If you want to argue with me about religion, I’m likely to tell you that we should agree to disagree.

If you don’t like my views on politics, I’ll just walk away.

I don’t engage in Facebook arguments. I’ll just unfollow you.

But if you want to question my views on doll therapy for those living with dementia, you’d better be ready for a fight.

Fair warning: If you are a blog subscriber and are opening your email first thing on a Monday morning to skim my post, do yourself a favor and go get some coffee first. I have a lot to say, and I don’t want you to have to endure it uncaffeinated.

There are some people who don’t think we should give people with dementia baby dolls. They think it’s demeaning. They think it takes away their dignity. They worry that we are treating adults like children.

I disagree.

I think it gives them something important–a sense of purpose.

Let me back up a bit.

I am fascinated by issues of gender and society. And this fascination plays into why the baby doll topic interests me. In my years of visiting memory care communities, I’ve never seen a guy with dementia carrying around a doll. Yet, women caring for their babies is a common sight.

When I talk about dolls at in-services, I ask staff if they’ve ever had a man who took an interest in a doll. I can only remember one instance when they responded positively. In that case, a facility had a guy who would pick up a baby doll, shove it in the face of a female resident, and say something like, “You need to change her. I’m tired.”

My thought (and it doesn’t take a genius to figure this out) is that women are interested in the dolls because the dolls allow them to recreate a time in their life when they felt much purpose–a time when they were the mother of an infant. If you ask most mothers their primary purpose in life, even after their children have left the home, it’s to be mother. Giving a mother a doll is giving her something that dementia has stolen…a sense of purpose…a reason for being…a feeling of making a difference.

I believe that people, no matter where they are in life, need a purpose.

I also ask staff if they’ve ever had a woman who was interested in the dolls who had not been a mother in her lifetime. They always seem unsure of the answer. That uncertainty comes from working with a generation where the vast majority of women were mothers.

But what about my generation? Fewer of us are mothers. I am not a mother, and I often wonder if someday I will sit in a memory community rocking my baby to sleep. Having never defined myself as a mother, I struggle to see it.

I wonder if they can give me a real-looking dog that I can walk, feed, and train. I am half-joking when I say this, but I have derived a great sense of purpose from the rescue dogs my husband and I have taken in and cared for (even as they get old and frail). If I’m lost in this world and need to feel like I matter, a dog might be just the thing.

(Or…If I find myself living with dementia in memory care someday, I will perceive that I am there to do an in-service for staff and give them lectures on working with people who have dementia. Wrap your brain around that.)

As for men….they seem to take little interest in the dolls even if they were fathers. Of course, this could be a generational thing. The fathers in my generation are more involved in hands-on care than fathers of the past. I’m proud to say I know a handful of stay-at-home dads.

One came to speak to my college students a few years ago. A student in the front row asked, “So did you get fired?”

When he explained that he had chosen to quit his job and care for kids full-time, the majority of my students looked suspicious.

So maybe we haven’t reached total acceptance yet…but stay-at-home dads are not as few and far between as they used to be. Will those stay-at-home dads be carrying their babies around in memory care communities in forty years?

To those who think the use of doll therapy is degrading, I make the case that it can be effective in improving quality of life.

One woman at a local nursing home was often agitated with employees to the point that she would verbally insult them. They had tried several different drugs to calm her anxiety. Then someone gave her a baby doll. When she attached to it, they even put a crib by her bed. She became gentler, calmer, less stressed…she stopped yelling at people because (shhhhhhh) the baby was sleeping. In the past, they had trouble getting her to sleep at night. Now she laid down by her baby at night and was out like a light.

I’ve seen female residents connect over the babies. What’s your baby’s name? Awww. How old is she? Oh my goodness. She’s adorable. Conversations that would have never been started without a baby to coo.

Once I saw two residents with dementia connect over the baby that one of them was burping. One of the women spent a few minutes talking about how cute the baby was, how little its toes and fingers were, and the tiny stocking cap it was wearing.

As she wrapped up the conversation, she turned to me and whispered in confidence, “That woman has that Alzheimer’s and thinks that baby is real. But I know it’s just a doll. That or a dead baby.”

I couldn’t help but let out just a tiny chuckle.

“Do you think dead babies are funny?” the woman asked me. I assured her that I definitely did not think dead babies are funny.

Here’s the rule on doll therapy. If a person with dementia thinks it’s a real baby, it is a real baby. And you will treat it as such.

I’ve seen a nurse’s aide take a woman’s baby and throw (yes, throw) it on her bed as the woman was taken for dinner. The woman watched in horror as you would expect from someone watching her baby be thrown across the room.

I wish I had stopped to explain the rule to this nurse’s aide, but I just glared at him. I’m really good at figuring out the perfect response to a situation…about twenty minutes after that situation has passed.

That scene continues to weigh on my mind. I have plenty of friends with infants. I can imagine that they would be beyond frightened and angry if a guy took their baby and deliberately threw it. Then imagine that guy removing them from the room and leaving the baby all alone. Why would this woman with dementia feel any differently?

Yes. That’s a rhetorical question. The answer is that she wouldn’t feel any differently. A baby is a baby is a baby.

As dementia progresses, I tell people they must step into the world of the individual with dementia. That means treating a baby like a baby. Many nursing homes and memory care facilities have set up nurseries with cribs.

Let me be clear in saying that doll therapy does not stop or slow the progression of dementia symptoms. However, there is some research (e.g, Braden & Gaspar, 2015; Ng et al., 2017; Shin, 2015) that shows it decreases aggression, obsessive behaviors, negative mood, and wandering. There’s also evidence that it increases social interactions.

I do understand the objections to doll therapy. I get that may be difficult for some families to accept. I know that some people think it’s undignified and disrespectful.

To me, dignity and respect are about supporting a person in their reality without judgment. Their reality is just as reality to them as your reality is to you. And if that reality includes a baby that gives them a sense of purpose and a reason for being, it means you treat that baby like a baby.