Validation Techniques for Dementia Care The Family Guide to Improving Communication By Vicki de Klerk-Rubin, R.N., M.B.A.

Excerpted from the Introduction of Validation Techniques for Dementia Care by Vicki de Klerk-Rubin, R.N., M.B.A.

Copyright © 2008 by Health Professions Press, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Introduction

This book is for people who are caring for disoriented very old loved ones. It is for daughters, daughters-in-law, sons, sons-in-laws, husbands, wives, brothers, sisters, friends, neighbors, and other extended “family members.” It does not matter whether you are caring for loved ones at home or in an institution, handling all of the care or just a part of it. If your loved one has received a diagnosis of some form of dementia and he or she is in his or her late 70s or older, then this book might help you.

Validation is a method of communicating with and helping very old people with dementia in their final stage of life. The goal is not to make disoriented elderly better but rather to help caregivers to change themselves so that they can enter the personal reality of the person for whom they are caring. Through a caring, empathic relationship, caregivers can reconnect or connect in a new way and give their disoriented relative more ease and pleasure. This is what Validation offers those who are distressed by the pain, effort, and anxiety that come with caring for disoriented elderly. Although Validation is not curative, it has value to the caregiver and the care recipient. When a caregiver has an intimate conversation, shares a laugh or a tear, or finally understands behavior that has seemed bizarre, it can be profoundly rewarding. Caregivers experience a feeling of relief when they do not need to fight or struggle to change their relative. Their self-respect increases as they feel more competent. Validation brings relief to and honors the humanity of the elderly. They benefit from less stress and from feeling accepted and valued for who they are now. Encouraged to communicate about issues that matter to them, they can keep connected to you instead of withdrawing further into themselves.

Validation does not require a lot of time, but it does ask a great deal from its practitioners. To practice Validation, you must be honest with yourself, face your own feelings, be able to set those feelings aside for a short time, and be willing to deal openly with the feelings of your relative. Not everyone wants to take these steps. It could be that after looking through this book you decide that Validation may be right for your relative but not something that you want to do. However, even a passive understanding of the Validation theories and goals can influence your attitude toward your relative and your situation and improve the way you respond to him or her. Also, if Validation is incorporated into the professional care of a loved one, then it is of value to family members and to their loved one to understand the basic principles.

This book will not teach you everything about Validation but will give you enough to make a start, and perhaps that will be enough to open up a whole new way of being with your disoriented relative. Part I starts with a basic primer in Validation principles and theory. Not all theory is discussed but enough to lead you to form realistic goals and support a basic emotional posture. Then comes a look at the relevance of and the meaning behind the behavior of disoriented very old people. This is followed in Part II by a step-by-step description of how you can use the Validation method with your disoriented relative. Part III gives several typical scenarios between family members and disoriented relatives and how Validation was used in each case. The commentary that follows each scenario is meant to give you specific ways of handling difficult situations.

The Validation method was created by Naomi Feil (1932), an American gerontologist. She found that the methods she was taught did not work in practice. She began to experiment, and through trial and error came up with a number of ideas, theories, and techniques that over time she formed into a cohesive method. Today, Validation is practiced in hospitals, in nursing facilities, and by community care workers in North America, Europe, Australia, and Japan. Naomi Feil’s books Validation: The Feil Method (1982, 1989, 2003) and The Validation Breakthrough (1993, 2002) both are still in wide distribution and have been translated into nine languages. Introductory videos are available in several languages and are used by many institutions and schools to sensitize and train staff in this humanistic way of working with individuals with dementia of the Alzheimer’s type. Naomi Feil has appeared numerous times on television and radio in the United States, Europe, and Japan; 15,000 professional and lay people attend her workshops each year. For more than 15 years, the Validation Training Institute has offered training and certification in the method, following international quality standards. Certification is recognized by many professional organizations and governments. The Validation Training Institute works with an international network of Authorized Validation Organizations. These are listed in Appendix 4 and can be contacted directly for further information, assistance, training possibilities, or the names of Validation practitioners in your area.