Receiving a diagnosis of dementia for a parent or loved one can be an emotional and scary time. While parts of life begin to make sense, others begin to crumble in painful ways. Fortunately, current research suggests there are ways we can help our elderly family members to cope with the challenges of their disease.
Validation therapy is a well-documented strategy for helping individuals with dementia retain their dignity and their quality of life. We will discuss what it is, where it came from, who it benefits, and how it helps in both homes and clinical settings.
WHAT IS VALIDATION THERAPY?
The concept translates in the medical community as a nursing intervention. It uses therapeutic communication to connect with patients who have dementia. This definition includes the practice of focusing on the individual’s emotions, rather than reality. The idea is that by managing an individual’s emotional attachment to concepts or objects, we can diffuse tough situations.
Validation therapy grew as a way of communicating with disoriented people and the elderly. Naomi Feil originally developed it. Feil is a social worker and public speaker who grew up in a nursing home under the care of her parents. Her father was the administrator, and her mother oversaw the Social Service Department.
Feil’s early exposure to patients with dementia and other conditions shaped her desire for compassionate care of aging adults. She has authored two books about validation therapy, The Feil Method, and The Validation Breakthrough. Feil also founded the Validation Training Institute. She serves as the Director while touring, teaching classes, and speaking about her approach.
Below, Naomi Feil discusses the concept of validation.
The Validation team includes a group of professionals who are overseen by a board of trustees. Practical advice and a support network for families coping with dementia are highlights on their list of offerings.
To assist families, caregivers, and medical professionals in learning the validation strategies outlined in her process, Feil routinely offers workshops on the subject. She tours numerous countries, including Germany, France, Canada, Australia, and the US. Her Training Institute has established worldwide branches of validation organizations that earned authorization in validation therapy.
THE FEIL METHOD
Validation is a practical collection of advice that can make managing dementia less stressful. It highlights being empathetic toward people living with dementia. Its primary goal is to try to see the world from their point of view. Feil suggests that many patients in their final stages of life are trying to resolve unfinished business so that they may pass in peace.
The three essential components of validation are the age-specific stages of behavior, an empathetic and nonjudgmental attitude, and specific techniques for managing behaviors. In validation therapy, four progressive stages define a patient’s state.
First is the malorientation state. This state is when individuals recall and even act out past conflicts in seemingly odd ways. Repressed memories or regular routines are ingrained in our unconscious minds. These can resurface when dementia takes hold. Second is time confusion, when the passing of time and the sense of time itself fade.
The third state is repetitive motion, when behaviors or movements replace verbal expressions. The final stage is vegetation, when the patient shuts out the world and seems to give up on life.
THE UNCONSCIOUS MIND’S IMPACT ON DEMENTIA
Many struggles that seniors with dementia experience are related to their pasts. Feil emphasizes that despite the aging process and the dementia symptoms appearing, older adults still crave acceptance and integration into their world.
Referenced in Feil’s discussion of the need for validation therapy is the study of the unconscious mind by Carl Jung and Sigmund Freud. One important observation stands out: that a cat who is ignored turns into a tiger. If we ignore and attempt to repress strange or upsetting behavior, it will only become worse.
Feil also mentions symbols and the need for interpreting and understanding them. An example she uses in describing the validation technique is a bed becoming a symbolic car. For a senior man who was a mechanic for decades, this was a symbolic portrayal of the past. A huge component of validation therapy involves trying our best to understand these apparent quirks. Then, making connections based on these dilemmas.
WHO CAN BENEFIT FROM VALIDATION THERAPY?
Before we can understand the population that can benefit from utilizing Feil’s methods, it’s important to define it. This therapy is used for patients with dementia. As the Mayo Clinic explains, dementia itself is not a disease. Dementia is the name given to a collection of symptoms that affect essential daily functions of the brain.
