Introduction

In , where empathy and compassion are paramount, a remarkable approach called Validation Therapy has emerged as a beacon of hope and comfort for individuals facing dementia and cognitive disorders in their final journey. As an experienced hospice registered nurse case manager, I’ve witnessed the transformative impact of on patients, allowing them to find solace, regain their self-worth, and experience a sense of dignity during their end-of-life phase.

In this article, we delve into the world of , exploring its core principles, real-life applications, and the profound difference it can make in those under our care. We’ll journey through vivid examples of how Validation Therapy can ease , resolve inner turmoil, and provide a compassionate presence in the face of profound challenges.

Join us as we unlock the secrets of this powerful tool, rooted in empathy and understanding, and discover how it can profoundly enhance the quality of care provided to terminally ill patients, especially those battling dementia. Validation Therapy offers medical solace and emotional healing, fostering an environment of empathy and respect as we our patients toward a peaceful and dignified transition.

What is Validation Therapy

Naomi Feil, a , developed validation therapy to connect with older adults with cognitive disorders and dementia. This therapeutic approach focuses on empathy, understanding, and validating the emotions and experiences of individuals with dementia. By employing Validation Therapy, we can help reduce , , pain, and discomfort, promoting a sense of dignity and well-being for those on their dementia journey.

Understanding Validation Therapy

Validation Therapy revolves around empathetically entering the world of individuals with dementia instead of trying to force them to accept our reality. It acknowledges that people with dementia may have unresolved issues that drive their behaviors and emotions, and the key is to validate their feelings and experiences. The stages of cognitive impairment, as classified by Naomi Feil, include Malorientation, Time Confusion, Repetitive Motion, and Vegetation. Each stage focuses on helping the person work through their emotions and restore their sense of self-worth and dignity.

Examples of How Validation Therapy Helps

  1. Validation of Emotional Needs: An older adult with dementia calls out for a deceased loved one. Instead of correcting them, acknowledge their need for comfort and reassurance by saying, “I understand how much you miss them. It’s okay to feel sad.”
  2. Resolving Unfinished Business: A person with dementia becomes agitated or confused about an event from their past. Validate their emotions and help them navigate the feelings by saying, “It sounds like that memory is important to you. Tell me more about it.”
  3. Providing Empathetic Listening: An individual with dementia expresses fear or anxiety. Offer reassurance and comfort by saying, “I’m here for you, and I’ll stay with you. You’re not alone.”

Live Examples of How the Writer Employed Validation Therapy

The following case examples are based on real-life events experienced by the writer. Any names mentioned are fabricated to avoid issues with HIPAA compliance and protect the privacy of those involved.

Case – Hospice at a Facility – patient with – anxiety, sadness, exit-seeking behaviors

The writer checked in at the nursing station to see if there were any changes on the patient in question and received the standard report that nothing was new. The writer then proceeds to the patient’s room, where the patient shares the room with three other patients, only to find the patient standing in the vestibule of the room fully dressed with a hunting cap on his forehead, a walking cane in one hand, and a pair of driving gloves in his other hand about to head out of the room (based on the clothing, it appeared the patient was either going to spend time outside or flee).

The writer introduced himself (never take it for granted that a patient with any cognitive difficulty will remember you) as a visiting nurse asking the patient if he was going to spend time outside because the weather was nice (internally hoping the answer was “yes,” as patients do receive leaves to hangout outside). Instead, the patient reported going to the parking lot to get their car and drive home.

This required quick thinking to create a time buffer that would allow validation therapy to be employed. The writer mentioned he didn’t believe the patient’s car was in the parking lot, to which the patient quickly responded that his brother Fred would pick him up. Based on that reply, the writer asked if we both could sit down for a few minutes so the writer could assess before the patient left. The patient replied yes, and then we sat. This became the start of the employment of validation therapy, which requires time for it to work well.

As the writer took his time to get out the equipment, he explored the patient’s feelings, starting with his home and slowly opening the door to ask who would care for the patient. Every answer involved having his feelings validated. After about thirty minutes of just sitting, talking, and validating feelings, the patient started crying, “I want to die at home.” That was the entire sum of why he was trying to escape the facility… He wanted to die at home, not in a county home where he is in a room with four strangers, at a place he calls home. Knowing that allowed me to update his family and our social worker; we cannot guarantee the result, but just taking the time and frequently validating his feelings enabled him to share the root of the issue, and from there, I was able to calm him by sharing I would get that message to his daughter. And if you are in a comparable situation, I recommend not making any promises you cannot keep or lying. Validate feelings and do what you can do to make a difference.

Case – – patient with cancer living alone – PTSD level panic attack

Imagine walking into the home of an almost 90-year-old gentleman with cancer at a location with to the brain who lives alone. The writer is this patient’s hospice nurse. Our team utilizes a lock box where original pill bottles are kept in a lock box, and the writer or another nurse, should the writer be unavailable to fill a pill planner from the original bottles, manages refills with the provider. Before this setup, due to forgetfulness and frequent confusion, the patient would often forget he had already taken his pills and taken them repeatedly, including narcotics.

Imagine you are the hospice staff walking in. The patient in question starts to exhibit signs of an extreme panic attack as evidenced by the person hyperventilating, making a fist with his hands, shaking hands trembling, speaking fast in a distressed voice, pacing, saying repeatedly he’s going to die, he’s going to die.

