Real Talk: Is Validation Demeaning for Dementia Patients?

a middle age and old woman talking

As dementia progresses, most people slip into a different reality that doesn’t make rational sense. This manifests in various forms, like for instance, that time your aging mom convinced their doctor to go home with them because she believes he’s her husband, or when she told you about her medical degree, how she delivered so many babies in the past — when there’s no single piece of evidence that will prove all of these. There are also negative false beliefs, where they will accuse you of throwing away their clothes or poisoning their food. These are delusions, a hallmark symptom of severe dementia. Although correcting a loved one may seem like the most rational response, some caregivers do the opposite: validation.

Yes to Delusions?

Validation is a communication therapy that many medical practitioners use among dementia patients. Its roots trace back to the ‘60s and ‘80s when a social worker named Naomi Feil grew frustrated with the traditional approach to dealing with disoriented elders. Instead of ‘talking some sense’ into seniors, she went the bizarre route of embracing irrational beliefs. Other practitioners weren’t picking it up until the mid-’90s, years after her first book about validation therapy was released.

It’s hard to make sense of a therapy that entertains alternative truths, let alone use it to your folks. Most people feel that it’s condescending. Others think it’s just outright lying. But if you think about it, correcting a demented loved one does little to alleviate their condition. In fact, in some instances, it only makes them upset, feeling like no understands them. Imagine being dismissed when you’re fearful for your life because ‘there’s poison in your food’. Or, being ignored when you boast of how many babies you’ve delivered. The thing is, validation isn’t all about confirming these false beliefs. It’s letting your loved one keep a sense of self-respect and dignity as you extend and stretch empathy towards them. If you ask therapists specializing in palliative care, Indiana practitioners will tell you that focusing on the emotional needs of your relative, more than the logic in what they’re saying will make a big impact on your loved one’s overall health.

Validation in Action

The first step in making validation work starts with you. You have to control that urge to call out your mom for their mistake. Before you act, take a pause, breathe, and fix your attention to the goal: attending to your loved one’s emotional needs. From here, reframe your conversations. For instance, when your mom insists again that their doctor is her late husband, instead of challenging the truth of their statement, get into the underlying emotions by telling her, “You must really miss the love of your life.” or “You must have been thrilled when you were with him.” When they accuse you of stealing stuff, console their feelings of loss, reassure them that their valuables are safe, and then rephrase again, “Your wedding ring is the loveliest. How was your wedding like?” What you’re doing here is you’re diverting attention from the delusions, putting them in a headspace that allows them to explore emotions, instead of thoughts. Facilitate the use of senses in your questions so that they can reminisce better.

The Goal of Dementia Care

It’s not easy to see your loved one lose their mind to delusions. As much as you can, you want them to stay in a ‘stable’ frame of mind. But you can only do so much with an advancing disease. So instead of attempting rationality in how you communicate with them, connect with them at a place where the disease won’t snatch them away from you: at their emotions. From heart to heart.

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