“By providing the resident with the doll and acknowledging how much she loved to take care of babies, I validated her feelings and helped to fulfill her basic human need to express love, and nurture or care for a child,” Altman explained in an e-mail. “We know that deep down she knows it is a doll and that providing a doll is never enough. We also need to make that human connection. By using empathy along with some validation techniques, we can provide meaning and purpose to residents, even those in the later stages of memory loss.”
Using validation at home
Strategies for talking to people with dementia are not so different from effective listening techniques. Jo McCord, a family consultant for the Family Caregiver Alliance in San Francisco, suggests imagining yourself in your loved one’s position.
“Arguing with them is very damaging to their self-esteem,” she says. “Depending on where someone is in the disease, use a different vocabulary. Adapt your behavior to accommodate theirs.”
Families hoping to maintain or improve communication with those who have cognitive problems can use principles of the validation method on their own, Feil says. These approaches can help with issues related to repetitive statements or questions, angry outbursts, false accusations or the longing to go home. In each instance, Feil advises family members to “center,” by focusing on their breathing. Breathe in through the nose, she says, count to eight, and then exhale. Repeat this six times. It’s a different take on the adage about counting to 10.
In the case of the patient who repeatedly asks a question, Feil suggests you first “imagine the opposite.” If the patient keeps asking what time you’ll leave, for instance, ask, “What will happen if we don’t? Are you worried? Do you think we’ll be late?”
Corcoran of GWU recommends avoiding questions that might make the patient sense that she has to justify her feelings. Corcoran recommends a slightly different approach, such as saying, “I know you don’t want to be late, and I don’t, either. I’ll make sure we leave on time.”
Feil suggests using “polarity”— ask “What would be the worst thing that could happen?” In listening to the response, recognize that you are looking for what’s behind the answer: What is causing the anxiety? What are the underlying concerns? Once you understand what the worries are, you can try to ease or dispel them.