Families and carers play a critical role in supporting people living with dementia. A lot of research has been done in understanding quality dementia care and how to improve the quality of life for those who have the disease.
As humans, we have an innate desire and need to have our feelings recognised and validated. Dementia causes changes to the way a person thinks, behaves and performs everyday tasks. In dementia’s late stages there is often a blur between memory and reality, especially when memory is more appealing than reality. For instance, someone with a form of dementia might suddenly call out for their loved one who passed away many years ago. When correcting a person’s reality, confusion and disorientation often occurs causing increased agitation and anxiety.
Helping care for a loved one with dementia no doubt has its challenges, especially when navigating memories from the past, in the present. This can be stressful and anxiety-inducing for families and carers as you grapple with redirection and diversion strategies, or potentially go along with their fantasy.
Several therapies and communication strategies for engaging with people who have dementia have been developed including, Validation Theory. At Home Care Assistance we are passionate about improving and maximising the quality of life for everyone who has dementia by building trust and support.
What is Validation Theory?
Naomi Feil defined Validation Theory between 1963 and 1980. Having grown up in a family home of seniors, before returning to do social work, she found herself frustrated with the therapies available for people with dementia, especially Alzheimer’s1.
Learning through her mistakes, Feil found that people in the later stages of dementia would withdraw or be further upset if forced to come back to reality in certain scenarios, no matter how kindly a carer approached the subject. Alternatively, she felt it wasn’t acceptable to lie and sympathy only got you so far, as it is objective.
Rather, Feil wanted to get to the heart of the matter, understanding that people living with dementia are trying to retain some sense of control. Trying to get to a place of empathy to feel how that person feels.
Naomi Feil’s definition of Validation Theory is: “Validation is a method of communicating with and helping disoriented very old people. It is a practical way of working that helps reduce stress, enhance dignity and increase happiness. Validation is built on empathetic attitude and a holistic view of individuals2“.
Validation Theory is when trust and a sense of security is built, when we enter the person who has dementia’s reality.3 It isn’t about lying, it isn’t about arguing, just re-phrasing with empathy by validating their feelings and their reality, whilst maintaining their self-esteem.
Validation Steps:
In practice, Validation Theory allows a carer to enter their loved one’s reality. It is about respecting the person with dementia’s emotions, offering comfort, and enabling them to find peace.
You can apply Validation Theory in everyday life through three easy steps.
⦁ Acknowledge respectfully what the person is expressing/ experiencing.
⦁ Honor the feeling behind the request.
⦁ Act to meet the need.
An example of how we use Validation Theory in practice:
Our Home Care Assistance Care Worker arrives at the home of Dorothy who has Alzheimer’s. Dorothy is upset because she is searching for her husband, her husband died years prior.
The Care Worker listens with empathy and acknowledges Dorothy by firstly showing physical signs of paying attention through eye contact and body language. Then asks, “What do you want to tell your husband?”.
Dorothy shares how much she loves and misses him. The Care Worker listens and honors the feeling by encouraging reminiscence, “What sort of life did you have with your husband?”.
The Carer then acts, by helping find a photo of her husband and hands it to Dorothy as she continues to talk about him.
Feil says that most people, in this instance Dorothy, would acknowledge minutes later that her husband is no longer with us. You don’t argue and you don’t lie, you just listen with empathy4. The carer didn’t embarrass Dorothy by correcting or discounting her feelings on her reality. Feelings that are expressed and validated, with empathy, are relieved.
Whilst it may take a little while to learn how to notice unmet needs and find ways to meet them. The benefits and reward for this extra effort will be returned greatly for both you and your loved one living with dementia. Once you begin practicing Validation Theory, just like riding a bike, it will become easier and second nature in no time.
If you’re struggling to work through the emotions of someone you care for or love who has dementia, speak to us at Home Care Assistance. Our Care Workers are trained and experienced in connecting, communicating and supporting your loved one throughout the different stages of dementia.
References:
1. https://best-alzheimers-products.com/validation-therapy-and-alzheimers.html
2 https://daughterlycare.com.au/dementia-care-validation-theory
3 https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dementia-communication
4 https://www.youtube.com/watch?v=ESqfW_kyZq8&t=474s
