Imagine your spouse, best friend or relative is diagnosed with dementia. This is someone who is close to you and with whom you've shared many memories. It can be jarring. I've seen and heard people talk about how they then avoid spending time with their loved one because they aren't sure what to say or how to react. That's okay -- you are not alone. But thankfully, we now have approaches to guide what may be anxiously anticipated encounters, to help you continue to connect with your loved one, just in a different way.
Enter Validation
It starts with Validation. Developed by Naomi Feil, Validation is an empathetic form of communicating with someone who has Alzheimer's or other form of memory loss. It forces us to change our mindset from trying to bring the person back to our reality, rather responding in a way that shows you are willing to enter their world and join their journey with them.
And although there is extensive information out there about the stages of memory loss, we know there are no two persons who experience memory loss in exactly the same way. Here are some helpful Validation tips you can use to connect with your loved one going through certain periods of memory loss:
Malorientation
Someone experiencing this phase is mostly oriented but showing early signs of forgetfulness, however often denies their feelings and losses and has issues trusting others. As a result, they may show signs of anger and can blame others when they are forgetful or misplace something. Hoarding objects is also common, since they're fearful of their increasing losses. What they need most from family, friends and caregivers is feeling nurtured and respected rather than judged.
Center yourself by taking a few deep cleansing breaths. Centering helps the caregiver to shut out the external dialogue and focus entirely on the present moment, thereby being more open and responsive.
Avoid arguing and asking about their feelings. Ask factual open questions instead. Begin with who, what, where, when and how. Do not ask why, because that can add to their frustration.
Rephrase by repeating the gist of their comment in a similar tone and rhythm. This helps them to know that you have heard and acknowledged what they have said.
Help them to find a familiar coping skill. For example, if the person is now living in assisted living and tells you, "I want to go home." Ask if they've ever been away from home, and if so, how they were able to handle or get through the experience of being away from home. Their response may enable you to help him or her tap into one of their prior coping methods and get them through what they are facing in the present time.
Time Confusion
In this phase, someone loses sense of time and no longer holds onto reality. According to Feil, they return to basic, universal feelings, including love, hate, fear of separation and a struggle for identity. Although unable to remember facts, he or she will know when a person is genuine or sincere versus pretending or just going along with them.
Continue to center, use open questions and rephrase.
Use genuine, direct, prolonged eye contact at their eye level.
Use music. For example, singing a song that they remember from their past can help to build a bridge of meaningful communication. Did you and your husband love dancing to Frank Sinatra? Play a song together and you'll see the magical connection can still be there.
Additionally, they may ask for a loved one who has passed away. It is important you understand this is most likely because of their human need to feel loved, secure. Take it as a sign for you to engage and emotionally connect even further. Ask them to tell you more about the person they inquired about and don't worry about the accuracy of the facts.
Repetitive Motion
A person in this phase may have regressed in their language skills. Movements or repetitive sounds can replace speech, so below are a few techniques to consider:
Use mirroring. In a very respectful and subtle way, observe and copy their body movements to help you to link their behavioral expressions to their need, such as their body movements, breathing patterns and even their vocalizations.
Use anchored touch. Early, emotional memories are permanently imprinted in the brain's circuits. If someone says they miss their mother, you could use touch, as a mother would, to give them a sense of security, as you softly touch their cheek.
Vegetation
Someone experiencing this phase may have completely shut out the world. Their eyes are usually closed or not focused and they do not initiate any activity. Try some of the following approaches, but only for a very brief amount of time:
Centering. You're probably noticing this is a theme.
Use a genuine, nurturing voice tone.
Use touch.
Use music.
Immersing yourself in a loved one's experience, rather than reorienting them, can make all the difference and also help to decrease your stress and anxiety. While the name "Validation" is intuitive, the common practice of using it may not be. For an easy-to-follow, self-guided learning experience that teaches the basic techniques, check out the Journey of Discovery. This unique form of empathetic, person-centered communication will bring you closer to understanding and appreciating your friend or loved one with memory loss, while at the same time dispelling any fears that you may have had about communicating with them.
So, I ask, will you allow the diagnosis of Alzheimer's or a related form of dementia to define the person or choose to recognize and validate the whole human being that they still continue to be? Stay present, remain connected, and embrace that you still have more in common than you have differences. It's the best thing you can do.