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Friday, November 29, 2013

Validation Therapy--We use it daily. Why is it a negative with Dementia sufferers? November 29, 2013

Validation Therapy and Dementia: Pros and Cons

Dementia is a decline in memory and/or intellectual functioning severe enough to interfere with social or occupational functioning. Dementia is not a disease itself, but group of symptoms. It is characterized as a progressive decline in cognitive function due to damage or disease (such as Alzheimer’s) in the brain. Areas particularly affected include: memory, attention, judgment, language and problem solving.

Dementia is condition in which a person loses the ability to think, remember, learn, make decisions and solve problems. Symptoms may also include personality changes and emotional problems. Personality does not change with age in the absence of mental disease.

There are many causes of dementia, including Alzheimer’s disease, brain cancer, and brain injury. Some Parkinson’s patients experience dementia at later stages of disease The idea behind validation therapy is to “validate” or accept the values, beliefs and “reality” of the person suffering from dementia. The key is to “agree” with them, but to also use conversation to get them to do something else without them realizing they are actually being redirected. So, if an 87 year old woman says that she needs a phone to call her grandmother, validation therapy says, “OK.” Here is an example for a caregiver working with someone with dementia in an adult day care:

Older adult: “I have to find my car keys.”
Caregiver: “Your car keys…” ( Don’t mention he doesn’t have a car and he hasn’t driven for years)
Older adult: “Yes, I need to go home – lot’s of work to do!”
Caregiver: “You are busy today?” (Don’t mention he is at adult day care and isn’t going home for hours)
Older adult: “Hell, yes! I’m busy every day.”
Caregiver: “You like being busy?” (Trying to find a topic of conversation that they might accept discussing)
Older adult: “Are your kidding? I didn’t say I LIKED it. I just have to work  like the rest of the world.” (He’s getting a little frustrated, but seems to have forgotten about the keys.)
Caregiver: “I know about work. I do some of that myself. In fact, I’m getting ready to fix some food for us. Care to join me?”
Older adult: “Sure, I can eat.”

I am quoting this description of validation therapy to counter the negative of "lying" to a person suffering from dementia. 

Just yesterday I witnessed the folowing conversation at the memory care center.

Resident: My closet door is locked.

Worker: Your closet door is locked? Do you feel cold?

Resident: I am always cold.

Worker: Let's walk over to this comfy chair and I'll get a blanket to tuck you in with and keep you warm.

Both walked off without any more reference to the closet door which must remain loacked so she doesn't repeatedly remove her belongings.

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