Dolls and toy animals for hospitalized elders--infantilizing or comforting?

The use of Piaget's theory in Alzheimer's disease

Child-like behaviors of adults with Alzheimer's disease are often puzzling and stressful to caregivers. The possibility of using Piaget's child developmental model to understand these behaviors is explored in this paper. Based on data from recent studies revealing that adults with Alzheimer's disease appear to lose cognitive functions in the reverse order of acquisition in Piaget's theory, the purpose of this paper is to describe how the use of this theory to understand cognitive changes characteristic of AD might enhance caregiving techniques.

Effects of toy stimulation on the cognitive, communicative, and emotional functioning of adults in the middle stages of Alzheimer's disease

Although several clinical reports describe the benefits of toy stimulation for dementia patients, there is little empirical support for this sensory stimulation approach. The purpose of this investigation was to examine the effects of toy stimulation on the language, cognition, and emotional state of patients in the middle stages of Alzheimer's disease (AD) during a formal testing situation. Eighteen patients completed a standardized test battery and picture description task twice, once with and once without a toy stimulus present. Three AD patients completed all tasks four times (twice with and twice without the toy) to examine performance consistency. Although some patients improved their performances in the presence of a toy, there were no significant group differences between the toy and no toy conditions for any experimental measure. Of the three patients who completed experimental tasks twice in the presence of a toy, two displayed some consistent improvements whereas the remaining patient's response pattern was variable. Caregiver feedback regarding toy stimulation was positive. Methodological limitations of the current study and suggestions for future research are discussed.

LEARNING OUTCOMES

As a result of reading this article, the participant will be able to: (1) summarize the previous literature regarding sensory stimulation treatment approaches for patients with Alzheimer's disease or other dementing illnesses; and (2) describe the effects of toy stimulation on the linguistic and cognitive abilities, and emotional status of patients in the middle stages of Alzheimer's disease.

Age- or stage-appropriate? Recreation and the relevance of Piaget's theory in dementia care

In this study, the immediate effects (within 10 minutes) of age- and stage-appropriate activities and two control activities were observed in 56 dementia sufferers. Compared with the control activities, the two experimental treatment conditions elicited greater reductions in agitation and negative emotion and increases in positive emotion and duration of activity. Stage-appropriate activity was superior to age-appropriate activity in increasing positive emotion and had about the same effect in reducing negative emotion and agitation. The study also addressed the idea that people with Alzheimer's disease may regress through Piaget's stages of cognitive development and thus display the play interests associated with each stage. There was a significant relationship between cognitive level and type of Piagetian play observed; however, Piaget's descriptions of play were not entirely appropriate for persons with with Alzheimer's disease.

Evaluation of infantilizing speech in a rehabilitation setting: relation to age

The purpose of the present study was to assess whether reactions to infantilizing speech and content are a function of age when levels of dependence within an institutional environment are controlled. Ten individuals below the age of sixty-five were compared with ten above age sixty-five. Respondents were given two sets of materials designed to produce comparative ratings of adult and infantilized speech content and intonation. The over sixty-five age group did not detect a difference between adult and infantilizing content. The under sixty-five age group reacted more negatively to infantilizing content than did the older group. Independence scores were not significantly correlated with either set of speech ratings, or to age. The difference between older and younger adults with the same level of functional impairment supports the empirical literature that infantilization is due in part to stereotyped expectations regarding the aged as more dependent and hence in need of childlike treatment.