DOLL THERAPY for managing challenging behaviour

Prepared by: YASMIN SHAMIMI BINTI SUHAIMI (20 20859982 ) MUHAMMAD ARIF AIMAN BIN AZLAN (2020840576).

Holding. Talking. Feeding. Cuddling. Dressing. A nonpharmacological intervention for patients with advanced dementia A person-centred and person-driven therapy A valuable tool to promote positive mood , behaviours , and social interactions Involves behaviours like:.

Miesen (1993) Application of Attachment Theory. Bowlby (1969) Attachment Theory.

Attachment Theory. (Mitchell & O’Donnell, 2013). The therapeutic use of doll therapy is best understood at a theoretical level from the work of the psychologist John Bowlby (1969) that work on attachment theory which was originally focused on child attachment with limited reference to older people with dementia. Attachment theory holds that the tendency of human beings to seek closeness & protection when feeling vulnerable or frightened is an expression of an innate (natural) motivational system. This system activates attachment behaviors directed to achieve proximity & protection from another person (eg: crying, calling, approaching & holding) The attachment behaviors persist during the entire life cycle, “from the cradle to the grave”..

Application of Attachment Theory. (Mitchell & O’Donnell, 2013).

Transitional Object Theory. (Mitchell & O’Donnell, 2013).

Why should doll therapy be used?. Ultimately, the use of the doll was perceived by participants as meeting residents individual needs.

Why should doll therapy be used?. (Fraser & James, 2008).

Why should doll therapy be used?. (Fraser & James, 2008).

Reduction in episodes of distress behaviour such agitation, wandering, anxiety and disengagement from others.

Guideline of using Doll Therapy (DT).

INDICATION ? Moderate to Severe Dementia. The effectiveness of doll therapy was not found to be acceptable with mild dementia..

2 most common types of dolls used in DT for people with dementia.

Dolls should have…. Soft bodies. Eyes open and close: to avoid distress over the doll being asleep/ dead..

Therapist should.... Educate family members to practice in a similar manner.

Suggested approaches when beginning doll therapy.

Suggested approaches when beginning doll therapy.

During doll therapy session. Assess whether it is a suitable intervention by monitoring the person’s response throughout..

Family Perspective. When introducing a doll, it is important to consider the family’s viewpoint..

Evidence-based of Doll Therapy. Authors Sample Interventions Outcome Cantarella et al. (2017) 29 nursing home residents aged from 76 to 96 years old, with severe dementia 20 sessions of doll. 5 times a week, for 1 month. 60 minutes/ session. The sessions took place in quiet room and avoiding distracting stimuli. DT group showed a reduction in BPSD and related caregiver distress. This study suggests that DT is a promising approach for reducing BPSD in people with dementia. Yilmaz and 29 elderly (aged 8 weeks DT was effective in Asiret 82-89) patients decreasing agitation and (2020) diagnosed with dementia Researchers visited the nursing home once a week to observe. behavioral problems in people diagnosed with moderate-to-severe dementia..

Evidence-based of Doll Therapy. Authors Sample Interventions Outcome Bisiani and 1 woman with Administered when the Reduction in anxiety, and Angus severe dementia participant showed negative behaviors. (2013) behaviors or emotions. Braden and Gaspar (2015) 16 older adults (age range 60–94 years) DT sessions: One at week for approximately 10 minutes each time. Participants had an increase in level of happiness, activity/ liveliness, interaction with staff and others, and ease of giving care. There was also a reduction in the level of anxiety..

Evidence-based of Doll Therapy. Authors Sample Interventions Outcome Shin 51 older adults with DT sessions: DT was administered Significant improvement (2015) dementia for 3 months occurred in verbalization, aggression, obsessive behavior, wandering, and depression at 1 and 3 months. Residents felt calmer immediately after applying therapeutic dolls at 1 week and 3 months..

Evidence-based of Doll Therapy. Authors Sample Interventions Outcome (Fernandez et al., 2014) adults (age >18years) diagnosed with dementia and living in a community setting or residential accommodation. DT sessions: DT three months follow-up an improvement in agitation and aggressive behaviors among residents who used the dolls Improvements in positive behaviors.

