Implementing and sustaining evidence-based practices in long-term care.

Dementia Care at Bloomington Cove - Using doll therapy

By: Janet Iwaszczenko, Executive Director, Bloomington Cove Care Community

Bloomington Cove Care Community, Stouffville

Bloomington Cove Care Community is home to 113 residents in rural Stouffville. It is the only licensed long-term care home in Ontario solely providing care to those with dementia.  Programs are based on current evidence-based practices and non-clinical approaches help to enhance quality of life for residents living with this challenging disease. This story is about how one resident, Mrs. Lu, benefitted from doll therapy.

On admission, Mrs. Lu was a seventy-eight year old resident with Alzheimer’s disease. She came to Canada as a young bride and spent her life looking after her home and raising her four children. Mrs. Lu’s first language is Russian but she spoke English fluently. With advancing Alzheimer’s disease, Mrs. Lu now speaks Russian only; however she can understand simple commands and gestures in English.

Presenting Challenge
On admission to Bloomington Cove, Mrs. Lu became very protective of a common seating area.  She showed verbal and physical aggression toward co-residents, yelling, striking out and lifting her walker in a threatening manner. In the early period of admission, Mrs. Lu’s Aggressive Behavioural Scale score was 8, which is in the severe behaviour range in RAI-MDS.

RNAO’s best practice guideline Delirium, Dementia and Depression in Older Adults: Assessment and Care (July 2016) recommends developing an individualized plan of care and promoting strategies for people living with dementia that preserve their abilities and optimize their quality of life.  The Program team recognized Mrs. Lu’s past ability of raising children and decided to have a staff member spend individualized time with her, introducing her to doll therapy. This involved taking Mrs. Lu to the nursery in her home area. The nursery is a room set up with a crib, change table, stroller and numerous baby dolls to choose from. Mrs. Lu quickly made her choice. She chose not one, but two baby dolls as her own.

Mrs. Lu’s immediate response to Doll therapy was positive. She went back to the nursery independently later in the day. Mrs. Lu’s attention turned to the two dolls and she was observed speaking, laughing, and singing to them. She kept them with her from then on, one doll tucked under each arm, displaying them proudly to others. She engaged other residents, staff, and visitors in the most pleasant manner to talk about her “babies”.

After being introduced to the dolls, Mrs. Lu’s Aggressive Behavioural Scale score was reduced dramatically from an 8 to a 3, which is within the mild aggressive range.

Sustaining change
Mrs Lu is well settled in to her life at Bloomington Cove. With ongoing care of her dolls, her lower Aggressive Behavioural score of 3 has been sustained.

This Doll therapy story shows how giving care based on a person’s needs can address behaviours and improve quality of life, with individualized care. It is an example of the excellent care that Bloomington Cove Care Community aims to provide.

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