End of life and dementia

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End of life conversations can be challenging. That said,  it is unlikely that most of us don’t have some firm ideas of how we would like to conclude a life lived.

This post looks at a variety of considerations and discussions around this very important topic.


Dementia Australia resources

palliative care and dementia _ daPalliative care and dementia : Paper 43 (2018)
This Dementia Australia discussion paper provides guidance for health professionals on palliative and end-of-life care for people with dementia and those who support them.

Download paper

 

Start2Talk has been developed by Dementia Australia and our partners to help all Australians start the conversations involved in planning ahead.

 


making tough decisionsMaking Tough Decisions about End-of-Life Care in dementia  by Anne Kenny (2018)

In Making Tough Decisions about End-of-Life Care in Dementia, Dr. Anne Kenny, a skilled palliative care physician, describes how to navigate the difficult journey of late-stage dementia with sensitivity, compassion, and common sense. Combining her personal experience caring for a mother with dementia with her medical expertise in both dementia and end-of-life care, Dr. Kenny helps the reader prepare for a family member’s death while managing their own emotional health.

Drawing on stories of families that Dr. Kenny has worked with to illustrate common issues, concerns, and situations that occurs in late-stage dementia, this book includes practical advice about

• making life-altering decisions while preparing for a loved one’s inevitable death
• medical care, pain, insomnia, medication, and eating
• caring for the caregiver
• having conversations about difficult topics with other family members and with health care, legal, and financial professionals

Available from the Dementia Australia library in hard copy or Ebook


Ted talk: How my dad’s dementia changed my idea of death (and life)

Beth Malone (2017)

With warmth and grace, Beth Malone tells the deeply personal story of her dad’s struggle with frontotemporal lobe dementia, and how it changed how she thinks about death (and life). A moving talk about a daughter’s love — and of letting go and finding peace.

 


end of life careEnd of life care for people with dementia : a person-centred approach  /  Murna Downs, Laura Middleton-Green, Jane Chatterjee and Sarah Russell.  (2017)

This book describes not only what can be done to ensure maximum quality of life for those in the final stages of the illness, but also how best to support those involved in caring for them. Emphasising the importance of being attuned to the experiences and needs of the person with dementia, the authors explain why and how they should be included in decisions relating to their end of life care. Practical strategies for ensuring physical and emotional wellbeing are provided, drawing on useful examples from practice and providing solutions to potential challenges that carers and family members will face. Dilemmas surrounding end of life care are explored in detail, including the moral dilemma of medical intervention, and the authors suggest ways of supporting family members through the process in terms of providing information, helping them adjust to change and loss, and involving them in their relative’s care, and at how care staff can be supported through appropriate education and training, team building and information-giving.

Available from the Dementia Australia library in hard copy or Ebook


death talkerThe death talker : what we need to know to help us talk about death  /  Molly Carlile  (2016)

Since the dawn of time, human beings have been curious about death. Most of us have little time in our busy lives to think about the things that are important to us. Often, it s not until we have a personal experience that we give any serious thought to our own life and our mortality.

The Death Talker offers a common sense approach to the issues we should all be thinking about so we can live and die well. The personal stories and practical information provide a sensitive guide for exploring the stuff that matters to each of us and to help us have meaningful conversations with the people we love.

Molly Carlile AM has over twenty years experience as a specialist palliative care nurse, grief and bereavement counsellor and educator. More recently she has held senior executive roles in both palliative care and acute health, currently as Chief Executive Officer of a large metropolitan, community palliative care service.

Available from the Dementia Australia library


being mortalBeing mortal  /  Atul Gawande  (2014)

Medicine has triumphed in modern times, transforming the dangers of childbirth, injury, and disease from harrowing to manageable. But when it comes to the inescapable realities of aging and death, what medicine can do often runs counter to what it should.

Through eye-opening research and gripping stories of his own patients and family, Gawande reveals the suffering this dynamic has produced. Nursing homes, devoted above all to safety, battle with residents over the food they are allowed to eat and the choices they are allowed to make. Doctors, uncomfortable discussing patients’ anxieties about death, fall back on false hopes and treatments that are actually shortening lives instead of improving them.

In his bestselling books, Atul Gawande, a practicing surgeon, has fearlessly revealed the struggles of his profession. Now he examines its ultimate limitations and failures-in his own practices as well as others’-as life draws to a close. Riveting, honest, and humane, Being Mortal shows how the ultimate goal is not a good death but a good life-all the way to the very end.

