What is Validation
Validation is a method of communicating with and helping disoriented very old people. It is a practical way of working that helps reduce stress, enhance dignity and increase happiness. Validation is built on an empathetic attitude and a holistic view of individuals. When one can "step into the shoes" of another human being and "see through their eyes," one can step into the world of disoriented very old people and understand the meaning of their sometimes bizarre behavior.
Validation theory explains that many very old disoriented people, who are often diagnosed as having Alzheimer type dementia, are in the final stage of life, trying to resolve unfinished issues in order to die in peace. Their final struggle is important and we, as caregivers, can help them. Using Validation techniques we offer disoriented elderly an opportunity to express what they wish to express whether it is verbal or non-verbal communication. Validation practitioners are caring, non-judgemental and open to the feelings that are expressed. When disoriented elderly can express the things that have often been suppressed for many years, the intensity of the feelings lessen, people communicate more and are less likely to withdraw into further stages of disorientation.
Validation has three basic components
Validation is a theory that very old people struggle to resolve unfinished life issues before death. Their behavior is age-specific. Their movements reflect human needs. Validation is a way of classifying their behaviors into four progressive stages:
Malorientation- Expressing past conflicts in disguised forms.
Time confusion- No longer holding onto reality; retreating inward.
Repetitive motion- Movements replace words and are used to work through unresolved conflicts.
Vegetation- Shuts out world completely and gives up trying to resolve living .
Each phase has specific physical and psycho-social characteristics.
Validation is based on a basic, empathetic attitude that respects and values very old people without judgment.
Validation includes specific techniques for individual as well as group work, based on the needs of the individual and his or her phase of resolution.
Principles were created by Naomi Feil, apply to maloriented and disoriented elderly; they help guide our actions and determine the Validating Attitude. Theoretical assumptions/bases: are created by other theorists, apply to the general population (not specific to disoriented elderly) and are useful in supporting Validation Principles when challenged by scientists or academics. Our Actions/behavior flow out of the Principles and support the Validation techniques.
1. All very old people are unique and worthwhile.
2. Maloriented and disoriented old people should be accepted as they are: we should not try to change them.
3. Listening with empathy builds trust, reduces anxiety and restores dignity.
4. Painful feelings that are expressed, acknowledged and validated by a trusted listener will diminish. Painful feelings that are ignored or suppressed will gain in strength
5. There is a reason behind the behavior of very old maloriented and disoriented people
6. The reasons that underlie the behavoir of maloriented or disoriented very old people can be one or more of the following basic human needs:
- Resolution of unfinished issues, in order to die in peace
- To live in peace
- Need to restore a sense of equilibrium when eyesight, hearing, mobility and memory fail.
- Need to make sense out of an unbearable reality: to find a place that feels comfortable, where one feels in order or in harmony and where relationships are familiar.
- Need for recognition, status, identity and self-worth
- Need to be useful and productive
- Need to be listened to and respected.
- Need to express feelings and be heard.
- Need to be loved and to belong: need for human contact
- Need to be nurtured, feel safe and secure, rather than immobilized and restrained.
- Need for sensory stimulation: tactile, visual, auditory, olfactory, gustatory, as well as sexual expression
- Need to reduce pain and discomfort
Example: An old woman moves her fingers like she used to use her typewriter, to maintain her dignity and identity as a typist. She cannot bear being old without a job. To restore balance, she works. A validating caregiver asks, "You certainly did a lot of typing in your life, didn't you?"
7. Early learned behaviors return when verbal ability and recent memory fails:
8. Personal symbols used by maloriented or disoriented elderly are people or things (in present time) that represent people, things or concepts from the past that are laden with emotion.
9. Maloriented and disoriented old people live on several levels of awareness, often at the same time.
10. When the 5 senses fail, maloriented and disoriented elderly stimulate and use their "inner senses'. They see with their "mind's eye' and hear sounds from the past.
11. Events, emotions, colors, sounds, smells, tastes and images create emotions, which in turn trigger similar emotions experienced in the past. Old people react in present time, the same way they did in the past.