Building Trust, Enhancing Relationships with the Validation Method
By Steve Klotz, Certified Validation Master, Executive Director of Validation Education at Country Meadows Retirement Communities based in Hershey, PA. Steve is also an Adjunct Professor in Gerontology at York College of PA.
When a family has a loved one living with dementia, it can be difficult to accept the changes in that loved one, particularly if a parent. Too many times, adult children become frustrated with their mother or father. They say, “Don’t you remember? I’m your daughter.” Or “I just told you, Mom.” Unfortunately, these kinds of statements can make a difficult situation worse, both for the senior who is experiencing disorientation or memory loss and for the caregiver or adult child who is struggling to cope with the new relationship with their beloved parent.
Frustration, stress, and sadness are normal reactions to the changes in a loved one who is experiencing memory loss. But one of the best actions we can take as caregivers is to learn techniques that will ease frustration, create successful connections and enhance loving relationships.
Validation is a method of communicating with and helping people who are disoriented as a result of dementia-related illnesses. Validation techniques require empathy and they focus on the whole person, allowing the caregiver to understand the emotions and needs of the older person, whether expressed in words or in actions.
Where did Validation come from?
Naomi Feil, MSW, ACSW, developed Validation as a method of communicating with and helping people who are disoriented as a result of dementia-related illnesses. Her parents worked – and lived – in a large personal care home for most of Naomi’s childhood and adolescence. This provided a rich background for understanding the ways that older adults with dementia relate to other people and the world around them.
After receiving a Master’s degree in Social Work, Naomi spent nearly 20 years striving to construct a methodology for helping elders who live with Alzheimer’s-type dementia to regain dignity and increase happiness, as well as to decrease anxiety and lower stress. She called her approach Validation, wrote journal articles about it and then in 1982 published her first book. She began giving workshops across the country and soon around the world. Validation is now taught and practiced by many leading elder care organizations in Europe, Japan, and in the US. Naomi still gives her day-long workshops.
How does Validation work?
The main goal is to “validate” a person’s emotions, needs, and concerns, no matter how rooted they appear to be in reality. This helps to reduce anxiety and to resolve difficult situations. For example, the daughter-in-law of an older man with dementia told me, “In the past, we always tried to re-orient Dad to here and now. We would try to convince him about how confused he was and his need for assistance, even if we had to argue with him. Then we went to a Validation workshop and learned to accept Dad where he is each day and even each moment. We realized that we could explore his life as a younger person – and we learned so much about him. We tried to help him let his feelings out instead of suppressing them, and we were all so much happier. Dad was much more prepared for his next steps with dementia – and so were we.”
Validation teaches us that disoriented elders need to express what is within them and be heard and accepted by people they trust.
How can I use Validation with my loved one?
A full understanding of the use of the Validation method is best accomplished by attending a workshop, which is conducted by a Certified Validation Teacher. However, there are basic principles you can apply when interacting with your beloved elder that will help to ease stress and confusion, allowing you to reconnect, build trust and reduce anxiety, even in a situation where the person is agitated.
- Slow down your internal pace. Relax your body. Set aside your own thoughts and expectations.
- Focus on your loved one: look into his eyes and take note of the emotions you see. Step into his world.
- Always approach her from the front, maintain eye contact and use her name. Doing this establishes a connection and shows respect and empathy.
- Be as close to your loved one as they comfortably accept. Distance cuts off connections, but nearness fosters it.
- Ask open-ended, broad questions to better understand and explore your loved one’s thoughts, feelings, and concerns.
- Begin with who, what, where, when or how questions. Listen for the emotions behind the responses and body language that is being used. Avoid asking “Why?” because it may frustrate the person.
- When a strong thought or emotion comes out, rephrase it back with the same emotion. Doing this shows that you are listening and understand. Never offer advice or instructions. Rather, ask your loved one what he or she thinks should be done. This will help promote self-worth and boost self-esteem.
- Accept what is shared without judgment – even if it is troublesome. Re-focus on what your loved one is feeling or struggling to express. Remember: this is not necessarily reality, but it’s what he or she is recalling or experiencing now.
- Bring your visit to a definitive end. Always thank him or her and say when you will return. This creates anticipation and helps to builds trust.
There are many types and levels of Validation training. Most people begin by attending an hour-long workshop or seminar. Some go on to take an introductory course or even an advanced course in practicing one-to-one Validation. A further course focuses on creating and leading Validation groups in which disoriented seniors are the members and active participants.
One woman, occasionally confused and forgetful, thought that her valuables were being stolen by her family. By entering the world of her emotions and memories, asking questions such as, “What do you want to say to them?” and “What’s the worst thing that’s been taken from you?”, she stated that her mind was being taken and it frightened her. She found relief in simply stating that to a trusted, empathetic listener.
A man, thinking back many years and reliving it in the present, was angry at how his wife’s body had been handled after her death in a hospital. He swore and said he wanted to get his hands on those guys who roughly put her body onto a stretcher and wheeled her away. After responding to exploratory questions like, “What would you do to them?” and “How did you always treat her?”, he recalled that he was always gentle with his wife because she was beautiful and caring toward him. He savored that memory for a few moments and then moved on to another subject.
How can I learn more?
Many retirement communities and nursing homes offer support groups and workshops that teach techniques similar to those used in Validation. To find a workshop or course led by a Certified Validation Teacher, go to www.vfvalidation.org and look under Workshops and Training. Or email the writer of this article requesting more information.
Note: This article originally appeared on August 7, 2015. It has been updated for general clarification.