My Master’s thesis was aimed at responding to an institutional question in a nursing home towards one of their therapeutic tools: the empathy doll. How does it work? When? With whom? In which context? And why? Those were the questions we tried to answer, with the active participation of all the residents of a protected living unit, all suffering from Alzheimer’s disease with severe psychological and behavioral symptoms.
To answer these questions, our goal was to define the moderators and mediators of the dolls therapeutic effects. For all purposes, we will define these two concepts: a moderator is a pre-intervention variable that creates favorable conditions in order to obtain a therapeutic change beforehand (for instance the characteristics of the environment, or the characteristics of the users), while mediators are the processes or mechanisms which permit to achieve change, they are the active ingredients of change, and therefore explain why it works. We were expecting this approach could enable the nursing staff to refine their therapeutic goals and practices towards mediating tools.
ABSTRACT
The use of empathy dolls with people with neurodegenerative pathologies in nursing homes, although increasingly usual, remains intuitive and random even today.
In order to optimize its use and its effects, we wanted to identify the different moderators and mediators underlying and conditioning the therapeutic effects of doll on its users.
Thus, 10 residents of a protected living unit, 3 doll users and 7 non-users, were observed and filmed for 45 minutes, 2 days per week, for a period of 9 weeks. The typewritten transcriptions of these observations were subjected to a transversal thematic qualitative analysis. In addition, a hetero-evaluation through the NPI-ES test (NeuroPsychiatric Inventory, team version) was carried out by a multidisciplinary team for these 10 persons upstream and downstream of this observation and intervention period.
We noticed a general drop among PBSDs (psychological and behavioural symptoms of dementia) and a substantial impact on the teams’ workload over the period, especially as regards the 3 doll users. The qualitative analysis suggests that these effects are partly due to the sensorial, emotional and cognitive awakening induced by dolls that would allow users to feel connected to themselves and to their congeners; it also contributes to providing a feeling of pleasure and security, especially through games and movements; self-worth was consolidated by the care given to others, by the responsibility generated by the presence of the dolls. Finally, this study suggests that the residents who are most likely to benefit from this tool may be individuals with severe and very severe neurodegenerative pathologies, with aberrant motor behaviors and a high propensity for social relations.
However, all these results are conditioned by the guarantee of a containing framework with benevolent, frequent and consistent use of the dolls, and the involvement of all members of the team.
All of this should be confirmed in further research on larger samples.
Key Words : Dementia, Alzheimer’s disease, empathy doll, doll therapy, non-pharmacological treatment.
Words I have learned :
For all purposes: à toutes fins utiles
Beforehand: au préalable
Upstream and downstream: en amont et en aval
Workload: la charge de travail
Framework: structure, cadre
Benevolent: bienveillant
Fanny AMET