DEMENTIA GETS DOLLED UP. Leah Bisiani Uplifting Dementia RN.1/Dementia Consultant/MHlthSc
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1 DEMENTIA GETS DOLLED UP Leah Bisiani Uplifting Dementia RN.1/Dementia Consultant/MHlthSc
2 AUTHOR: Promoting uplifting and joyous environments for people living with dementia to enable continuation of life as they know it, retaining the spark to thrive during this chapter of their life journey Leah Bisiani
3 DEMENTIA GETS DOLLED UP:
4 DEMENTIA GETS DOLLED UP: Terminology: Doll therapy Child representation therapy Focusing and judging terminology may be detrimental to the provision of positive care.
5 RESEARCH AIMS: Examine & evaluate the impact of a doll, used as a therapeutic tool, to improve life quality/support a person living with dementia s specific reality Evaluate potential benefits of reducing/resolving behavioural expression Analyse association with past attachment needs Stimulate meaningful communication & social interaction opportunities Promote well being as opposed to ill being of an individual Dispel the myth
6 WHY?? Doll therapy supports the individual, thus may: Maintain personhood/the place held in the world Enable, enrich & empower by providing meaning, control & stimulation Provide opportunities to stimulate and express positive emotion/eg. Nurturing, joy Improve self worth & self esteem Stimulate long term memory, reminiscence & establish links to a long lived life
7 DEMENTIA GETS DOLLED UP: Never lose touch with your inner child
8 IMAGINE HOW IT MUST FEEL: Cognitive deficit Loss of validation of your humanity Searching for a distinct place in the world/isolated Craving companionship/attachment/focus Unable to communicate need/core suffering/despair Losing that spark of life
9 LITERATURE: Kitwood, (1997)suggests: meaning can be given to the lives of people living with dementia & they can definitely respond to favourable attachments related to long term memories. Miesen s, (1992) expansion of Bowlby s, (1969) theories suggests: those that cling to dolls and soft toys appear to be using these objects as a representation of the personal support they are searching for.
10 SUITABILITY & RESTRICTIONS: Do not restrict suitability based on your: Cognitive viewpoint Assumptions Feelings However use is suitable if the doll: is beneficial to the individual does not emotionally distress provides solace and joy improves communication reduces behavioural expression meets attachment needs
11 MINIMISING RISK: Adherence to the philosophy of care underpinning Kitwood s person centred care approach Any sign of emotional trauma & the doll would be removed/withdrawn
12 METHODOLOGY: Phase 1 Pre introduction of Doll Selection criteria Observations for a week regarding behavioural expression Collection & analysing of data Journal Staff & family involvement/information Care planning
13 METHODOLOGY: Phase 2 Introduction of Doll Doll selection Gifting of doll to participant No distractions Immediate reaction Staff involvement
14 METHODOLOGY: Phase 3: Post introduction of doll Observations for a week re behavioural expression Collection & analysing of data/journal Establish benefit/change re behavioural expression Unexpected results eg. Interaction/mobility
15 RESEARCH RESULTS: Considerable decline in behavioural expression Improved communication with staff, residents, family Improved intake & dining experience/weight management Improved mobility related to changed focus/decreased anxiety, tremor, tears, panic Reduced social isolation & withdrawal Improved well being& self worth delight/joy Sense of control & comfort Personhood validated & quality of life enhanced
16 UNEXPECTED RESULTS: Impact on other residents: Approached participant for a nurse Asked the infants name Initiated conversation - both Both men and women involved positively Improved community & interaction overall Crossed barriers of differing levels of cognitive decline Staff: Reinforced the possibilities open to them as caregivers Stimulated further therapeutic interventions
17 CONCLUSION: Substantial evidence to support the potential benefits of the use of doll therapy in: Reduced behavioural expression such as anxiety & agitation Meeting of attachment needs Stimulation of the nurturing instinct Conversion of ill being to well being Retention of personhood Improved interaction & maintenance of relationships Meeting of bio psychosocial & emotional needs Provision of comfort, peace, sense of control Resolution/prevention of depression Improved physical condition
18 DISCUSSION: Doll therapy: Has extended our understanding of the use of complementary therapies to inform professional practice Promotes opportunities for the exchange of knowledge Stimulates further research & promotes best practice Encourages change in attitude regarding many alternative therapeutic ways of meeting the specific requirements of a person living with dementia Demonstrates another valuable way forward in the provision of person centred dementia care
19 FURTHER INFORMATION: This research project emerged out of a thesis as part of a Master of Health Science Aged Services program at Victoria University, Melbourne The published paper is titled: 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 This paper supports Killick and Allan s (2001), view that: it is not the activity itself which dictates the nature and meaning of an experience, but rather the way it is carried out (p.115).
20 DEMENTIA GETS DOLLED UP: Be the change you want to see in the world. Ghandi
21 REFERENCES: Bisiani, L. & Angus, J. (2012). The use of doll therapy to meet past attachment needs and diminish behaviours of concern in people with dementia: A case study approach. Dementia, published online 15 February 2012: DOI: / Bowlby, J. (1969). Attachment and loss: Volume 1 Attachment. London: Hogarth Press. Killick, J., & Allan, K. (2001). Communication and the care of people with dementia. Buckingham: Open University Press. Kitwood T (1997) Dementia reconsidered the person comes first. Buckingham: Open University Press. Miesen BML (1992) Attachment theory and dementia. In G. M. M. Jones, & B. M.
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