Weighted stuffed animal and dementia

When someone you love has dementia, you sometimes see moments of restlessness, sadness or confusion. At those times, words do not always get through any more. Something soft to hold can give a lot of comfort in a moment like that. A weighted stuffed animal can be a lovely aid here: soft, familiar and with a calming weight. Below, you can read how to use one with care and respect.

Why can something to hold give comfort?

Dementia changes the way someone understands the world. Conversations become harder, but touching and holding often stay familiar for a long time. Something soft in your hands or on your lap can give a sense of security, just like a hand holding yours or a familiar blanket.

A weighted stuffed animal adds weight to that, usually 1 to 2 kg. Many people find firm, soft pressure like this calming. Everyone is different, though: one person loves it, another does not get much from it or finds it unpleasant. You discover what someone likes by trying it calmly and watching carefully.

What do we know from research?

Research into weighted stuffed animals themselves is still in its early days. They have not yet been studied in dementia, and neither have weighted dolls. What does exist is about weighted blankets and about dolls without weight.

The largest blanket study was carried out in Swedish nursing homes. The residents were 87 years old on average and used a chain blanket of 4 to 8 kg for 28 days. Researchers saw improvements in sleep, quality of life, eating, thinking skills and the use of medicines for mood and behaviour. However, there was no comparison group, so you cannot be sure whether those improvements came from the blanket. Of the 110 residents who started, 38 (35%) stopped because the blanket was uncomfortable. A good reason to choose a light weight for a stuffed animal.

A study of 21 people with dementia who lived at home showed that using a weighted blanket was feasible and was well received. Another study described how people with advanced dementia called out or made noises less persistently after ten minutes under a weighted blanket.

There is a review study on dolls without weight. There were signs of less restlessness and a better mood, but they were weak, and the largest controlled study found no clear decrease in restlessness or anxiety. There is also an ethical question: when is a doll like this comforting, and when does it treat someone like a child?

In practice, this means: a weighted stuffed animal can be a lovely source of comfort for some people with dementia. It is an addition to good care and attention, not a treatment for restlessness.

How do you offer a weighted stuffed animal respectfully?

Dignity comes first. Someone with dementia is an adult with their own history and taste. A few starting points:

• Choose a suitable shape. A calm animal or a neutral shape often suits better than something brightly coloured or childish. Think about what the person used to love, for example a cat if they always had cats.
• Offer it, do not push it. Put the stuffed animal within reach or hand it over calmly. Let the person decide for themselves whether to hold it.
• Talk about it in an ordinary way. ‘Feel this, it's lovely and soft’ works better than something that sounds like a toy.
• Choose a calm moment. For example after lunch in a familiar chair, or together on the sofa with music from the old days.
• Watch for signals without words. Pushing it away, becoming more restless, sweating or a pained expression means: take it away.

Never use a weighted stuffed animal to make someone sit still or to keep them in bed.

Which weight is suitable in dementia?

Choose the lightest weight that still feels pleasant. Older people often have less muscle strength, fragile skin or painful joints. The Dutch aid guide Vilans Hulpmiddelenwijzer warns, for weighted blankets, that pain from a worn hip or knee, for example, can get worse. A review article on weighted blankets also recommends the lightest possible blanket for frail older people.

The most important test: can the person lift the stuffed animal and put it aside themselves? If not, it is not suitable. You can read how to choose a weight in general in How heavy should a weighted stuffed animal be?

What do you need to know about care and restrictive measures?

In a nursing home or other care setting, using a weighted aid is a more sensitive matter. The Vilans Hulpmiddelenwijzer writes that within a care institution, a weighted blanket can be a restrictive measure. A knowledge platform on dementia puts it like this: a person must always be free to take off a weighted blanket, otherwise it counts as coercion.

In the Netherlands, the Care and Coercion Act (Wet zorg en dwang) sets out when care counts as involuntary, for example when someone's freedom of movement is restricted. Whether a weighted stuffed animal falls under this depends on the situation: does the person resist, or are they unable to put the stuffed animal aside themselves? So always discuss it with the care team and the person responsible for their care, and have its use recorded in the care plan. That way, everyone knows how to use the stuffed animal pleasantly and safely. In Belgium, ask the residential care home which agreements apply there. Rules differ from country to country, so wherever you live, ask the care team or the care home what applies.

You can read more about weighted aids in care settings in Weighted stuffed animals in care and occupational therapy.

Can you give a weighted stuffed animal as a gift?

Certainly, if you do it with care. Ideally, talk it through first with the people who care for your loved one every day, especially if they live in a care home. Include an explanation of safe use and choose a shape that suits the person. You can read tips in A weighted stuffed animal as a gift. There is a separate article for older people without dementia: A weighted stuffed animal for older people.

Not sure whether a weighted stuffed animal is a good idea? Then also read When is it better not to use a weighted stuffed animal? You will find other uses under benefits and uses.