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Leah Bisiani, MHlthSc: Dementia gets dolled up: Utilising psychosocial care to reinforce self-worth
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Leah Bisiani, MHlthSc: Dementia gets dolled up: Utilising psychosocial care to reinforce self-worth

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Leah Bisiani, RN.1/Dementia Consultant/MHlthSc – “Uplifting Dementia” delivered this presentation at the 2014 National Dementia Congress. The event examined dementia case studies and the latest …

Leah Bisiani, RN.1/Dementia Consultant/MHlthSc – “Uplifting Dementia” delivered this presentation at the 2014 National Dementia Congress. The event examined dementia case studies and the latest innovations from across the whole dementia pathway, from diagnosis to end of life, focusing on the theme of "Making Dementia Care Transformation Happen Today. For more information on the annual event, please visit the conference website: http://www.healthcareconferences.com.au/dementiacongress2014

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  • 1. DEMENTIA GETS DOLLED UP Leah Bisiani – “Uplifting Dementia” – RN.1/Dementia Consultant/MHlthSc
  • 2. AUTHOR: “I promote uplifting and joyous environments only for people living with dementia so they can live their life and continue to thrive.” Leah Bisiani –
  • 3. DEMENTIA GETS DOLLED UP:
  • 4. AIMS: • Examine and evaluate the therapeutic impact of a doll as a tool in regards to improving life quality/support a person living with dementia’s specific reality • Evaluate potential benefits of reducing/resolving behaviours of concern • Analysing whether this associates with past attachment needs • Improve communication and social interaction • Promotion of well being as opposed to ill being of an individual.
  • 5. WHY?? Doll therapy supports the understanding of each individuals specific personhood and the place they hold within the world. This tool can be utilised for select persons who respond favourably to this alternative therapy, thus enabling, enriching and empowering their lives by providing meaning, control and stimulation.
  • 6. DEMENTIA GETS DOLLED UP:
  • 7. IMAGINE WHAT IT MUST BE LIKE: • To have a cognitive deficit • To feel no one validates your humanity as a person • Searching for a distinct place in the world • Living within a reality in which you are totally alone • Craving companionship/attachment/control/focus • Feeling and displaying emotion that relate to core suffering/despair/anxiety and agitation • To lose that spark that keeps us going
  • 8. AS PROFESSIONALS WE SHOULD TRY: • To establish links to the memories of a long lived life • Participate in the journey • Provide companionship • Preserve personhood • Resolve depression/withdrawal • Prevent behaviours of concern • Promote self worth, self esteem and quality of life • Assist persons living with dementia to continue to ‘live’
  • 9. LITERATURE: Kitwood, (1997): suggests that: meaning can be given to the lives of people living with dementia and they can definitely respond to favourable attachments related to long term memories. Miesen’s, (1992) expansion of Bowlby’s, (1969) theories: suggests that 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. DEMENTIA GETS DOLLED UP:
  • 11. SUITABILITY AND RESTRICTIONS: • Do not restrict suitability based on our cognitive viewpoint or assumptions • Do not restrict based on what we would feel However it is suitable if the doll: • is of benefit • does not emotionally distress • provides solace and joy • improves communication • reduces behaviours of concern • meets attachment and nurturing needs
  • 12. MINIMISING RISK: Risk is minimised by the philosophy of care underpinning Kitwood’s person centred care approach. Any risk of emotional trauma and the doll would be removed/withdrawn.
  • 13. DEMENTIA GETS DOLLED UP:
  • 14. METHODOLOGY: Phase 1 – Pre introduction of Doll • Selection criteria • Observations for a week regarding behaviours of concern • Collection of data
  • 15. METHODOLGY: Phase 2 – Introduction of Doll • Doll selection • ‘Gifting’ of doll to participant • Resident and staff reactions significant
  • 16. DEMENTIA GETS DOLLED UP:
  • 17. METHODOLOGY: Phase 3: Post introduction of doll • Observations for a week re behaviours of concern • Monitoring of changes other than behaviours of concern eg. interaction/mobility/intake/communication
  • 18. DEMENTIA GETS DOLLED UP:
  • 19. RESULTS: • Considerable decline in behaviours of concern – anxiety/ agitation/tremors/panic attacks/tearfulness • Improved communication with staff and residents • Improved intake and dining experience/weight management • Improved mobility due to changed focus/decreased anxiety • Reduced social isolation and withdrawal • Improved well being – delight/joy • Comfort • Sense of control • Personhood validated
  • 20. UNEXPECTED RESULTS: Impact on other residents: • Approached resident/doll for a nurse • Asked the infants name • Initiated conversation • Both men and women involved positively Staff: • Tears – (happy tears) • Reinforced the possibilities open to them as caregivers
  • 21. DEMENTIA GETS DOLLED UP:
  • 22. CONCLUSIONS: Substantial evidence to support the potential benefits of the use of doll therapy in: •  Reduced behaviours of concern such as anxiety and agitation •  Meeting of attachment needs •  Stimulation of the nurturing instinct •  Conversion of ill being to well being •  Retention of personhood •  Improved interaction •  Meeting of emotional needs •  Providing comfort, peace, a sense of control
  • 23. DEMENTIA GETS DOLLED UP: •  Has extended our understanding of the use of complementary therapies to inform professional practice •  Promotes opportunities for the exchange of knowledge •  Stimulates research and promotes best practice •  Encourages change in attitude of one of the 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.
  • 24. FURTHER INFORMATION: • This research project emerged out of a minor thesis as part of a Master of Health Science – Aged Services program at Victoria University, Melbourne and a recently published paper 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, 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).
  • 25. DEMENTIA GETS DOLLED UP:
  • 26. DEMENTIA GETS DOLLED UP: “Be the change you want to see in the world.” Ghandi
  • 27. 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: 10. 1177/1471301211431362. 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.