When Pretend Play Is Real For Alzheimer’s Patients
dementia patient with her baby doll

Sitting beside a neatly made crib, 88-year-old Vivian Guzofsky held up a baby doll dressed in puppy dog pajamas.

“Hello gorgeous,” she said, laughing. “You’re so cute.”

Guzofsky, who has Alzheimer’s disease, lives on a secure memory floor of a home for seniors. Nearly every day, she visits the dolls in the home’s pretend nursery. Sometimes she changes their clothes or lays them down for a nap. One morning in August, she sang to them: You are my sunshine, my only sunshine. You make me happy when skies are gray.

No one knows whether she believes she is holding a doll or a real baby. What the staff at Sunrise Senior Living do know is that Guzofsky — who can get agitated and aggressive — is always calm when caring for the dolls.

Nursing homes and other senior facilities nationwide are using a controversial technique called doll therapy to ease anxiety among their residents with dementia. Senior care providers and experts say the dolls are an alternative to medication and help draw in elderly people who are no longer able to participate in many activities.

“A lot of people with Alzheimer’s are bored and may become depressed or agitated or unhappy because they aren’t engaged,” said Ruth Drew, director of family and information services at the Alzheimer’s Association.

Caregivers aren’t trying to make their charges believe the dolls are real infants, and they don’t want to infantilize the seniors, Drew said. They are just “trying to meet them where they are and communicate with them in a way that makes sense to them.”

Other senior facilities that use the dolls include On Lok Lifeways in San Francisco and the Los Angeles Jewish Home in the LA suburb of Reseda. Some, including Texas-based Belmont Village Senior Living, eschew them, arguing that it can be demeaning for seniors to play with dolls.

“They are adults and we want to treat them like adults,” said Stephanie Zeverino, who works in community relations at Belmont Village Senior Living Westwood. “These are very well-educated residents.”

The facility prefers other types of therapy, including art and music, she said. And staff members there work with residents to play brain games that promote critical thinking.

“We want to provide a sense of dignity,” Zeverino said.

Studies on doll therapy are limited, but some research has shown it can reduce the need for medications, diminish anxiety and improve communication, according to Gary Mitchell, a nurse specialist at Four Seasons Health Care in the United Kingdom who has authored a new book about doll therapy.

However, Mitchell acknowledged it is possible that doll therapy, because it can infantilize adults, “perpetuates a lot of stigma with dementia care that we are trying to get away from.”

Some families worry about their relatives being laughed at when they engage in doll therapy, Mitchell noted. He said he understands those concerns, and even shared them when he worked at a senior residential center. But when one resident requested that he allow her to continue caring for a doll, he soon saw the positive impact of the therapy.

Mitchell said it can be very beneficial for some people — especially those who may get easily distressed or pace obsessively. “Having the doll … offers them an anchor or a sense of attachment in a time of uncertainty,” he said. “A lot of people associate the doll with their younger days and having people to care for.”

At Sunrise Beverly Hills, the nursery is set up like a baby’s room. A stuffed bear rests inside the wooden crib. On a shelf above are framed photos of Guzofsky and a few other women who regularly interact with the dolls. A few bottles, a swaddling blanket, a Dr. Seuss book and diapers sit on a nearby changing table.

The nursery is just one of several areas in the Sunrise centers designed to engage residents, said Rita Altman, senior vice president of memory care for Sunrise, which has facilities in the U.S., Canada and the U.K. There are also art centers, offices, gardens and kitchens where residents may find familiar objects from their past.

Altman said the nurseries tend to attract residents who have an instinct to care for babies. Some people, she said, may not be able to talk anymore but still find a sense of security with the dolls. “You can read it in their body language when they pick up the doll,” she said.

Sunrise caregivers also use the dolls to spark conversations by asking questions: How many children do you have? Was your first baby a boy or a girl? What are the best things about being a mom?

The executive director of the Beverly Hills facility, Jason Malone, said he was skeptical about the use of dolls when he first heard about them.

“I almost felt like we were being deceitful,” he said. “It didn’t feel like it was real.”

But he quickly changed his mind when he realized that staff could use the dolls respectfully.

“We don’t want to confuse treating our seniors as children,” Malone said. “That’s not what this activity is truly about.”

Guzofsky began caring for the dolls soon after moving into the facility. When asked what she likes about the dolls, she said, “I love babies. I have some very nice ones back where I live now.”

Guzofsky’s daughter, Carol Mizel, said her mom raised three children and volunteered extensively in Colorado and Mexico before being diagnosed with Alzheimer’s about five years ago. Mizel said she doesn’t see any downside to her mother caring for the dolls. It is “creative way of dealing with her where she is now,” she said.

“I always describe my mother as being … very similar [to] many of my young grandchildren in her cognitive skills,” Mizel added.

For some residents, including 87-year-old Marilou Roos, holding the dolls is one of the only times they interact with the staff. Roos is confined to a wheelchair and rarely speaks. She sleeps much of the day.

“There is not much [Marilou] can participate in,” said Vladimir Kaplun, former coordinator of the secure memory floor. “When she spends some time with the babies, she wakes up and she brightens up.”

