Using dolls in dementia care (doll therapy)

Holding or just being with a doll or soft toy animal, such as a cat or dog, can be particularly helpful for people who are withdrawn, restless, distressed or anxious, improving their wellbeing and ability to communicate. The sensation of holding a doll or toy animal can be soothing. It might remind them of a time when they had young children or a pet of their own.

Some people with dementia experience ‘sundowning’ – a state of intense confusion and distress that typically occurs in the evening. They may feel a strong need to go home, even if they are already at home, or to collect their child from school, even if they are grown up. Having a doll or toy animal to focus on at this time of day may ease these feelings of distress and insecurity.

‘Caring’ for a doll or soft toy can also give people with dementia a renewed sense of purpose and help them connect with the outside world. This can have a knock-on effect on their energy, activity levels and mood.

If there are younger people in the family, such as grandchildren or – in the case of young onset dementia (where symptoms develop before the age of 65), the person’s own children – playing with or talking about the toy together could help them interact and foster feelings of closeness.

• Introduce the doll or soft toy animal gradually. You could place it on a chair before the person enters the room. Wait and see if and how they respond
• Let them discover the doll or toy animal in their own time. If they show no interest, don’t try to press it on them. Some people with dementia simply aren’t interested in dolls and soft toys, but you can always try again another day
• You could offer a choice of different dolls or soft animals to pick from
• If the person is interested in the doll or soft toy, use it as a way to connect with them. You could ask them questions about the doll or animal, referring to it as he, she, or they
• If they have difficulty communicating, you could make observations about the doll or toy animal instead. For a doll, for example, you could say: “Doesn’t she have a nice face?” or “What a pretty dress.” For an animal, you could say: “What lovely fur”, or “It looks like (name of a pet from the past)”
• Some companies sell lifelike dolls and animated soft toy animals which are marketed for people with dementia, but there is no need to make an expensive purchase as ordinary dolls and cuddly toys can be just as effective

It’s also a good idea to discuss your plans to give the person a doll or toy animal with other family members. Some people worry about the person being treated like a child, but explaining the benefits may ease their concerns.

The person with dementia may become very attached to their doll or toy animal and be upset if someone else picks it up. You might want to avoid having the toy out in situations where this may happen – for example, in a communal area of a care home. If the person with dementia has young children or grandchildren, you could keep the toy in the person’s bedroom, or provide the child with a similar doll or animal so they are less likely to be attracted to their special toy.

• If the person with dementia has home carers or is in a care home, ensure the care staff know that the doll or animal is important to them to avoid it being misplaced or handled by other people
• If the person seems to believe the toy is real – for example referring to a doll as their ‘baby’ – do not try to correct them as this may cause distress
• Consider buying a duplicate doll or soft animal in case the original gets lost or needs to be cleaned

If the person is missing out on taking part in activities because they feel they have to look after their toy, introduce the idea of someone ‘babysitting’ it so it doesn’t restrict their participation.