Available from the Dementia Australia library in hard copy or Ebook


good life to the end.jpgA Good Life to the End Taking control of our inevitable journey through ageing and death  / Ken Hillman (2017)

A huge majority of people at the end of their lives want to die at home, but only a small number manage to do this. This vital book asks why.

Professor Ken Hillman has worked in intensive care since its inception. But he is appalled by the way the ICU has become a place where the frail, soon-to-die and dying are given unnecessary operations and life-prolonging treatments without their wishes being taken into account.

A Good Life to the End will embolden and equip us to ask about the options that doctors in hospital should offer us but mostly don’t. It lets us know that there are other, gentler options for patients and their loved ones that can be much more sympathetic to the final wishes of most people facing the end of their lives.

Available from the Dementia Australia library in hard copy or Ebook


Website : Dying to talk – Palliative Care Australia
Dying to Talk aims to reach into the community to normalise dying in Australia and to help Australians work out what’s right for them at the end of their lives. Having a conversation with your loved ones about your end-of-life wishes will help them to make decisions on your behalf should you be unable to communicate your wishes. The Dying to Talk Discussion Starter guides you through talking with your loved ones.

http://dyingtotalk.org.au/


when breath becomes air.jpgWhen breath becomes air  /  Paul Kalanithi  (2016)
When Breath Becomes Air chronicles Kalanithi’s transformation from a medical student asking what makes a virtuous and meaningful life into a neurosurgeon working in the core of human identity – the brain – and finally into a patient and a new father.What makes life worth living in the face of death? What do you do when when life is catastrophically interrupted? What does it mean to have a child as your own life fades away?Paul Kalanithi died while working on this profoundly moving book, yet his words live on as a guide to us all. When Breath Becomes Air is a life-affirming reflection on facing our mortality and on the relationship between doctor and patient, from a gifted writer who became both.

Available from the Dementia Australia library in hard copy or Audio book 


2013 post    End of life planning and care for people with dementia

 

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Poetry and dementia

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Poetry reaffirms our common humanity by revealing to us that individuals, everywhere in the world, share the same questions and feelings. Poetry is the mainstay of oral tradition and, over centuries, can communicate the innermost values of diverse cultures.

This post looks at how poetry might intersect with dementia.


poetryanddementiaPoetry and dementia : a practical guide  /  John Killick  (2017)

Poetry is an engaging and inclusive activity for older people that can help develop memory, imagination and identity. This book provides guidance on setting up and monitoring poetry projects for people living with dementia in group care homes and individual families. It explains the benefits of creative expression for people with dementia, and shows how to facilitate poetry reading and writing groups in different environments.Specific techniques for introducing poetry to older people can be employed by family members or professional care staff to enhance the wellbeing of the individual living with dementia. The ethical issues of running poetry projects in dementia care are explored along with examples of poetry produced by individuals and groups, interviews with care workers, and case studies.

Available from the Dementia Australia library in hard copy or Ebook


forget-me-nots-2017Forget-me-nots = Spominčice  /  Danijela Hliš ; editor, Blaž Propótnik ; illustrations, Stephen Wilson.  (2017)

A bilingual collection of poems and stories about living with dementia, written by author Danijela Hlis.
The book titled Forget me nots/Spomincice is written in Slovenian and English and it has received a grant from the Slovenian Ministry of Arts and Culture.
With 45 years of writing behind her and two previous published books, (Hideaway Serenade and Whisper), Danijela has used her writing talents as well as her experiences with people living with dementia to produce the new book.
For bilingual individuals living with dementia, reversion to their first language is common. Without support and engagement tailored to the individual’s language and culture, communication difficulties and isolation can occur.

Available from the Dementia Australia library


memory weaving_webMemory weaving: an anthology of dementia journeys  /  edited by Carolyn Vimpani  (2014)

The threads of each of our lives are woven to form unique personal memories, our stories.  With the onset of dementia these threads become tangled and frayed forming unfamiliar designs interwoven with strands collected from yesterday’s fragmented recollections and today’s confusing encounters.
If you have or care for someone with dementia, you will find your own experiences in this anthology.  If you want family and friends to understand the journey you and the one you love are making, give them this book!’ (from the cover)

Available from the Dementia Australia library


love-life-loss-v2Love Life Loss – A Roller Coaster of Poetry Volume 2 : Days with Dementia / Kate Swaffer (2016)

