Baby doll therapy in dementia patients

Abstract

<p>Dementia is a condition exhibited by emotional and physical states such as anxiety, agitation, sleeplessness, inability to care for oneself, wandering, defiant and sometimes violent behavior, and other unsafe actions.&nbsp; Chemical restraints are often used to control agitated behaviors, but are not always effective and produce untoward effects.&nbsp; A review of the literature for alternative therapies to chemical restraints indicated that doll therapy has provided purposeful activity that can help dementia residents feel useful.&nbsp; In most instances they are less agitated, sleep better, relate to others better, and have an over-all positive affect improvement (Baumann, 1990, Higging, 2010, &amp; James, Mackenzie, &amp; Mukaetova-Ladinska, 2006).</p> <p>The PICOT question for this evidence based project was: In female residents over 65 with moderate to severe dementia (P), how does exposure to baby-doll therapy (I) compared to no baby-doll therapy exposure (C) influence behavior (O) over a one-week period (T)?&nbsp; The project was implemented using the Rosswurm and Larrabee framework (1999) &ldquo;A Model for Change to Evidence-Based Practice.&nbsp; An &ldquo;Implementation Protocol for Baby Doll Therapy in Dementia Residents&rdquo; was developed based on the evidence found in the literature.&nbsp; Those residents who met the criteria, and with caregiver consent, were the participants in this protocol evaluation project.&nbsp;</p> <p>The Project was implemented with 16 residents in a dementia care center.&nbsp; Their participation was garnered through identification by nursing staff using predetermined criteria and upon the resident&rsquo;s acceptance of the doll offered to them.&nbsp; Outcomes were measured by the residents&rsquo; caretakers on their perceptions of the impact of the dolls in six areas of behavior; activity/liveliness, interaction with staff, interaction with other residents, happiness/contentment, agitation, and amenable to personal care.&nbsp; The behavioral outcomes were evaluated on a five-point Likert-type scale with 5 being much more change and 1 being much less change.&nbsp; The Project Lead also evaluated the residents interaction with the doll using an adopted Engagement Observation Rating Tool (Cohen-Mansfieldabc, Marx, Dakheel-Alia, Regier, &amp; Theina, 2010) , both upon introduction of the doll and approximately one-week later.</p> <p>Participants had a statistically significant increase in the level of happiness with a similar trend for the behaviors of: activity/liveliness, interaction with staff, interaction with others, and ease of giving care.&nbsp; There was also a trend that indicated there was a reduction in anxiety level.&nbsp; Case studies provide the response and engagement of the participants to doll therapy.&nbsp; The evidence based protocol provided guidance on the implementation of doll therapy for those with dementia.&nbsp; Recommendations based on the outcomes of the project include use with female residents with moderate to severe dementia who have had or cared for young children in their past.&nbsp; Evaluation of the implementation of doll therapy protocol by staff caregivers and family members was positive and supportive of the findings in the literature.&nbsp; This cost effective non-pharmacological approach to improving the well-being of residents with dementia is a therapeutic option.&nbsp; The dementia center staff expressed interest in continuing use of baby doll therapy as an option for their residents.&nbsp; Introduction of the baby doll to future residents can be accomplished by the following the guidelines established by the Project Lead.</p>