Non-pharmacological therapies: Reminiscence and doll

therapy - Text Overview of Video

Professor Fran McInerney

Can you talk to us a little bit about what reminiscence is?

Dr Joanna Sun
So, reminiscence therapy, that's really quite popular, even when I was working. There's a lot
of different ways you can do or carry out reminiscence therapy. So, I think one of the most
common ones would be just looking at photo books, and it can be done in a family setting or
in a more professional aged care setting, as well. And for example, with photo books you
may get the family, or the family themselves, they may contribute some old photos and
they'll populate the books with those, and then they'll talk about each of the photos with
the person, so it helps to get the person to communicate and have them think about some
of these happier memories of the past. Yeah, but it can be a bit tricky. So, I think with
reminiscence therapy, sometimes with reminiscence therapy there may be a bit of trauma,
as well, with some of the memories, and we can't discount that. So for example, talking
through one of my clients, it brought back thoughts about a child that passed away. When
she saw a family photo, she started crying. And it's okay.

Professor Fran McInerney

Yeah, it's interesting, isn't it? We were earlier talking about ongoing reminders of the death
of a mum, or indeed the loss of a child. It's not that all memories are happy and it's not that
we're trying to protect the person from any feeling other than happy feelings. If we're
serious about the dignity of the person and the validity of their feelings, we have to be open
to them shedding tears about the loss of a child. And that might be a real loss, it might be an
imagined loss, but it's still real for the person. So, being prepared for that, being
acknowledging of that pain, and being comforting in that space, just like we'd all expect
comforting, be it a handhold, a cup of tea, perhaps a distraction or a comfort with music or
something to help the person process their feelings. So, yes, they're often really positive,
those reminiscence activities, but you know if we're reminiscing, even as a group, about oh,
I don't know, going through the war, for some people, and looking at rationing, for example,
that might spark conversation and connection, but it might also bring up some pain. And
that's life, isn't it?

Dr Joanna Sun
That's right.

From the Understanding Dementia MOOC https://mooc.utas.edu.au

©2021, Wicking Dementia Research and Education Centre, University of Tasmania
1
 Professor Fran McInerney
But we're not trying to deliberately inflict pain. We're trying to accept and respond to pain,
and help people work through positive and negative feelings, that people with dementia are
entitled to. Okay. So, we've come a long way, I hope, from this strict reality orientation,
where we have to know everything according to what we believe is true, to a more nuanced
or a subtler way of understanding reality; the present, the past and the future.
Another approach that has some controversy or argument attached to it, that we might
touch on, is 'doll therapy.' Can you talk to us a little bit about what doll therapy means, Jo?

Dr Joanna Sun
So, for doll therapy, when I was working in aged care and we carried out doll therapy,
basically the person would have a doll, and the doll would be quite lifelike, for some. Some
of them, it could be pets as well. So, there's a range of different types of dolls that people
can use. The most important thing with the doll therapy was that the doll, when we carry
out doll therapy, it needs to be respected and the doll needs to be treated like a person as
well.

Professor Fran McInerney

Right.

Dr Joanna Sun
Because the person living with dementia, they have quite a tight association or a
relationship with the doll. A lot of them may feel that it may be a child, or their child, and
you can see a lot of people carrying out very maternal sort of behaviours with the doll. And
it helps to improve their quality of life. People have a close association with the doll.

Professor Fran McInerney

So yes, so we're talking about a doll that is potentially assuming the role of a child.

Dr Joanna Sun
That's right.

Professor Fran McInerney

And we know for many people with dementia there's some social isolation, there's some
loss of intimate relationships and there may be that desire to nurture, which is a normal
human response, and so the doll becomes a substitute care object for the person. Okay, so
you mentioned 'maternal.' I wondered, do men have any role in this? Are they allowed to
have paternal feelings?

From the Understanding Dementia MOOC https://mooc.utas.edu.au

©2021, Wicking Dementia Research and Education Centre, University of Tasmania
2
Dr Joanna Sun
That is true, yes. So yes, we do have men that have yeah, definitely it brings up that
nurturing aspect of them, and yes that paternal side of the person really comes out and they
really take a lot of time to take great care with the doll. So yeah, it has been very effective
for some people.

Professor Fran McInerney

Yes, and when you say for some people, that's like any strategy. We're wanting to evaluate
its effectiveness. So, we're not blanket saying "doll therapy is the go" or indeed
"reminiscence therapy is the go for everyone." We're looking at its appropriateness for an
individual, but we're wanting to give it its best chance. What I've observed, and what some
of the literature tells us from time to time, is that staff or family can feel that this is
patronising, or treating the person with dementia as a child, and being untrue to them by
pretending that the doll is real. To call on those principles of validation that we've discussed,
if you believe that the doll is real and you have a nurturing, meaningful relationship with
that doll, it's not for us to dismiss that.

Dr Joanna Sun
That's right.

Professor Fran McInerney

What I have seen done a couple of times is staff resisting the doll therapy and throwing the
doll in a cupboard at the end of the day. Now if you're a person living with dementia and
you believe that this is an infant, that's a quite traumatic thing to be doing.

Dr Joanna Sun
And it's really disrespectful, as well, to the person, and it can be quite a shocking scenario
for the person, and they may exhibit behaviours.

Professor Fran McInerney

That's right. We may have escalation of the very behaviours that we're hoping to reduce, to
help the person live as best a life as they can. So, if we're going to engage in doll therapy, in
that doll/infant way, as opposed to this is just a fun doll to hold, if we're going to do that, we
all have to be committed to that.

Dr Joanna Sun
That's right.

From the Understanding Dementia MOOC https://mooc.utas.edu.au

©2021, Wicking Dementia Research and Education Centre, University of Tasmania
3
 Professor Fran McInerney
Families, staff, at home, in an institution, wherever the setting might be, we have to take it
seriously and respect that that doll, it needs a place to sleep, it needs to be taken seriously.

From the Understanding Dementia MOOC https://mooc.utas.edu.au

©2021, Wicking Dementia Research and Education Centre, University of Tasmania
4