“What do you do with a diagnosis of dementia? And especially younger-onset dementia? in this second volume of poetry, Kate Swaffer responds with love, life and torrents of words. Some of the words show loneliness and fear, exclusion, apprehension. But her strong theme is how to be a vigorous involved participant in the world of light, gardens, cats and, above all, people. Her poems affirm ‘believe you can when others say you can’t’. And on behalf of people with dementia, ‘we are all real!’ ‘Like a good red wine or an old red rose’, these poems are full of wisdom, understanding and a view of the world from someone with dementia, living through dementia but also above dementia.” – Emeritus Professor Roly Sussex

Available from the Dementia Australia library


brainisaboundaryThe Brain is a Boundary : A Journey in Poems to the Boundaries of Lewy Body Dementia  /  By Alexander Dreier , Introduction by Arthur G. Zajonc  (2016)

There are many boundaries in consciousness, such as those between waking and sleeping, language and reality, life and death, observer and observed.
Alexander Dreier, an author, poet, comedian and student of human consciousness, was diagnosed with Lewy Body dementia. This unique collection of poems explores crossing boundaries in a brilliant and moving way, recording the author’s journey over the boundary from one existance to another.
The book includes an introduction by Arthur Zajonc, the former President of the Mind-Life Institute.
Available from the Dementia Australia library


articles_finalGaps and spaces: Representations of dementia in contemporary British poetry  /  Hannah Zeilig in Dementia: The international journal of social research and practice, Volume 13, Number 2, March 2014
This article considers the work of a number of contemporary British poets who have attempted to articulate some of the experiences that dementia entails. The unique potential of poetry as a means of portraying the dislocations and reinventions of self that dementia involves has been mostly overlooked. The insights offered by critical gerontology are central to this article. This perspective calls for critical thought about the ways in which dementia has been socially constructed. The challenges posed by poets such as Vuyelwa Carlin, Valerie Laws and Jo Shapcott in particular, are examined. The complex poetic representations offered by these poets acknowledge the pathological declines of dementia and simultaneously celebrate the individuality and life of their subjects. Considering dementia with reference to the work of contemporary poets and critical gerontology is one way in which we can deepen our understanding of what this illness involves and humanise those who suffer from it.
Request from the Dementia Australia library

Healing words: A study of poetry interventions in dementia care / Aagje M.C. Swinnen in Dementia: The international journal of social research and practice,
Vol 15, Issue 6, pp. 1377 – 1404

This article focuses on poetry interventions as one example of cultural arts interventions. The use of poetry might seem counterintuitive, given that people with dementia lose their language abilities and that poetry is regarded to be the most complex literary form. The author argues that expanding on existing research on poetry interventions from a health and science perspective with a humanities approach will help illuminate how poetry works to enhance the exchange with people with dementia. Drawing on participant observations of poetry interventions by Gary Glazner (Alzheimer’s Poetry Project, USA) at the New York Memory Center, the author frames poetry interventions as a specific form of oral poetry in which people with dementia are positioned as cocreators of embodied texts and directly benefit from the power of the spoken word.
Request from the Dementia Australia library

 

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Younger onset dementia

 

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In 2018, there is an estimated 26,443 people with younger onset dementia in Australia, expected to rise to 29,375 people by 2025 and 42,252 people by 2056

Younger onset dementia describes any form of dementia that has an onset of symptoms before age 65. Dementia can develop at any age, but a lack of awareness and understanding, even among health professionals, means that people with younger onset dementia are often misdiagnosed and face even longer delays in getting a diagnosis of dementia.

This post looks at some recent resources around younger onset dementia as well as revisiting some older favourites.


Dementia Australia help sheets 


 Prescription for life (2016)

Lovell-ebook

The Lovell Foundation has teamed up with Edith Cowan University (ECU) and not-for-profit aged care and retirement living providers Bethanie and Mercy Health, to develop an  innovative educational toolkit to support carers of people living with Younger Onset Dementia (YOD).

The e-flipbook incorporates pre- and post-knowledge tests, which will allow anyone who completes the book to be credited with professional development.

Download the free E-Resource

 


somebodyIusedtoKnowSomebody I Used to Know  /   Wendy Mitchell and Anna Wharton  (2018)

When she was diagnosed with dementia at the age of fifty-eight, Wendy Mitchell was confronted with the most profound questions about life and identity. All at once, she had to say goodbye to the woman she used to be. Her demanding career in the NHS, her ability to drive, cook and run – the various shades of her independence – were suddenly gone.

