Abstract

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. Chemical restraints are often used to control agitated behaviors, but are not always effective and produce untoward effects. 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. 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, & James, Mackenzie, & Mukaetova-Ladinska, 2006). 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)? The project was implemented using the Rosswurm and Larrabee framework (1999) ";A Model for Change to Evidence-Based Practice. An ";Implementation Protocol for Baby Doll Therapy in Dementia Residents"; was developed based on the evidence found in the literature. Those residents who met the criteria, and with caregiver consent, were the participants in this protocol evaluation project. The Project was implemented with 16 residents in a dementia care center. Their participation was garnered through identification by nursing staff using predetermined criteria and upon the resident's acceptance of the doll offered to them. Outcomes were measured by the residents' 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. The behavioral outcomes were evaluated on a five-point Likert-type scale with 5 being much more change and 1 being much less change. The Project Lead also evaluated the residents interaction with the doll using an adopted Engagement Observation Rating Tool (Cohen-Mansfieldabc, Marx, Dakheel-Alia, Regier, & Theina, 2010) , both upon introduction of the doll and approximately one-week later. 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. There was also a trend that indicated there was a reduction in anxiety level. Case studies provide the response and engagement of the participants to doll therapy. The evidence based protocol provided guidance on the implementation of doll therapy for those with dementia. 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. Evaluation of the implementation of doll therapy protocol by staff caregivers and family members was positive and supportive of the findings in the literature. This cost effective non-pharmacological approach to improving the well-being of residents with dementia is a therapeutic option. The dementia center staff expressed interest in continuing use of baby doll therapy as an option for their residents. Introduction of the baby doll to future residents can be accomplished by the following the guidelines established by the Project Lead.

Description

Conducting any evidence-based project such as this would not be possible without the help and expertise of those involved with the project. In that context I wish to thank my project Chair, Dr. Phyllis Gaspar, whose many hours of editing and critical review were so invaluable, and my committee members Dr. Judy Ribak and Dr. Gladeen Roberts for their critical reviews and recommendations for the project. I wish to thank Ms. Jodi Jamison, the UT Librarian who did searches and advised me on so many items. I also need to thank the nursing director, the staff, the patients, and the family members of the dementia center where I implemented this project! Lastly, I offer my regards and thanks to all of those who supported me in any respect during the completion of the project.

Author Details

Barbara A. Braden, DNP, MS, MSN, FNP, NP-C

Sigma Membership

Nu Phi

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Outcomes Research

Research Approach

Mixed/Multi Method Research

Keywords:

Dementia, Dolls

Advisors

Gaspar, Phyllis||Ribak, Judy||Roberts, Gladeen

Degree

DNP

Degree Grantor

The University of Toledo

Degree Year

2014

Rights Holder

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All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Faculty Approved: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2014-05-09

Full Text of Presentation

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