Evidence-based of Doll Therapy. Authors Sample Interventions Outcome (James, 2006) 33 residents with dementia offered either doll or bear The impact of the toys was assessed on five domains over a 12-week period. Noted greater activity, interaction and happiness . Doll therapy did not worsen of any residents, but improved the wellbeing of some residents..

FITT Principle. Frequency Ranging from 1 – 5 times/ week Time & Duration Ranging from 1 – 3 months Ranging from 10 – 60 minutes/ session Type of doll Life-like, lightweight dolls (weighing around 1500 g) Soft materials Eyes open and close (eyes would close in the supine position and open when upright) Does not make noises Smiles (Cantarella et al., 2017; Yilmaz & Asiret, 2020; Bisiani & Angus, 2013); Braden & Gaspar, 2015; Shin ,2015; Turner & Shepherd, 2014).

Video. https://www.youtube.com/watch?v=JsYlAsduIbA.

Video. https://www.youtube.com/watch?v=tS-S1DHAmxc.

Video. https://www.youtube.com/watch?v=420KucWPUJ4 https://www.youtube.com/watch?v=hnPPGDfr30Y https://www.youtube.com/watch?v=vPn6rN1brjU https://www.youtube.com/watch?v=CML2bKcjaZ0 https://www.youtube.com/watch?v=EVz9aBpm1Rc https://www.youtube.com/watch?v=r8o31joPB0g https://www.youtube.com/watch?v=1X1zPVI4fZE.

References. Baharudin, A. D., Din, N. C., Subramaniam, P., & Razali, R. (2019). The associations between behavioral-psychological symptoms of dementia (BPSD) and coping strategy, burden of care and personality style among low-income caregivers of patients with dementia. BMC Public Health , 19 (4), 447. Bisiani, L., & Angus, J. (2013). Doll therapy: A therapeutic means to meet past attachment needs and diminish behaviours of concern in a person living with dementia–a case study approach. Dementia , 12 (4), 447-462. Braden, B. A. (2014). Baby doll therapy in dementia residents. Braden, B. A., & Gaspar, P. M. (2015). Implementation of a baby doll therapy protocol for people with dementia: Innovative practice. Dementia , 14 (5), 696-706. Cantarella, A., Borella, E., Faggian, S., Navuzzi, A., & De Beni, R. (2018). Using dolls for therapeutic purposes: A study on nursing home residents with severe dementia. International journal of geriatric psychiatry , 33 (7), 915-925. Devshi, R., Shaw, S., Elliott-King, J., Hogervorst, E., Hiremath, A., Velayudhan, L., ... & Bandelow, S. (2015). Prevalence of behavioural and psychological symptoms of dementia in individuals with learning disabilities. Diagnostics , 5 (4), 564-576. Fraser, F., & James, I. (2008). Why does doll therapy improve the well-being of some older adults with dementia. PSIGE Newsletter , 105 , 55-63..

References. Lary-Waller, J. (2020). Implementation of Doll Therapy for Agitated Residents with Dementia. McCracken, P. N., Kagan, L., & Parmar, J. (n.d.). Recognizing and Treating Behavioral and Psychological Symptoms of Dementia. Mitchell, G., & O’Donnell, H. (2013). The therapeutic use of doll therapy in dementia. British Journal of Nursing , 22 (6), 329-334. Mitchell, G., & Templeton, M. (2014). Ethical considerations of doll therapy for people with dementia. Nursing ethics , 21 (6), 720-730. Mitchell, G., McCormack, B., & McCance, T. (2016). Therapeutic use of dolls for people living with dementia: A critical review of the literature. Dementia , 15 (5), 976-1001. Romero, A. P., & Garrido, S. G. (2018). The importance of behavioural and pyschological symptoms in Alzheimer disease. Neurología (English Edition) , 33 (6), 378-384. Shin, J. H. (2015). Doll therapy: An intervention for nursing home residents with dementia. Journal of psychosocial nursing and mental health services , 53 (1), 13-18. Turner, F., & Shepherd, M. (2014). Doll Therapy in Dementia Care: A Review Of Current Literature. Communicare , 1 (1). Yilmaz, C. K., & Aşiret, G. D. (2020). The Effect of Doll Therapy on Agitation and Cognitive State in Institutionalized Patients With Moderate-to-Severe Dementia: A Randomized Controlled Study. Journal of geriatric psychiatry and neurology , 0891988720933353..