All staff who care for people with dementia, particularly advanced dementia, are very aware that it can be a particularly difficult challenge. With the progression of the condition service users withdraw into themselves more and more, they don’t let anyone come near them and they no longer remember recent events.
However, in order to meet people’s needs, staff must have some means of communicating with the person – either verbally or non-verbally. Dementia Support suggest there is another method that can help those who care for people with dementia to make a positive connection with them. This method, developed by Naomi Feil in the 1980s, is known as Validation Therapy, and it enables staff to react effectively in response to a service user’s behavior.
By using the Validation method, staff can reduce tension between themselves and those in their care, and begin to develop a closer relationship with them. One critical element of validation, for example, is that it shows that you have respect for who they are and that you accept their current feelings and expression of their emotions.
The central belief and goal of Validation Therapy is that people with dementia should always be taken seriously – no matter what they say, feel or how they act.
Objectives and goals of validation therapy
Whenever you use the Validation method, you are making a connection with the feelings of those in your care. Knowing their Life History, therefore, plays an important role in providing this advanced level of care.
The objectives of Validation Therapy will give staff an understanding of what the approach is trying to achieve:
Cognitive Goals: Improves the persons capabilities
Physical Goals: Improves their wellbeing
Emotional and Personal Goals: Resolves any past conflicts
Social Goals: prevents social isolation of the person
In order to achieve these goals staff should aim to meet the following intermediate goals:
Convey the persons esteem
Reinforce their identity and self-respect
Revive past emotions
Establish effective communication
Communicate at the emotional level.
The aim of Dementia Care & Support, is always to give managers practical, step-by-step advice so that they and their staff can learn quickly and effectively how to apply advanced care techniques in their daily work. Rather than offering unnecessary theory, here are their fast-track tips for implementing the Validation Method in your care service:
First, observe the person in your care
Within a short period of time, you’ll notice certain behavioural patterns that recur time and again. You’ll then be able to draw on these later.
Convey to them a feeling of their own esteem
Esteem is a prerequisite for gaining their confidence. You can express your esteem for them by:
• Giving them your full attention
• Showing them that “I have time for you”
• Adopting and reflecting back to them their manner of expressing themselves and their body language
• Being tactile and being close to them.
But don’t overdo it and be sure to express only genuine feelings. Even if people with dementia often give the impression of being confused and disoriented, they’re still exceptionally sensitive to feelings and moods. They will pick up on the exact tone of your voice and the intention behind it.
When using Validation Therapy, there are a set of rules of communication that you can follow that are especially appropriate to the feelings and behavior traits of people with dementia. Dementia: Care & Support have put together the following checklist for you to use in your care home.
Validation therapy also encourages carers not to contradict the person with dementia and to instead enter their world, rather than trying to bring them (usually unsuccessfully) into your own.
‘Validation is about being in the moment with the person,’ explains Julia Pitkin, one of the first validation practitioners in the UK. ‘Being corrected can make a person feel devalued.’ Whether you call it special care or validation therapy, both approaches recommend using distraction techniques rather than lying.
So, for example, if a service user keeps asking where her husband is, instead of reminding her he died five years ago, you could say, ‘it sounds like you’re really missing him, how did you meet? Can I see some wedding photos?’
Empathy and respect are what matters, say supporters of both approaches. Feeling listened to and supported, they argue, helps people with dementia regain their dignity and feel a greater sense of calmness and peace.
Managers and staff are always on the lookout for new approaches to engaging and communicating with people who suffer from dementia. Validation Therapy is not new, but the benefits of this approach are now being recognized. There is a great deal of literature available on this topic if managers are interested. Including: Dementia Care and Support for Care Home Personnel.
There is also a video by Naomi Feil available on YouTube here.
Albert Cook BA, MA & Fellow Charted Quality Institute