Q:There are many books for caregivers of older adults with dementia available. How is this book unique?

Validation Techniques for Dementia Care is the only book about Validation written specifically for family members and friends caring for older adults with dementia. This book contains practical, easy-to-implement techniques for improving communication and relationships.

Q:What is the Validation method?

Validation is a method for communicating with disoriented very old people. Using an empathetic, respectful basic attitude, caregivers communicate by entering into the personal reality of the other person, exploring the feelings and needs rather than the facts. Specific verbal and non-verbal techniques make it easier for the older person to respond and express him- or herself.

Q:How did you become involved with Validation?

I became involved through my mother, Naomi Feil, who developed Validation. Back in 1989 I was living in Europe and began organizing her workshop tours there. She asked me to help her revise and update her books, and that became my in-depth training in the theory behind Validation. Hospitals and nursing homes began to ask me to talk about Validation and I thought, "I can do that." But of course, without any practical experience, my talks were shallow and theoretical.

Then began the big shift in my life. I began volunteering in a local nursing home, working on a dementia unit. I started a Validation group of disoriented residents, and trained a team of professionals to use Validation. At the same time, I went back to school and got my nursing degree (in The Netherlands). With the practical experience and technical background in hand, I moved forward, becoming a Validation teacher.

Q:What benefits result from the use of Validation?

Increased communication between the caregiver and family member, of course. But also, both individuals experience less stress, more satisfaction, and increased moments of closeness. The disoriented person can express him- or herself, be listened to, and resolve unfinished issues from the past. The caregiver has fewer moments of not knowing what to do, less burnout, and more moments of peace.

Q:Who can use Validation? Who should Validation be used with?

In theory, any person can use Validation, no matter what level of training, education, or expertise. The only requirements are: the ability to be empathetic, honest, and respectful and the willingness to not change the other person, but to accept him or her as he or she is in the moment.

Validation works best with people who have been diagnosed with late-onset Alzheimer's disease, also sometimes described as Dementia of the Alzheimer's Type.

Q:What are some of the techniques that family members can use to improve communication and interactions with loved ones with dementia?

The most important step is to center yourself and clear away initial emotions, reactions, and thoughts so that you can be open to your family member. Really observe what is going on, listen to his or her voice tone and words. Identify the emotions and needs that are being expressed. Then respond by exploring. If your family member is verbal, you can use verbal techniques such as asking open questions and rephrasing with empathy. If he or she is not verbal, then you can use non-verbal techniques such as mirroring and anchored touch, which connects touch and emotion. These simple techniques can work profoundly to increase communication.

Q:Can you give some examples of problematic caregiving situations that Validation techniques can help resolve?

In Validation Techniques for Dementia Care I describe how Validation can help family caregivers with the following situations:

• Mother keeps repeating the same thing over and over again, "where are we?"
• My wife thinks it is 1942 and she is working in a factory and I don't know what to say or do.
• My mother claims that her best friend has stolen her house and constantly wants to go home.
• I care for my mother 24/7 and she keeps screaming at me to go away.
• Jill is scared of her grandmother because she says and does crazy things.
• I don't know if it's worthwhile to visit my mother in the nursing home because all she does is sit in the hall waiting for "Johnny" to come home and she doesn't recognize me any more.
• My husband locked me out of the house and didn't recognize me at all - after 57 years of marriage.
• I had to put my older sister into a nursing home. Now she's furious at me, saying that I've locked her up and constantly saying, "Take me home now."
• My mother thinks that she is still working in the family business but she can't anymore because of her increasing dementia.
• My husband has angry outbursts, often directed at me and I don't know how to handle them.

Q:What is the best way for people to learn Validation? How long does it take to learn the techniques?

This book is a great way to start learning about Validation and how to apply some basic techniques with an older adult with dementia. After reading this book, a caregiver may be able to start using some elements of Validation. The techniques are simple and easy-to-implement in the natural course of caring for a person with dementia.

For more in-depth Validation training, it is best to take a course from a certified Validation teacher. A Level 1 course (using Validation with individuals) has 5 lesson blocks spread out over 8-12 months. In each lesson block students learn the theory, practice techniques, and integrate the basic attitude into their practice. In between lesson blocks, students practice what they have learned, take videotapes of their work with disoriented elderly, and receive supervision of their work. Professionals who work regularly with older adults find this training valuable.