June 3, 2016
Many care providers of individuals with dementia wonder what to do when their client or loved one makes up stories or experiences delusions. Should they correct the person, orienting them to present day reality? The anxiety and agitation almost always escalate with this approach. But entertaining the person’s delusions or untruths feels wrong to most, particularly when it is a loved one with whom they’ve previously shared an honest relationship.
The Alzheimer’s Association advises to avoid arguing with a loved one who has dementia. Arguing will usually not change someone’s mind but can increase agitation and frustration, not just for the person for dementia, but also for the care provider. They also advise not to criticize or correct and instead to listen to the meaning behind what is being said, and turning the focus to feelings, not facts.
Developed in the 1960s and 1970s, the validation method is a holistic therapy for treating dementia. It focuses on empathy and provides a means for individuals with dementia to communicate. The validation method’s creator, Naomi Feil, is a social worker for the elderly who started her career in the 1960s. She grew dissatisfied with common practices in dealing with severely disoriented older adults, so she devised her own method and published a book on it, called Validation: The Feil Method, in 1982.
A common example would be when someone with dementia asks to go “home”, but they might already be in their home or residential facility. Reality Orientation (RO) might suggest we remind them that they are already home -that this is where they live- which could potentially be very upsetting. Therapeutic lying would offer optional replies such as, “we’ll go home after lunch”, to appease the person in the moment, though by its very nature is untruthful. Employing the validation method addresses the feelings behind the desire to go home. A compassionate, mindful response in this case could be something as simple as, “tell me about home” or “you want to be back in your house - what would you do there?”, which gives the person permission to process whatever they’re feeling in that moment.
Through empathy and respect, validation method practitioners help people with dementia feel listened to and supported. They can regain the dignity their disease has stolen, and, ideally, feel a greater sense of peace in their final stage of life.
