Emotionally Personalized Doll Therapy for Behavioral Symptoms in an 88-Year-Old Woman With Alzheimer's Disease - A Case Report

Sep 28, 2026

Uploaded by Theodore

Behavioral and psychological symptoms of dementia (BPSD), including agitation, sleep disturbance, and repetitive speech, are common in Alzheimer disease and burden patients and caregivers. Doll therapy (DT) has been studied in institutional settings, but the home role of emotionally personalized dolls is insufficiently reported. This case describes an 88-year-old woman with AD whose nocturnal agitation and repetitive vocalizations markedly decreased after reencountering her granddaughter’s childhood doll, with improved sleep continuity and daytime engagement.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

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Introduction

Behavioral and psychological symptoms of dementia (BPSD)

Nonpharmacological interventions

Doll therapy (DT)

Key Clinical Message

Clinical Case Reports CASE REPORT OPEN ACCESS Emotionally Personalized Doll Therapy for Behavioral Symptoms in an 88-Year-Old Woman With Alzheimer's Disease: A Case Report Alireza Shouri Bidgoli1 | Azar Darvishpour1,2 1Department of Nursing, Zeyinab (P.B.U.H) School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran | 2Social Determinants of Health Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran Correspondence: Azar Darvishpour ([darvishpour_a@yahoo.com](darvishpour_a@yahoo.com)) Received: 10 October 2025 | Revised: 1 December 2025 | Accepted: 21 December 2025 Keywords: Alzheimer disease | case report | dementia | doll therapy ABSTRACT Behavioral and psychological symptoms of dementia (BPSD), such as agitation, sleep disturbance, and repetitive speech, are common in Alzheimer's disease (AD) and significantly burden both patients and caregivers. Doll therapy (DT) has been explored as a nonpharmacological approach in institutional care, but the potential role of emotionally personalized dolls in home care remains underreported. We describe an 88-year-old woman with AD who presented with persistent nocturnal agitation, repetitive vocalizations, and restlessness despite stable pharmacological management. During a household rearrangement, she reencountered her granddaughter's childhood doll. She quickly developed a strong emotional attachment and engaged with the doll in caregiving behaviors (cradling, rocking, singing, and feeding gestures). Within days, her agitation and repetitive speech markedly decreased. Sleep continuity improved, daytime activity increased, and her emotional expression became richer. She was more cooperative at mealtimes, demonstrated modest motor gains, and on several occasions verbalized urinary needs. Hallucinatory speech diminished substantially. Notably, she refused interaction with other dolls, suggesting that the personal and emotional significance of this specific doll was central to the observed improvement. This case highlights the potential therapeutic value of integrating emotionally personalized objects into dementia care at home. Personalized doll therapy may help activate residual emotional memory and attachment systems, leading to meaningful behavioral improvements without changes in medication. While promising, these findings are limited to a single case and warrant further investigation through systematic studies. 1 | Introduction Alzheimer's disease (AD) is a multifaceted, progressive neurodegenerative disorder characterized by widespread neuronal damage across multiple brain systems, leading to gradual cognitive decline and functional impairment [1, 2] . It is the most common cause of dementia, currently affecting more than 50 million people worldwide, a prevalence expected to rise in line with global population aging [3] . Beyond hallmark cognitive deficits, AD is almost invariably accompanied by behavioral and psychological symptoms of dementia (BPSD), including agitation, sleep disturbances, repetitive vocalizations, hallucinations, delusions, wandering, and mood changes [1] . These symptoms emerge in nearly all patients at some stage of the disease, substantially reducing quality of life and complicating disease management for both patients and caregivers. BPSD represents a heterogeneous constellation of neuropsychiatric symptoms often classified into cognitive/perceptual, motor, affective, verbal, and vegetative domains [4] . Their occurrence is strongly associated with increased caregiver burden, higher risk of institutionalization, and rising healthcare costs. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2025 The Author(s). Clinical Case Reports publi

FAQs

What behavioral symptoms were targeted in this case?

The report focused on nocturnal agitation, repetitive vocalizations (repetitive speech), and restlessness, along with sleep disruption and hallucinatory speech.

How was emotionally personalized doll therapy delivered?

During a household rearrangement, the patient reencountered her granddaughter’s childhood doll and quickly formed an emotional attachment, engaging with it through caregiving behaviors such as cradling, rocking, singing, and feeding gestures.

What changes were observed after introducing the doll?

Within days, agitation and repetitive speech decreased substantially, sleep continuity improved, daytime activity increased, emotional expression became richer, and she showed less hallucinatory speech. She also refused other dolls, suggesting the personal emotional significance of the specific doll mattered.

Sep 28, 2026

Uploaded by Theodore