Philosophical, profoundly moving, insightful and ultimately full of hope, Somebody I Used to Know is both a heart-rending tribute to the woman Wendy once was, and a brave affirmation of the woman dementia has seen her become.

 


young onset dementia_ 2018Young onset dementia : a guide to recognition, diagnosis, and supporting individuals with dementia and their families  /  Hilda Hayo, Alison Ward, and Jacqueline Parkes (2018)

The book explores the experiences of people living with a diagnosis of young onset dementia through detailed case studies, and gives learning points to implement in practice for the better provision of appropriate support and care. It explains the need for adapting services which are often designed for older people, and how the complicated diagnostic process can lead to misdiagnosis among younger people. Key issues are considered, including at-risk groups, work and dealing with potential loss of employment, changes in personal and family relationships, readjusting life expectations and plans, and social isolation.

 


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Supporting people with younger onset dementia in the National Disability Insurance Scheme (NDIS) / Dementia Australia (2017)

The National Disability Insurance Scheme (NDIS) is the new way supports will be provided to eligible Australians with a disability or disease such as younger onset dementia.

The purpose of the NDIS is to provide people with greater choice, individualised support and the flexibility to manage these supports.

People living with younger onset dementia are now better equipped to understand and navigate the NDIS through the release of the NDIS Toolkit for People Living with Younger Onset Dementia and their Carers 

 


before I forget_lge.jpgBefore I Forget: How I Survived a Diagnosis of Younger-Onset Dementia at 46  /  Christine Bryden  (2015)

When she was just 46, Christine Bryden – science advisor to the prime minister and single mother of three daughters – was diagnosed with younger-onset dementia. Doctors told her to get her affairs in order as she would soon be incapable of doing so. Twenty years later she is still thriving, still working hard to rewire her brain even as it loses its function.
The unusually slow progress of her condition puts Christine in a unique position to describe the lived experience of dementia, a condition affecting tens of millions of people worldwide. In this revealing memoir, she looks back on her life in an effort to understand how her brain – once her greatest asset, now her greatest challenge – works now. She shares what it’s like to start grasping for words that used to come easily. To be exhausted from visiting a new place. To suddenly realise you don’t remember how to drive. To challenge, every day, the stereotype of the ’empty shell’. Brave and inspiring, this is Christine’s legacy for people with dementia and those who care about them.


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Dementia Australia Quality Dementia Care Series

Quality Dementia Care 5 (2015)
Younger onset dementia: a practical guide
Quality Dementia Care 4 (2013)
Understanding younger onset dementia 

 


what-the-hell-happened-to-my-brainWhat the Hell Happened to My Brain? : Living beyond dementia  /  By Kate Swaffer  (2016)

Kate Swaffer was just 49 years old when she was diagnosed with a form of younger onset dementia. In this book, she offers an all-too-rare first-hand insight into that experience, sounding a clarion call for change in how we ensure a better quality of life for people with dementia. Kate describes vividly her experiences of living with dementia, exploring the effects of memory difficulties, loss of independence, leaving long-term employment, the impact on her teenage sons, and the enormous impact of the dementia diagnosis on her sense of self. Never shying away from difficult issues, she tackles head-on stigma, inadequacies in care and support, and the media’s role in perpetuating myths about dementia, suggesting ways in which we can include and empower people with the diagnosis. She also reflects on the ways in which her writing and dementia advocacy work have taken her on a process of self-discovery and enabled her to develop a new and meaningful personal identity. Kate’s powerful words will challenge misconceptions about dementia, and open our eyes to new ways of supporting people with the diagnosis.


Fiction

rain birdsRain birds  /  Harriet McKnight.  (2017)

Alan and Pina have lived contentedly in isolated – and insular – Boney Point for thirty years. Now they are dealing with Alan’s devastating early-onset Alzheimer’s diagnosis. As he is cast adrift in the depths of his own mind, Pina is left to face the consequences alone, until the arrival of a flock of black cockatoos seems to tie him, somehow, to the present.
Nearby, conservation biologist Arianna Brandt is involved in a project trying to reintroduce the threatened glossy black cockatoos into the wilds of Murrungowar National Park. Alone in the haunted bush, and with her birds failing to thrive, Arianna’s personal demons start to overwhelm her and risk undoing everything.
At first, when the two women’s paths cross, they appear at loggerheads but – in many ways – they are invested in the same outcome but for different reasons.
Ultimately, unexpected events will force them both to let go of their pasts and focus on the future.

beforeyouforgetBefore you forget  /  Julia Lawrinson (2017)

Year Twelve is not off to a good start for Amelia. Art is her world, but her art teacher hates everything she does ; her best friend has stopped talking to her ; her mother and father may as well be living in separate houses; and her father is slowly forgetting everything. Even Amelia.

