to a person with dementia is linked to two psychological theories, originally applied to children ‘attachment theory’ and the use of ‘transitional objects’. Advocates of doll therapy assert that because the person with dementia often becomes disorientated, in a similar way to children, the use of a doll can fulfil a number of complex needs. Those who do not favour the use of doll therapy often question its therapeutic value suggesting it is both infantile and dehumanizing to the person.
There is limited empirical evidence available on the efficacy of doll therapy. Despite this, there is concurrence within published literature, which suggests positive therapeutic outcomes from doll therapy use in people with dementia.
There are obvious ethical issues associated with the use of doll therapy, including: deprivation of dignity, deceit and infantilisation. While published guidelines do exist, these have been generally developed in response to a single research project, not following a collective analysis of all available evidence. With the increased emphasis on evidence-based practice, it is puzzling that the use of doll therapy in dementia has grown in popularity given the paucity of empirical research to support its use.