title: Therapeutic use of dolls for people living with dementia: A critical review of the literature.
abstract: BACKGROUND
  There are a number of therapies currently available to assist healthcare professionals and carers with non-pharmacological treatment for people living with dementia. One such therapy that has been growing in clinical practice is doll therapy. Providing dolls to some people living with dementia has the potential to enhance personal well-being through increased levels of communication and engagement with others. Despite its potential for benefits, the practice is currently under-developed in healthcare literature, probably due to varied ethical interpretations of its practice.
  
  
  OBJECTIVE
  To undertake a critical review of the published literature on doll therapy, using the Critical Appraisal Skills Programme Checklist (CASP) tool, in order to determine the potential benefits and challenges of this therapy for people living with dementia.
  
  
  METHODS
  A comprehensive literature search, incorporating the CINAHL, Medline, Embase, PubMed, Joanna Briggs, Cochrane Library and PsycINFO data bases, was conducted.
  
  
  CONCLUSIONS
  Despite many commentaries and anecdotal accounts of the practice, this review identified only 11 empirical studies that were eligible. The majority of studies found that the use of dolls could be therapeutic for some people living with dementia by reporting increased levels of engagement, communication and reduction in episodes of distress. Some studies identified limitations to the therapy including; confusion over the ownership of the doll and healthcare professional uncertainty about issues pertaining to autonomy.
  
  
  CONCLUSIONS
  According to this review, doll therapy has the potential to increase the well-being of some people living with dementia. This review illuminates that some healthcare professionals feel uncomfortable about its use in clinical practice. The operationalisation of doll therapy in clinical practice has been shown to be inconsistent with different approaches to the practice being advocated. This highlights the need for further empirical research to identify best practice and education to increase awareness in both healthcare professional and carer populations.
authors.affiliation: Dementia Services Northern Ireland & Wales, Four Seasons Health Care, Northern Ireland, United Kingdom; School Of Nursing And Midwifery, Queen's University Belfast, United Kingdom gary.mitchell@fshc.co.uk.
authors.forename: Gary
authors.initials: G
authors.lastname: Mitchell
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom; Buskerud Vestfold University College, Drammen, Norway; University of Technology, Sydney, Australia; School of Medicine & Dentistry, University of Aberdeen, United Kingdom; Department of Nursing, University of Pretoria, South Africa.
authors.forename: Brendan
authors.initials: B
authors.lastname: McCormack
authors.affiliation: Institute of Nursing and Health Research, School of Nursing, University of Ulster, Newtownabbey, United Kingdom.
authors.forename: Tanya
authors.initials: T
authors.lastname: McCance
mesh_terms: D003704:Dementia / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D018802:Patient-Centered Care; D010989:Play Therapy / Q000379:methods*; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Alzheimer’s disease; dementia; doll therapy; non-pharmacological interventions; person-centred care; therapeutic interventions