 

 

forgetting-fosterForgetting Foster  /  Dianne Touchell  (2016)

‘Foster suddenly recognised the feeling that rolled over him and made him feel sick. It was this: Dad was going away somewhere all on his own. And Foster was already missing him.’ Foster Sumner is seven years old. He likes toy soldiers, tadpole hunting, going to school and the beach. Best of all, he likes listening to his dad’s stories. But then Foster’s dad starts forgetting things. No one is too worried at first. Foster and Dad giggle about it. But the forgetting gets worse. And suddenly no one is laughing anymore.


For more resources see our 2013 post on younger onset dementia

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Fiction and dementia

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Stories have been told for as long as we have been able to speak.  The writing and reading of fiction to facilitate the telling and retelling of stories is an important aspect of being human. The enduring appeal of the novel is demonstrated by the place of libraries and bookshops in the community, the flourishing of book groups and the popularity of creative writing courses.
The body of work weaving the topic of dementia into everyday stories continues to grow.
Take a look at some of the standout titles added in 2017 and consider for your summer reading list.

A full list of fiction  held in the Dementia Australia libraries can be found here.


 

rain birdsRain birds  /  Harriet McKnight (2017)
Alan and Pina have lived contentedly in isolated – and insular – Boney Point for thirty years. Now they are dealing with Alan’s devastating early-onset Alzheimer’s diagnosis. As he is cast adrift in the depths of his own mind, Pina is left to face the consequences alone, until the arrival of a flock of black cockatoos seems to tie him, somehow, to the present.

Nearby, conservation biologist Arianna Brandt is involved in a project trying to reintroduce the threatened glossy black cockatoos into the wilds of Murrungowar National Park. Alone in the haunted bush, and with her birds failing to thrive, Arianna’s personal demons start to overwhelm her and risk undoing everything.

At first, when the two women’s paths cross, they appear at loggerheads but – in many ways – they are invested in the same outcome but for different reasons.
Ultimately, unexpected events will force them both to let go of their pasts and focus on the future.

 

gingerbread houseThe gingerbread house  /  Kate Beaufoy  (2017)

Recently-redundant Tess is keen to start work on a novel and needs to make it work. She and her freelance journalist husband Donn desperately need the money and three weeks looking after Donn’s aged mother while the carer takes a break seems like an opportunity to get started. She knows it’ll be tough looking after Eleanor, who has increasingly severe dementia, but she’ll surely find some time for herself, won’t she? Arriving at the isolated country house their daughter Katia has named The Gingerbread House, a tearful Tess begins to realise that she has a far more difficult few weeks ahead than expected. Her mother-in-law is now in need of constant attention and Donn can’t help as he has to stay in town for work. Narrated by Katia – their only child – who prefers not to speak but observes everything, The Gingerbread House is a deeply moving and compassionate story of a family and its tensions and struggles with her grandmother’s dementia, as the reclusive teenager describes the effect it has on everyone in a strangely detached but compassionate way.

 

goodbye vitaminGoodbye, vitamin  /  Rachel Khong (2017)

Ruth is thirty and her life is falling apart: she and her fiancé are moving house, but he’s moving out to live with another woman; her career is going nowhere; and then she learns that her father, a history professor beloved by his students, has Alzheimer’s. At Christmas, her mother begs her to stay on and help. For a year. Goodbye, Vitamin is the wry, beautifully observed story of a woman at a crossroads, as Ruth and her friends attempt to shore up her father’s career; she and her mother obsess over the ambiguous health benefits – in the absence of a cure – of dried jellyfish supplements and vitamin pills; and they all try to forge a new relationship with the brilliant, childlike, irascible man her father has become.


Young adult writing

beforeyouforgetBefore you forget  /  Julia Lawrinson (2017)

Year Twelve is not off to a good start for Amelia. Art is her world, but her art teacher hates everything she does ; her best friend has stopped talking to her ; her mother and father may as well be living in separate houses; and her father is slowly forgetting everything. Even Amelia.

