Validation Therapy for Dementia

What is validation therapy?

Validation therapy is a communication approach to dementia treatment that uses empathy and understanding, helping the person with dementia to feel heard and maintain their dignity.

In using validation therapy, the caregiver listens carefully to the feelings underlying behavior of those in late-stage dementia. The therapeutic techniques enable connection and engagement between the caregiver and the senior experiencing dementia symptoms. At the core of validation therapy, is the understanding that upset behavior indicates an unmet need. By providing understanding, caregivers are more able to get to the heart of what that unmet need is.

Developed by Naomi Feil in the 1980s, validation therapy focuses on respectful, caring responses to the reality that a person with dementia is expressing, rather than trying to correct or confront, Challenging behaviors are seen as attempts to communicate feelings – therapies are focused on the root of the behavior, rather than the actual behavior. This can calm those with anxiety and agitation and the behaviors brought about by the anxiety.

How can validation therapy help people with dementia?

Validation therapy can help people with dementia symptoms feel listened to, respected, and cared for with dignity. By being supportive, caregivers and family members, using validation therapy can lessen the anxiety and agitation that people with dementia feel. As the person is able to let go of their anxiety, they may be able to participate in activities.

Reported benefits through Feil’s research include an increase in self-worth, some re-entry into the outside world, better communication, help in resolving unfinished life issues, and facilitation of independent living.

As people with dementia respond to these therapies, it can also benefit caregivers and family members as challenging behaviors lessen and issues from the past are brought forward. With better understanding, deeper bonds can be formed and renewed.

What are some examples of validation therapy?

To use a validation therapy approach, use these three steps to guide your thinking:

• Acknowledge: Rather than argue, if your loved one were to say something like – “I want to go home.” Answer them with something like “What would you do if you were home.”
• Honor: Ease the feeling by trying to get at what the patient is feeling – cold, hungry, lonely?
• Act: Act to meet the need. For example, if the senior talks about a prior stumbling experience, check their shoes or the environment around them – while the exact incident they’re describing may not be realistic, the feeling often is.

Some other validation therapy strategies include:

1. Speak in a low-toned, loving voice.
2. Use eye contact and gentle touches.
3. Ask about the basic facts surrounding a situation. The who, when, and where may be easier to answer than the why. For example – Was Uncle Tom there?
4. Turn the conversation toward positive experiences in their youth.
5. Try to set your emotions aside and focus on what they are trying to communicate so that they feel heard.

Remember that reality for the late-stage dementia patient may be different from what we are experiencing. Acknowledging your loved one’s feelings and experiences enables them to continue with dignity.