Alisa Tagg, President of the National Association of Activity Professionals, and Scott Silknitter, founder of R.O.S. Therapy Systems, share how to engage, communicate and validate someone who has dementia.
Learn more about how to use these tips to communicate with your loved one.
Dementia Behaviors, Communication and Validation
A vital component of R.O.S. Therapy Systems is what we teach regarding communication in Alzheimer’s or dementia activities and engagement: Validation.
Validation was developed in an attempt to understand the emotions that a person with Alzheimer’s disease or related dementia is expressing and allow caregivers to respond in a way that encourages the person to express their emotions freely. Another term for validation is the “therapeutic lie.” Instead of exploring the depth of a loved one with dementia’s reality, the “therapeutic lie” maintains a superficial politeness.
The best questions to ask a person during the validation process begin with:
- Who
- What
- Where
- When
- How.
The caregiver should never ask “Why,” as this can become accusatory to their loved one.
Take this conversation that many caregivers can relate to, where validation is helpful in understanding a person’s feelings: One afternoon your loved one, Susan, has repeatedly tried to attempt to leave the house while saying:
“I have to get home to make dinner for my family.”
Some caregivers may want to tell Susan that she is already home and that she needs to come sit down and stop trying to leave the house. This can lead to an argument between Susan and her caregiver because Susan truly believes that she has to leave to get home and does not understand why “this person” is trying to keep her from leaving.
Using validation, however, the caregiver could take a different approach and reduce the risk of the situation escalating into an argument.
The caregiver can begin with a series of questions and discussion points about Susan’s family and what she wants to make for dinner by asking:
- Who is coming to dinner?
- What is your favorite meal to cook?
- How do you cook the meal?
- Is there anything I can help you with?
This may work in de-escalating the situation and calming Susan down. If Susan does not calm down, the caregiver can move to the next line of questions about Susan’s house. This can include questions like:
- Where is your home?
- What street is it on?
- What color is it?
- How many bedrooms does it have?
- What is your favorite room in the house?
These two lines of questions will generally resolve the situation. While going through this process, the caregiver must remember to be calm and guiding, but not controlling.
Using the Validation Method
Using validation also provides a caregiver an opportunity to investigate what is causing Susan’s behavior. Behaviors, like Susan’s insistence that she needed to leave, are nothing more than a means to communicate when words are no longer effective. The caregiver must become a detective to find out what is causing that behavior.
Knowing the person’s life history can assist the caregiver to know how and when validation should be used. Why? Because as short-term memory begins to fail due to Alzheimer’s, memories and feelings of the past begin to resurface. These feelings should be acknowledged and validated by a caregiver. When we validate a person, the caregiver provides the person with an empathetic listener. Remember the most critical part of effective communication is the ability to listen.
During this process, caregivers must be able to put aside their own judgments of a person and their behavior, and learn to be sensitive to the logic behind the disorientation. Please note that this part of the process — setting aside personal judgement — can be especially challenging for a husband or wife. Seeing your partner of thirty, forty or fifty years act out in a way that you are not used to is difficult. Accepting that your loved one may not recognize you can be painful. However, if this can be done and the validation technique is used, it will reduce the anxiety of the person and allow the caregiver time to figure out the cause of a behavior.
The key is to “agree” with what the person is saying and then guiding them to something else without them realizing they are being redirected.
Using validation is a personal choice of each caregiver. We believe it is an important part of engaging and communicating someone with Alzheimer’s or related dementia. For more information, please see any of the R.O.S. Family Caregiver books:
About the Authors
Alisa Tagg, BA, ACC/EDU, AC-BC, CDP, is the President of the National Association of Activity Professionals which has been the training and education authority for quality of life and leisure engagement in senior care since 1982. Scott Silknitter, inventor, author, and speaker, is the founder of R.O.S. Therapy Systems which began as a 2010 project to help his mother and father in a 25-year battle with Parkinson’s disease and dementia.
For more information about Alisa, Scott or the R.O.S. family of companies, visit: www.ROSTherapySystems.com or contact (888) 352-9788.
How do you engage, communicate or validate a loved one with Alzheimer’s or dementia while caregiving? Share your suggestions with us in the comments below.
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