At times funny, at times heartbreaking, this is an ultimately uplifting story about the delicate fabric of family and friendship, and the painful realisation that not everything can remain the same forever.


For the younger readers

grandma_forgets

Grandma forgets  /  Paul Russell and Nicky Johnston.  (2017)

A warm, uplifting picture book about a family bound by love as they cope with their grandmother’s dementia. When your grandmother can’t remember your name it should be sad, but maybe it is just an opportunity to tell her more often how much you love her. Over the years, the little girl has built up a treasure trove of memories of time spent with Grandma: sausages for Sunday lunch, driving in her sky-blue car to the beach, climbing her apple trees while she baked a delicious apple pie, and her comforting hugs during wild storms. But now, Grandma can’t remember those memories. She makes up new rules for old games and often hides Dad’s keys.  This is a warm, hopeful story about a family who sometimes needs to remind their grandmother a little more often than they used to about how much they care.


Past posts highlighting fiction

2017

2016


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Doll, child or animal representational therapy and dementia

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Doll therapy, child representational therapy and animal representational therapy are successful forms of therapy for supporting some people with dementia. It has been found, both anecdotally and clinically,  that these therapies can reduce anxiety and agitation  and have a truly trans-formative effect for some people with dementia, bringing them a sense of purpose, joy and peace.


doll therapy in dementia careDoll Therapy in Dementia Care : Evidence and Practice  /  Mitchell, Gary  (2016)

Advocating doll therapy as an intervention for people with dementia, this book combines theory and evidence to show its many benefits and present guidelines for best-practice. Despite being widely and internationally used, doll therapy is a controversial and often misunderstood intervention. This book debunks the myths surrounding doll therapy, highlighting its proven positive impact on the well-being of people with dementia. The book gives care professionals an indispensable overview of doll therapy within the context of current advocated best practices, using original research and evidence to present the rationale of its use. The book also engages with ethical issues, ensuring that professionals are aware of the aspects of doll-therapy that may be counter-productive to person-centred care. Providing clear guidelines on how best to utilise doll therapy, this comprehensive book is an important resource for any professional looking to implement this intervention.

 


Understanding Behaviour in Dementia that ChallengesUnderstanding behaviour in dementia that challenges  /  Ian Andrew James and Louisa Jackman  (2017)

This revised second edition guide to assessment and treatment of behaviours that challenge associated with dementia includes a chapter on the  Use of therapeutic dolls 

 


 

articles_finalTherapeutic use of dolls for people living with dementia: A critical review of the literature (2016) in Dementia Vol 15, Issue 5

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.
Abstract

Implementation of a baby doll therapy protocol for people with dementia: Innovative practice (2015) in Dementia Vol 14, Issue 5

Dementia is exhibited by both emotional and physical states such as agitation. Chemical restraints, often used for agitated behaviors, are not always effective and produce untoward effects. Baby doll therapy is a nonpharmacologic therapy that can affect agitated behavior in dementia patients, yet a protocol for the therapy did not exist. An implementation protocol for doll therapy for those with dementia was developed and implemented with 16 residents in a dementia care center. Outcomes were measurements of the impact of the dolls on six areas of the resident’s behavior and their reactions to the doll. Participants had an increase in level of happiness, activity/liveliness, interaction with staff and others, and ease of giving care. There was also a reduction in the level of anxiety. The increase in happiness was a statistically significant outcome. Baby doll therapy is an effective nonpharmacological approach for improving the well-being of patients with moderate to severe dementia.
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The utilization of robotic pets in dementia care (2017) in Journal of Alzheimer’s Disease. Vol.55(2) pp. 569-574.

Behavioral problems may affect individuals with dementia, increasing the cost and burden of care. Pet therapy has been known to be emotionally beneficial for many years. Robotic pets have been shown to have similar positive effects without the negative aspects of traditional pets. Robotic pet therapy offers an alternative to traditional pet therapy.
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Group sessions with Paro in a nursing home: Structure,observations and interviews (2016) in Australasian Journal on Ageing Volume 35, Issue 2 June  pp. 106–112

Observations were conducted focusing on engagement, how residents treated the robot and if the robot acted as a social catalyst. In addition, 16 residents and 21 staff were asked open-ended questions at the end of the study about the sessions and the robot.
This study supports other research showing Paro has psychosocial benefits and provides a guide for those wishing to use Paro in a group setting in aged care.
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Maria’s baby: a case study  (2016) in Nursing Ethics. Vol.23(6),  pp. 713-716.

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