Validation Training Institute

VTI Blog

My Journey with Validation by Rita Altman, MSN, RN, CVM

In 1998 I began working as a Corporate Director of Memory Care for Country Meadows whose headquarters are based in Hershey, PA. During the interview, Michael Leader the CEO, asked me about Naomi Feil and the Validation Method. Sadly, my response was that while I had heard about Validation, I didn’t have any experience with using it. He told me that he planned to invite Naomi Feil to Country Meadows to present workshops at several of their communities.
Months later, when Naomi came to present those workshops, we started off by visiting a memory care community together. I had no idea of what was in store for me that day and I will never forget the experience because it was a defining moment in my career as well as in my life.

For about an hour we toured the building which consisted of three floors of memory care neighborhoods. Looking back, I realize that thanks to Naomi Feil I learned more about communicating with disoriented older adults during that hour than I had learned in my many years of working in memory care.

As Naomi walked through the neighborhood she intentionally stopped and greeted each person she saw. During her brief interactions with residents, I observed something I had never seen before. There was something truly remarkable about the way that she was ‘fully present’ and almost ‘bigger than life’ as she listened with empathy and warmth making everyone she met feel like the most important person in the world.

Naomi’s face and especially her eyes conveyed such warmth as she looked directly into the eyes of each resident. Her head and body were slightly tilted forward as she intently listened to each one of them. There was also something very special about the way that Naomi reflected the resident’s mood, down to the way she matched the tone and tempo of their voice. Even more amazing to me was the change I saw in each resident. As a result of having only a few moments of time with Naomi, I noticed an almost immediate added sparkle in their eye, or saw their heads and shoulders seemed more upright, and some even seemed to have a bit more spring in their step! Because of Naomi Feil’s validating presence each person appeared to have more dignity and well-being.
As we entered the third floor, where residents who were in the late stage of memory loss lived, our attention immediately shifted to a resident who was shouting out and pounding the table. This resident was very distressed because she missed her husband. I stepped in and did my best to provide some comforting words. However, my poor attempt to reassure her seemed to escalate her anxiety and anger. I didn’t realize it at the time, but in trying to make it ‘all better’ for her, like the way a nurse applies a dressing on a wound, I was making it worse. The more I told her that her husband loved her and would be there soon, the more she cried out and pounded the table. I was offering reassurance when all that she needed was Validation.

I looked over my shoulder and asked for Naomi’s help. Naomi moved in closely to Martha and looked directly into her eyes, she matched the expression on Martha’s face along with the tone and tempo of her voice building a bond of trust and connection between the two of them.

Martha: “I need my husband, the S.O.B left me here and I am all alone.” “I need him NOW!” “He said he would never leave me, but he did leave me here!”

Naomi: (Mirroring Martha’s motions and matching her emotion said): “You don’t like it here. You miss your husband, and he left you here?” “It’s hard to be alone and that makes you angry.” “You need him NOW.”
To my amazement, instead of crying more loudly, Martha’s eyes became more focused, and she responded, “Of course, I need him, but he left me here!”
Naomi’s eyes scanned the dining room and saw a resident named Tom who often walked about and rarely spoke a word. His posture was typically bent forward with his hands clasped behind his back and his eyes and face were usually cast downward to the floor.
Naomi approached him and said, “Sir, can you please help me?”

I was surprised by Tom’s response. He raised his head and stood more erectly and looked directly into Naomi’s eyes. He nodded yes and then followed Naomi to Martha’s table.
Naomi shared with Tom that Martha was angry and sad because she missed her husband. She told Tom that Martha needed a nice man like him to sit next to her.

Next, Naomi gently placed Martha’s hand on the top of the table, and then she reached over for Tom’s hand and gently placed it over Martha’s hand. At the touch of his hand Martha appeared relieved.
Her basic human need for security had been met by the intervention of Naomi Feil, a pioneer in person-centered care and the woman who developed the most powerful and transformational method of communication with persons living with the challenges caused by cognitive change and unresolved issues from the past.

Naomi taught me a lot about humanity that day. It was clear to me that we needed to do more than reassure or merely distract disoriented older adults. Instead, we needed to enter their world and validate their feelings. She also reminded us that it is possible to build caring and supporting relationships between residents. On that day Naomi taught me that Validation is much more powerful than simply offering reassurance. Martha felt heard by Naomi, it was almost as if her best friend was there.
Before leaving the building, Naomi made it a point to meet with the staff. She stressed the importance of adding this person-centered intervention to Martha’s care plan. Naomi wanted to be sure that going forward, in the evening as Martha waited for her husband to visit, she would now have a friend to help her feel less alone while she waited.

As an RN trained to look for evidence-based outcomes, I was a bit skeptical about how long the intervention could be sustained. Before leaving the building, I checked back to see if Tom was still there with Martha. To my surprise he was! This intervention by Naomi not only validated Martha but was also validating to Tom because he now had meaning and purpose.
In the days that followed, Naomi presented Validation workshops across the company, and all were received with enthusiasm. This powerful method of empathetic communication was exactly what we needed to offer in our memory care program and Country Meadows became the first Authorized Validation Organization in America!

Vicki de-Klerk, Naomi’s daughter and currently the Executive Director of VTI, regularly traveled from Europe to certify the first group of Validation Workers in the United States. A bonus was that sometimes Naomi joined her. Because of Vicki and Naomi’s education and mentoring, I became certified as a Level I Worker, Level II Group Worker, Presenter then Teacher and later as a Validation Master.

After joining Sunrise Senior Living in 2007 to head up their memory care program, I wrote a training called A Journey of Discovery, which featured Validation and all the ways it aligned with Sunrise’s Principles of Service and values. Team members were trained in the basics of Validation and Sunrise became an Authorized Validation Organization (AVO).
In 2021, I transitioned from my leadership role in memory care to become a memory care consultant and Sunrise’s Memory Care Advisor, supporting evidence-based, person-centered care and Validation training and certification.
It’s been an honor to serve on the Validation Training Institute’s Board of Trustees for over 23 years. Our objective is to nurture respect, dignity, and well-being in the lives of older adults experiencing age related cognitive decline and offer education and support to their caregivers.

So many of us are still experiencing heartfelt sadness over Naomi Feil’s death on December 24, 2023. I will always be grateful to Naomi Feil for the positive impact that she made in my life and career, but most importantly for the countless number of older adults living with cognitive decline who now can experience more dignity and well-being because of Validation. I am certain that Naomi Feil’s legacy will live on because of the support of the Validation Training Institute and thousands upon thousands of Validation Workers and people whose lives she touched around the world.