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Mom thinks Therapy doll is Real. She worries about it having a wet, dirty diaper. Having more diffuculty distinguishing between real/fantasy. I realize that they use these dolls to calm dementia patients and give them something to cuddle with, but we are concerned when we hear her talking about adopting it and knowing she doesn't have long to live and she doesn't want to leave the baby. She is also worried about what she needs to have for the baby to wear, and that her diaper hasn't been changed, and how she must be soaking wet or have a stinky diaper. She says the baby sleeps just a little, and she never cries. She believes this doll is real. Several times she asked us tonight what is the baby supposed to wear and asked us about diapers for her. She even said that she heard the baby would be destroyed after six months if no one took care of it and asked if they buried it after that or what do they do with it. I read you should not call these babies dolls, but, how do you handle a situation like this? Since she had access to the doll or a doll it appears to us that she is having more difficulty distinguishing between what is real and what is fantasy. She has been talking about babysitting a baby for about two months now, but tonight is the first time we have seen her carry it around. Could this be another step in her dementia? She will be 80 in December and has been in this facility a little over a year. She has been confused before, but it seems to be getting worse. Any thoughts or suggestions?

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I agree that I would support her care of the doll by giving encouraging and comforting comments about how everything will be okay. I discovered that in the early stages, my loved one was worried about her beloved cat. She had irrational fears, like the cat would escape from the house through a crevice the size of a pea or that the cat might be sick. Her obsession wasn't healthy, but, she did forget about the cat, after she moved into AL.

Later, she would obsess over a staff member or other resident. She would worry that they were okay or about where they were. She was difficult to console. The doctor prescribed medication for her that treats the anxiety and she had drastic improvement. She went on Cymbalta, which is taken daily. I noticed nothing different about her except a decrease in her anxiety. I'd explore meds with her doctor.

My point is that if she overly worried, anxious and obsessed, it will likely transfer to something else, even if the doll is removed.
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Sometimes, I think what we want for our loved one with dementia is often at odds with what they want or what they are even able of comprehending any longer. I know on my own mothers journey I was always dismayed at her lack of "joining in" - first at IL when there were bus trips and classes I knew she would like - but she didn't want to socialize with all "those old decrepit people" and later in AL and her NH when it was a matter of exercise and basic socializing at movie day or wheelchair stretches class. Mom had always been a very social person. Once in a great while I'd be surprised to see her taking part in something - but for the majority of the time mom was most content when she was alone in her room - apart from family visiting. I think us wanting what's best for them - being measured by reason and logic - is just another thing we as their adult children- have to learn to let go off.
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Don't get me wrong, we have nothing against her having the doll, especially if it brings her any kind of comfort. We know it won't be destroyed, but getting her to see that is a different story. Not only is it the issue of the clothes and diapers it is also that she worries about it getting cold, or she might roll over on her. She said she knows when she gets a little bigger, that babies will start to flip over and will could fall off the bed, just like her stuffed bear does. She says she finds her bear on the floor all the time. It also concerns us that she will start to isolate herself from her activities, and socialization so that her baby won't be neglected. It is critical that she has those. But, we hate to remove the baby from her now that she has gotten so attached to her. She was telling us what a comfort she was and how the baby would smile at her and how much the baby liked looking at bright lights. Her overall demeanor last night was more confusion than usual. We could even see it in her face when we walked in. We realize this may completely different next time. You never know how she will be. She is either complaining about the other residents, or asking us the same questions over and over. We know that is all part of this though.
We don't want to deny her of any happiness, but at the same time, we don't want it to consume her completely. Especially when she still can get around, at least in a wheelchair.
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She's getting worse? Sadly, that's what dementia patients do.

I think I'd go along with Mom about the doll, giving her comfort and reassurances. "Mom, it is so considerate of you to be thinking what will happen to MaryJane after you are gone. The staff here will find someone else to love and care for her. And no, they don't destroy these babies. There will always be someone to love them." "There is a nursery aide here who makes sure all the babies have dry diapers. Isn't that nice? Wish I had an aide when I had babies!"

My mother's doll wore a newborn or 9 month size and I found nice bargains in the thrift store. Seeing the doll all dressed up in different clothes was my mom's favorite part of owning her, and we wound up with about 10 outfits for her.

I've heard these same worries expressed by women with dementia who don't have a doll, over an imaginary baby. They fret that the baby needs to be changed or the baby is sad, locked in the closet. I guess if you are geared to be nurturing that aspect may come out in strange ways when you have dementia!
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I have no experience with this type of behavior so my response is purely a gut instinct. But first - you said your mom appears "worse". This is one thing I do know - dementia is a progressive disease and it will get worse. Then - there is always the possibility of a UTI to blame for a sudden worsening of state of mind - can you ask to have your mom tested for that? As for the doll itself being responsible- I guess I would weigh all the factors. Is the doll helping in any way? Giving your mother a sense of purpose or any sort of comfort? If there aren't any positives and you feel the doll is causing worry and/or obsessive behavior - can you talk to someone in authority and ask that your mother not be given the doll to hold and be redirected if she finds it on her own? The first time I heard about giving a dementia patient a doll or stuffed animal to hold and care for I remember thinking "that's just silly". Since that time I became familiar with a few residents at my moms NH who had stuffed animals and I was very surprised to see the huge amount of comfort they derived from holding and cuddling them. If your mother is having some positive reactions from caring for "the baby" other than the worries you've mentioned - would it do any good to go along with your mom - reassure her and agree to bring diapers - in theory- on your next visit? I have also heard of cases where family have actually brought in baby clothes in order for the patient to dress/care for the baby. Beyond all of that - there is also the likelihood that this is a phase with your mother and in time she will move on to something else and the baby will be forgotten.
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