In this case, prompt actions were required to ensure the patient’s safety, starting with encouraging him to sit down. Because he was in such a complete panic, the actual implementation of validation therapy needed to wait. Once sitting, the writer called the patient’s family member quickly, asking for permission to give liquid lorazepam (Ativan) and asking that the family member come over to be with the patient (the writer knew it would be some time). The writer then obtained the medication and received permission from the patient, partly because helping the patient understand this medication would help bring him peace.

Once the mediation was given, validation therapy could start with the exploration and validation of feelings that lead to the panic attack. Here, the patient expressed feelings of loss of control over having his driver’s license and car taken from him, the loss of autonomy by not being able to leave the house when he so desired, the confinement of the home itself, and that “this is no way to live.” Yes, a suicide assessment was necessary with certain statements, and thankfully, it was negative.

Conclusion

Validation Therapy is a powerful tool for providing compassionate care to individuals with dementia. By entering their world and validating their emotions, we can help them find comfort, restore their self-worth, and improve their quality of life during their end-of-life journey.

Resources

Validation Therapy developed by Naomi Feil may be the best way to communicate with older people with dementia

The Validation Method for Dementia Care – Practical Neurology

Using Validation Therapy for People With Dementia

A Compassionate Approach to Dementia Care

My Loved One with Dementia

Understanding Dementia (Alzheimer’s & Vascular & Frontotemporal & Lewy Body Dementia) (Video)

How Do I Know Which Dementia I’m Looking At? (Video)

Dementia Training material (Free)

Promoting Meaningful Relationships with Dementia Patients through Validation Therapy

Unlocking the Power of Validation Therapy in Compassionate End-of-Life Care

Validation Therapy: A Valuable Tool for Families and Healthcare Teams

Best Practices for Approaching Combative Dementia Patients

Dementia Insights: The Validation Method for Dementia Care

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The Validation Breakthrough: Simple Techniques for Communicating with People with Alzheimer’s Disease and Other Dementias

As an Amazon Associate, I earn from qualifying purchases. The amount generated from these “qualifying purchases” helps to maintain this site.

How Do I Know You? Dementia at the End of Life

The Dementia Caregiver: A Guide to Caring for Someone with Alzheimer’s Disease and Other Neurocognitive Disorders (Guides to Caregiving)

Sundown Dementia, Vascular Dementia and Lewy Body Dementia Explained

The Caregiver’s Guide to Dementia: Practical Advice for Caring for Yourself and Your Loved One (Caregiver’s Guides)

Ahead of Dementia: A Real-World, Upfront, Straightforward, Step-by-Step Guide for Family Caregivers

The Dementia Caregiver’s Survival Guide: An 11-Step Plan to Understand the Disease and How To Cope with Financial Challenges, Patient Aggression, and Depression Without Guilt, Overwhelm, or Burnout

Dementia Care Companion: The Complete Handbook of Practical Care from Early to Late Stage

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The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer’s Disease and Other Dementias

Dementia Care Essentials series

Dementia Caregiver Essentials: Comprehensive Guide for Dementia Care (one book that contains the ten books below for less than one-third the price of all ten)

Holistic Nurse: Skills for Excellence series

The Validation Breakthrough: Simple Techniques for Communicating with People with ‘Alzheimer’s-Type Dementia’

Dementia Home Care: How to Prepare Before, During, and After

Atypical Dementias: Understanding Mid-Life Language, Visual, Behavioral, and Cognitive Changes

The Dementia Caregiver’s Survival Guide: An 11-Step Plan to Understand the Disease and How To Cope with Financial Challenges, Patient Aggression, and Depression Without Guilt, Overwhelm, or Burnout

Fading Reflection: Understanding the complexities of Dementia

Dementia Caregiving: A Self Help Book for Dementia Caregivers Offering Practical Coping Strategies and Support to Overcome Burnout, Increase Awareness, and Build Mental & Emotional Resilience

Navigating the Dementia Journey: A Compassionate Guide to Understanding, Supporting, and Living With Dementia

Ahead of Dementia: A Real-World, Upfront, Straightforward, Step-by-Step Guide for Family Caregivers

Four Common Mistakes by Caregivers of Loved Ones with Dementia and What Do Differently (video)

Eldercare Locator: a nationwide service that connects older Americans and their caregivers with trustworthy local support resources

CaringInfo – Caregiver support and much more!

Surviving Caregiving with Dignity, Love, and Kindness

Caregivers.com | Simplifying the Search for In-Home Care

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Compassionate Caregiving series

My Aging Parent Needs Help!: 7-Step Guide to Caregiving with No Regrets, More Compassion, and Going from Overwhelmed to Organized [Includes Tips for Caregiver Burnout]

Take Back Your Life: A Caregiver’s Guide to Finding Freedom in the Midst of Overwhelm

The Conscious Caregiver: A Mindful Approach to Caring for Your Loved One Without Losing Yourself

Dear Caregiver, It’s Your Life Too: 71 Self-Care Tips To Manage Stress, Avoid Burnout, And Find Joy Again While Caring For A Loved One

Everything Happens for a Reason: And Other Lies I’ve Loved

The Art of Dying

Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying

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