Everyone values validation—whether it’s a toddler looking for parental approval after their first steps or an adult seeking affirmation about their job performance. While it’s important not to become overly reliant on validation for minor achievements, receiving it can significantly enhance our mental health and self-esteem. This need for validation persists into old age, where older adults may struggle to obtain it. This is where validation therapy comes into play.
If you’re unfamiliar with this approach, let’s delve into what validation therapy is and how it may assist individuals with dementia and other cognitive challenges.
What is Validation Therapy?
Validation therapy was developed by social worker Naomi Feil between 1963 and 1980 to assist older adults and individuals with cognitive impairments. According to a 2003 article in the Cochrane Database of Systematic Reviews by Martin Neal and Philip Barton Wright, validation therapy is rooted in the principle of acceptance—acknowledging the reality and personal truths of others’ experiences. Although Feil didn’t create this therapy specifically for dementia, it has found application in supporting those affected by the condition.
Since the 1990s, validation therapy has gained traction among healthcare professionals, though it has faced some criticism. Skeptics question the evidence supporting its principles and techniques, with some asserting that it can come across as patronizing or demeaning, as it may involve validating false perceptions.
Who is Naomi Feil?
Naomi Feil is a prominent gerontologist whose childhood in a senior care home, the Montefiore Home for the Aged in Cleveland, sparked her passion for working with the elderly. Her education in social work at Columbia University, along with her husband Edward R. Feil’s support, led her to develop validation therapy and produce numerous films related to her theories on dementia.
How is Validation Therapy Used for People with Dementia?
Validation therapy is centered around empathy and attentive listening. It recognizes individuals with dementia as valuable and unique, often in their final life stages. Dana Larson, writing for A Place for Mom, explains that the therapy aims to help seniors resolve unresolved matters, allowing them to achieve peace before passing. The caregiver’s role is to provide a safe space for expression, whether through verbal or nonverbal means.
People with dementia may exhibit behaviors that seem odd to outsiders, such as hallucinations or living in an alternate reality. Validation therapy involves respecting their words and actions rather than dismissing or reacting negatively. As Elmcroft Senior Living describes, this approach focuses on being present without questioning the “why” behind their actions.
Examples of Validation Therapy Techniques:
- Using a calm, clear tone when speaking
- Taking a moment to center yourself before responding
- Maintaining eye contact
- Avoiding arguments or corrections
- Reflecting their feelings back to them to validate their experiences
- Asking open-ended questions about their memories
- Engaging their senses with questions about the past
What Are the Benefits of Validation Therapy?
Current research on the effectiveness of validation therapy is inconclusive. However, caregivers and professionals working with individuals with dementia have reported positive outcomes, including:
- Improved posture
- Increased eye contact
- Enhanced social interaction
- Reduced distress behaviors like crying or pacing
- Less anger and a lower need for medication or restraints
- Better verbal and nonverbal communication
- Greater mobility and reduced anxiety
- A restored sense of self-worth and humor
Given that individual responses vary, it’s essential to consult with a healthcare provider before implementing validation therapy.
Is Validation Therapy Calming or Condescending?
For those with dementia, reality can differ significantly from that of healthy individuals. Validation therapy aims to comfort and affirm their experiences, but some critics argue it may come off as condescending. However, denying their experiences can lead to frustration and confusion. Since dementia affects memory and rational thought, understanding their perspective is crucial.
How to Communicate with Someone with Dementia Using Validation Therapy:
When engaging with someone with dementia, consider the following:
- Stick to light, social topics.
- Avoid questions about recent events or short-term memory.
- If they reference something incorrectly, gently shift the conversation without correcting them.
- When leaving, don’t say goodbye; instead, mention your next activity to ease the transition.
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In summary, validation therapy presents a unique approach to supporting individuals with dementia, emphasizing empathy and respect for their experiences. While more research is needed to determine its efficacy, many caregivers report positive changes in those they assist.
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