As a caregiver, it can be difficult to support residents coping with Alzheimer’s. Day to day, even hour to hour, you may find that your resident is experiencing a present reality that is quite different from your own. How you react to these episodes can be the difference between your resident feeling safe and respected or feeling anxious and fearful.

The Validation method of therapy is a way of communicating with elderly people who have been diagnosed with dementia. Validation was developed by Naomi Feil, whose parents both worked with the elderly and who spent much of her time in the senior living facilities where her parents worked. She introduced her concept of Validation in her book, Validation: The Feil Method, in the early 1980s.

The Validation Method

The Validation Method is built on a classification system that outlines four progressive stages of behavior that a person coping with Alzheimer’s goes through as they attempt to deal with unresolved issues or conflict in his or her life.

  1. Malorientation – expressing and struggling with past conflicts
  2. Time confusion – a loose hold on reality which causes the person to retreat inwards
  3. Repetitive Motion – movement replaces words and is used to resolve conflict
  4. Vegetation – the person shuts out the world and gives up trying to resolve conflicts

When a resident experiences an emotional trigger they may regress into their past and react to situations as they did in the past. For example, they may revert to childlike behaviors, worry about the well-being of their young children, or relive a traumatic event from their past.

Validation goes beyond simply indulging a resident’s behaviors and redirecting him onto another activity. Instead, it’s about validating his feelings, allowing yourself to enter into his current state of mind, and helping him work through the emotions and conflict he is experiencing.

Validation Therapy vs Reality Orientation

For many of us, our initial reaction to a resident who is suffering from an episode of malorientation or time confusion would be to remind her what’s happening in the present day. This is referred to as reality orientation and it serves as a reawakening or correction to the individual with dementia that what she is experiencing is not real. For a long time this was the standard, and accepted, technique for working with individuals suffering from Alzheimer’s.

However, repeated episodes of reality orientation can be psychologically damaging because they force a resident into a reality that she cannot understand. Instead, Validation techniques allow the resident to experience an eased transition back to current reality when you redirect her while you’re validating her thoughts, feelings, and emotions.

Benefits of the Validation Method

Research from the Validation Training Institute has discovered a variety of positive results that older adults with some forms of dementia experience when Validation Therapy is used:

  • Increased communication
  • Increased positive affect
  • Reduced aggressive behavior
  • Less need to use psychotropic medications

Additionally, caregivers feel more capable of handling difficult situations and have more pleasure in their work.

Putting Validation Into Practice

As you practice Validation, it’s important to accept your memory support residents as they are and not try to change them by forcing them to change their reality to yours. Listening and empathizing with your resident builds trust, reduces anxiety, and restores dignity. When painful feelings are expressed, acknowledged, and validated, they begin to diminish.

Esther Heerma, MSW, who has worked closely with hundreds of individuals with Alzheimer’s, outlines the steps you should take when using Validation therapy methods with a resident.

  • Take a deep breath, center yourself and get into the right mindset.
  • Reminisce with your resident and ask her questions about the conflict she is experiencing.
  • Ask questions that use extremes, “do you always feel that way?” or “what do you miss the most?”
  • Acknowledge and validate her emotions by joining your resident in her feelings.
  • Rephrase your residents’ feelings so that she senses that you understand her; this can reduce her anxiety.
  • Ask questions that force your resident to use her senses, “did that taste good?” or “was it pretty there?”

If you’re interested in teaching your staff more about the Validation method, a technique for assisting residents coping with Alzheimer’s, SeniorLivingU offers several Alzheimer’s & Dementia Training Resources.