How can doll-therapy facilitate a more person-centred approach to meeting ADL needs of older people with dementia in acute care?

Abstract

Dementia is a progressive disease of brain tissue that causes various cognitive symptoms such as memory loss, reduced clarity of thought and changes in feelings, behaviour and thinking. Currently the number of older adults with dementia in Scotland is around 90,000 and roughly two thirds of people in hospital beds are over the age of 65; an estimated 30% of them have dementia. Dementia affects each individual in different ways; however, generally admission to an acute hospital is a very stressful experience which disrupts the routine of the person with dementia. Acute care environments are challenging for people with dementia due to established routines and nursing staff's busy schedules that do not allow for the flexibility in approach to care that many people living with dementia require. The evidence suggests that some members of nursing staff feel that people with dementia are a disruption to their workday and they do not know how to manage some of the behavioural symptoms of dementia such as wandering and aggression. This highlights the importance of identifying a method of providing care to people with dementia that would result in them having a better care experience and would assist nurses in providing this care in a person-centred way. Doll therapy is a relatively new practice that utilises dolls in order to improve social wellbeing and quality of life for people living with dementia. There is currently very limited evidence underpinning doll therapy and what does exist does not include its use in acute care settings. From the existing evidence it appears that doll therapy has the potential to benefit some older adults with dementia, however, although it is a new practice, doll therapy has already generated a great deal of controversy. Many nurses perceive the use of dolls for older adults with dementia to be infantile and unethical which poses a great challenge to the development of this therapy. The purpose of this research proposal is therefore to explore the possible benefits that doll therapy could bring to older adults with dementia during an acute hospital admission. However, due to the negative preexisting opinions many nurses have towards this therapy, it will be conducted using a Participatory Action Research methodology. This research aims to work alongside participants on an acute medical ward in one NHS Health Board to work towards making acute care settings more person-centred for people with dementia. Group interviews and ward observations will be the methods utilised to plan the implementation approach as well as provide a continuous approach to evaluation throughout the entire process. The findings of this research will be utilised to inform future research cycles and to act as the first study to focus on the use of dolls for older adults with dementia in acute care settings.