Validating another’s feelings or words is not the same as agreeing with them. Validating what another says is simply affirming that you understand and accept what they are saying. Hold on, you may think. What if my 96 year old mom complains that her caregiver throws water all over her every morning to wake her up? How can I affirm what she says about something like that? Believe it; you can validate her words and save her dignity at the same time. Validation is so beneficial to care recipients, their family members, and caregivers that it deserves to take center stage this month.
Naomi Feil is the creator of Validation and the Executive Director of the Validation Training Institute. She teaches that validation is a communication technique which begins with an empathic and a non-judgmental attitude toward someone whose memory is failing or has failed. As dementia progresses, its course is generally punctuated by periods of clarity and periods of varying confusion or incomprehension. Whatever the state of their memory, what people DO retain is their feelings. They are just as mortified at a loss of dignity as anyone with full cognition; they are just as frustrated at not being able to articulate a thought as we are at trying to decipher it.
People who have moderate to advanced dementia often have trouble expressing their needs, and they sometimes express them in ways that can cause great alarm or worry for family and caregivers. Their speech and behavior can be described as withdrawn, disoriented and sometimes bizarre at times. For instance, Feil explains that the woman who wakes up wet every morning may be trying to convey that she needs someone to help her to the bathroom during the night. In this case, Feil suggests that an empathetic caregiver could ask, “Does this happen every morning, or is there a morning when she doesn’t throw water on you?” Mom could then tell her, “Well, only when the very nice young lady comes to look in on me in the night. She asks if I need to go to the toilet.”
Disoriented people see things differently. For instance, a bed can look like a car to someone with dementia. A validating caregiver will ask the former auto mechanic who rarely says a word and who is sure to be part way under his bed at least couple of times a week what kind of car he is working on and what’s wrong with it. Chances are good that he will get out from under there and talk up a storm. He will be back in his element and we will be happy that he is happy and communicating with us. Feil advises, “When older people see or hear things that we do not, we accept those as being part of their personal reality and understand that they are trying to meet their human needs.” This man needs to feel useful or competent or in charge just the way he did in the past.
If your loved one is to the point where they do not respond to conversation of any sort but they used to love music, find out what music they like and make it possible for them to listen to it. I urge you to take the time to watch the short video “Alive Inside” on Naomi Feil’s website where you will see a man escape an almost vegetative state to experience joy and lively conversation. The video also shows how to ask questions to stimulate someone’s memory (www. https://www.walking-in-their-shoes.com/using-music.html).
Prepare yourself to engage with your loved one by doing a self-calming exercise for yourself. A good way to do that is to use the technique to breathe optimally described in a previous article, “Thieves of Peace”. Avoid asking why something happened or why they did what they did. Instead, ask questions that can be answered by a yes or no response and can be used to build further questions. For instance, if you know dad liked gardening back in the day ask, “Do you like gardening?” and wait for him to launch into talking about his garden. If he needs further prompting, ask what type of vegetable/flower he likes the most.
Anyone can learn to use wonderful techniques like those described here that reduce stress, anxiety, and agitation. Health care professionals and family members who are looking for ways to improve communication and maintain or restore dignity to care recipients find them very helpful.
When care recipients have deep seeded unresolved issues, a counseling gerontologist or psychologist is often key to releasing the pain that profound inner turmoil causes to manifest as seething anger, resentment, complicated grief, unremitting remorse or severe depression.
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Counselors use therapeutic validation techniques to relieve bitterness, misery and hateful behavior toward others, so do not give up on your loved one who is locked in a web of misery. They can be guided to resolve those issues and find peace, which is a benefit to both them and to their family.
Validation helps to keep the older adult as mentally active as possible. Memory loss steals the ability to make new associations, to be creative, to learn new things, to do all the things we do as fully cognitive individuals. We must remember that one of the major goals of caregiving for one who has memory loss is to help them to have days and moments that are as pleasant as possible. We can all make a positive difference for someone by just taking time to validate them by listening with empathy and accepting where they are in the moment.
Kathy C. Faenzi MA is a Clinical Gerontologist and Senior Care Consultant based in San Mateo, CA.
JC Spicer, M.Ed. is a Freelance Social Science Writer and Developmental Editor based in the U.K.