On a recent day, caregiver Jessica Butler sat next to Roos, who held a doll against her chest and patted her on the back. She kissed the doll twice.

“The baby’s beautiful like you,” Butler said.

“It’s a boy,” Roos said. “Five months.”

“Is the baby five months?” Butler asked. “You’re doing a good job holding the baby.”

Caring for the dolls is second nature to Roos, who made a career of being a mom to five children and was involved with the PTA, Girl Scouts and other activities, according to her daughter, Ellen Swarts.

Swarts said it’s been difficult to watch the decline of her mother, who hasn’t called her by name in over a year. Watching her with the dolls helps, she said.

“To see the light in her eyes when she has a baby in her arms, I don’t care if it’s real or if it’s pretending,” she said. “If that gives her comfort, I am A-OK with it.”

KHN’s coverage in California is funded in part by Blue Shield of California Foundation.

KHN’s coverage of aging and long-term care issues is supported by The SCAN Foundation.

Kaiser Health News (KHN) is a nonprofit news service committed to in-depth coverage of health care policy and politics. And we report on how the health care system – hospitals, doctors, nurses, insurers, governments, consumers – works. KHN is an editorially independent program of the Kaiser Family Foundation, a nonprofit organization based in Menlo Park, Calif., that is dedicated to filling the need for trusted information on national health issues.

Related Articles

Popular categories

Finances
Burnout
After Caregiving
Housing
Relationships
Finding Meaning
Planning
Dying
Finding Support
Work
Grief

Don't see what you're looking for? Search the library

Share your thoughts

19 Comments

  1. Yes this works. it is calming and so many of these beautiful people took care of others most of their lives so to be able to give them something to care for is just so natural. We did this with my grandma and many times in the memory care I worked in.

    Reply
  2. I have been a nurse in longterm care for nearly 20 years. It works! This is my own grandmother with dementia. She was happiest when she had her babies. She KNEW her babies and could tell you all about each of them.

    Reply
  3. My Grandmother got very agitated because she could “hear” her baby crying but could not find him. This went on for a few days. My Mom went and found one of my sisters discarded dolls. Cleaned it up. We then wrapped it up and told my MoMo that we found her baby. Agitation gone. As long as she had her “baby” she stayed calm. Sundowning stopped. It is not creepy at all. These poor people live in there own mental hell every day. I saw proof that this can give them an inner peace we cannot understand. I applaud these homes. Just my two cents.

    Reply
  4. Each person, each case is unique. Thoughtfully used, doll therapy can help give a better quality of life. We use music for many dementia sufferers, why not dplls, as well.

    Emily, review your gentleman’s past for some clues that might help you.

    Reply
  5. My Grandma gave birth to 11; holding a baby was just a natural action for her.

    Reply
  6. Dolls always calmed my mother and brought back her motherly ways of caressing loving kissing cuddling etc it was amazing

    Reply
  7. Just kind of creepy…but hey..whatever works

    Reply
  8. Why not get animals…dogs…cats

    Reply
    • I got my uncle a cat before I knew what he had and he stopped feeding him..bad idea.

      Reply
    • Beth, people who have Alzheimer’s or dementia seem to go back in time with no real focus on the present. Perhaps the connection to a doll for a woman is a reminder of her own youth or caring for her children during her lifetime. If it gives some happiness, all is good.

      Reply
    • Beth, some patients have stuffed animals and treat them like precious real pets. It is not creepy when you see a person happy and calm. As Barbara Bowker indicated it brings a reminder of youth or young children. As long as it helps a patient it is a good thing. It is interesting to see the differences in what makes patients happy.

      Reply
  9. My mom became attached to two baby dolls several months ago. The staff at the nursing home ensures she has her dolls with her almost all the time. She talks with them and just caresses them as she needs to. She does not call them by name in front of me, but I have been told she calls one by my name. I keep them cleaned up for her.

    Reply
  10. My mom started relating to dolls while she lived with me…she was about 89 at the time…she fed , dressed and slept with them. Worried about their schooling and who would care for them when she was gone. We had to put mom in a nursing home, her babies went with her…they remain a very important part of her life. Mom will be ninety nine on April 19th this year. When one of her babies is in a mood, whether it be happy, angry, scared or sad, we know that is mom’s way of expressing her own feelings.

    Reply
  11. I have worked with individuals who have stopped eating in order to feed their dolls. I prefer finding items related to his/her former career or hobbies.

    Reply
  12. Great article..but what about the men??? Any helpful suggestions…and keep in mind the man I take care of puts everything in his mouth or tries to eat it…

    Reply

Share your thoughts and experiences

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Join our communities

Whenever you want to talk, there’s always someone up in one of our Facebook communities.

These private Facebook groups are a space for support and encouragement — or getting it off your chest.

Join our newsletter

Thoughts on care work from Cori, our director, that hit your inbox each Monday morning (more-or-less).

There are no grand solutions, but there are countless little ways to make our lives better.

Share your insights

Caregivers have wisdom and experience to share. Researchers, product developers, and members of the media are eager to understand the nature of care work and make a difference.

We have a group specifically to connect you so we can bring about change.

%d bloggers like this: