The effect of doll therapy on cognitive status and agitation among elderly with dementia

Dementia is an acquired organic mental disorder that causes heavy loss of intellectual capacity which provides physical and psychosocial functionality. Agitation is one of the most important neuropsychiatric symptoms which affect the daily life of the patients along with cognitive decline among people with dementia. Doll therapy is a non-pharmacological method utilized in the management of behavioral symptoms like agitation for people diagnosed with moderate to severe dementia. The purpose of the therapy is to enable the elderly to feel themselves useful and needed and to provide them with something positive to focus on. In this respect, this study was conducted as an experimental design in order to test the effect of DT on cognitive state and agitation among long term institutionalized dementia patients. The universe of the study is 110 elderly patients hospitalized in an institutionalized care center in a city. The size of the sampling was calculated using power analysis. The sample of the study consisted of DT (Doll Therapy) Group and C (Control group) including 16 and 19 patients respectively. Cohen-Mansfield Agitation Inventory (CMAI) and Mini Mental State Examination (MMSE) were used as data gathering tools. The results were categorized as the beginning (T0), the week right after DT (T1), and as 3-months application (T2). The elderly in the group are similar in their socio-demographic features, nature of their institutional care, psychiatric history, physical diseases, cognitive and agitation levels (p>0.05). A meaningful difference was found between DT and K groups in their CMAI total agitation level and Physical Non-Aggressive agitation level in favor of DT sample (p<0.05). However, the difference among CMAI Verbal Non-Aggressive, Verbal Aggressive and Physical Aggressive agitation sub dimensions and the change in MMSE levels did not prove to be significant (p>0,05). The results proved DT effective in stopping the progression of dementia but not the reversal of the process. In fact, agitation scores at total, sub dimension and item level increased over time. In other words, non-intervention group had a striking decline. 4-week DT was realized as an enjoyable and purposeful activity for the elderly diagnosed with dementia and caretakers expressed that the dolls provided emotional support for the patients. Keywords: Doll Therapy, Dementia, Elderly, Agitation, Cognitive Status