Thursday, October 1, 2009

Validation Therapy Used in Dementia Care

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Caring for a person with dementia is difficult. Knowing about dementia makes the job easier. Validation therapy helps a caregiver to take care of a dementia patient because it relies on the patient's feelings. Emotions are one of the last things to be lost in a person with dementia. Although not all aspects of validation therapy work for every person with dementia, understanding the concept of it is useful to the dementia caregiver.


Dementia, a brain condition, is characterized by a group of symptoms that cause changes in the functioning of the brain. The changes have to do with thinking, perception and learning. These changes affect decision making, judgment, memory, spatial orientation, thinking, reasoning and communication. This condition interferes with daily life because of the seriousness of the changes in the brain. Behavior and personality problems most often occur. As we age, the likelihood of developing dementia increases. Validation therapy helps control problem behavior.

The Dementia Sufferer's Reality

Time, for a person with dementia, can be the present at one moment, the past at another and the future at another. Time has absolutely no continuity.
People with dementia know what they know at any given moment. Accepting the dementia world is difficult for caregivers. You cannot force those with dementia to accept the real world. Caregivers need to accept the dementia world. This makes their job much easier.
Dementia patients pick up on the feelings being expressed. For a caregiver it is how you say things, not what you say.

Validation Therapy

Naomi Feil, a social worker, designed validation therapy to help dementia sufferers. It relies on the patient's emotions. Feil reported in her book "The Validation Breakthrough" that after six months of using validation therapy once a week, persons with dementia showed improvement in eye contact, walking and behavior. Her theories explain why people with dementia behave the way they do.
History of Validation Therapy
Feil developed validation therapy between 1963 and 1980 for older people with cognitive impairments. Initially, this therapy did not include those with dementia. Applying validation therapy in dementia care occurred in the early 1980s. Validation therapy attracted a good deal of criticism from researchers. Many studies have been conducted over the years with no proof that it is effective in dementia care. Feil strongly believes that validation therapy works. Validation therapy in dementia care may work in your particular situation.
Principles of Validation Therapy
Validation therapy classifies individuals with cognitive impairment, or pre-dementia, in one of four stages. These stages are mal-orientation, time confusion, repetitive motion and vegetation.
The therapy is based on the general principle of validation and treating people who have dementia with genuine respect and legitimatizing the expression of their feelings.Treat each person with dementia as an individual. Even the most disoriented person has value. Improper behavior happens for a reason.
When more recent memory fails, people with dementia try to restore balance in their lives by retrieving earlier memories. Painful feelings that are expressed, acknowledged and validated by a trusted listener diminish. Painful feelings that are suppressed gain strength.
Empathy builds trust, reduces anxiety and restores dignity.
Caregiving With Validation
Some parts of validation therapy work for most people with dementia. You, as a caregiver, must discover what portions are effective for the person you are taking care of.

Here are some hints.

Never argue with a person who has dementia, because he believes what he is seeing and feeling is real. Logic does not work. Instead, agree with the individual with dementia. Then steer him to something else. In other words, refocus and redirect his feelings and actions.

This works best when you know the present interests of a person with dementia. Knowing what triggers bad behavior is also helpful. You must be a detective and a stretcher of the truth.

Here is an example: A person with dementia is asking to go home because he thinks that he left the front door open. You as a caregiver know this information is not true. Tell the dementia sufferer that you will call his niece to shut the front door. Then pretend to call the niece. If the dementia patient still insists on going home, tell him that we will right after we set the table and eat supper or another thing you know he will want to do. The trick is to nip agitated behavior in the bud before the dementia patient gets too upset and needs medication to calm him down.

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