People with symptoms of memory loss, impaired thinking, and reduced social abilities often receive a dementia diagnosis. Often a lack of awareness prevents people from accessing care for this condition, even though a new case of dementia is diagnosed every 3 seconds worldwide.
Alzheimer’s disease is the most widely known cause of dementia, but it’s not the only one. Vascular dementia is the second most common type of dementia, and blood vessel problems cause it. Many dementias have no known cause, but certain kinds are reversible with treatment.
Both cognitive and psychological changes happen in individuals with dementia, and these changes can make caring for an older adult with these issues a big challenge. According to the Alzheimer’s Association, nearly half of people over age 85 have Alzheimer’s disease. Also, this figure does not include other forms of dementia not caused by Alzheimer’s.
Worldwide, there were roughly 35.6 million people with dementia in 2010. Unfortunately, those numbers are only expected to rise, nearly doubling by 2030. Fortunately, early diagnosis can help families come to terms with previously misunderstood ailments. At that time, various therapies become helpful.
HOW DOES THIS METHOD IMPROVE PATIENT OUTCOMES?
One small-scale study showed promise in treating dementia patients with validation therapy techniques. While the group of 116 total patients is not sufficient to establish conclusive results, it gives caregivers for people with dementia hope for progress.
The driving force behind adapting to dementia this way is to make our elderly patients’ lives more comfortable and peaceful. To that end, this form of therapy practically guarantees results. By communicating openly and sympathetically with loved ones, we can calm their fears and embrace what is important to them.
Some positive results of validation therapy, according to Naomi Feil’s organization, include:
- Greater social aptitude and control
- Fewer expressions of anger
- Less anxiety
- Improved awareness of reality
- Heightened sense of self-worth
PRACTICAL APPLICATIONS: HOW VALIDATION THERAPY IS USED
Validation therapy can be implemented by families, doctors, nurses, and other caregivers and family friends to accommodate the needs of individuals with dementia. Simple tips from nurses who care for dementia patients include suggestions such as:
- Treating patients with respect
- Speaking simply
- Controlling your own emotions
- Use distraction to reduce stressful experiences
- Observe to understand
- Accept that you cannot “fix” everything
The short case studies shared by nurses in the field reflect what we already know about human connection based on psychology. Nurses agree that by offering validation, not only are they building relationships with patients, they are also improving the level of care given. Maintaining a patient’s mental well-being is equally important as maintaining their physical health.
HOW CAN I VALIDATE?
Naomi Feil’s website offers a section with practical tips for anyone wanting to implement validation therapy for dementia. From physicians who routinely care for dementia patients, to children who may be struggling with a grandparent’s inability to recognize them.
The main takeaways from the tips are to avoid arguing, ask questions to encourage reminiscing, and to maintain the dignity of the person with dementia. Allowing older adults with dementia the opportunity to explore their pasts through describing memories can be healing for them.
Maintaining trust and letting individuals express themselves is a core piece of validation therapy. More than just nursing home staff and medical professionals can use these tools. Families should help patients to manage feelings and experiences, and this method offers a simple path to doing so.
Feil’s website includes a generous collection of caregiver resources, including newsletters that discuss events and give advice for families and practitioners.
During a time when a loved one’s diagnosis seems to only mean a harder life for all of those involved, finding a means to cope can help everyone. Thoughtful and composed family support systems are the ideal setting for implementing validation techniques. However, the impact of trained staff employing these strategies as well can be enormous.
For such an extensive field of thought, the premise of validation therapy is quite simple. Connecting, reinforcing positive emotions, and reminiscing over good memories is good for us all. Despite the struggles of dementia, we can rest well knowing that our loved ones are receiving empathetic care.
An ideal resource for further validation therapy information is Naomi Feil’s website. There, families and caregivers can find specific examples of therapy in action, links to studies, and the opportunity to sign up for a caregiver class taught by one of Feil’s team.
Have you tried validation therapy with a loved one? We encourage you to share your experience in the comments section below!