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Validation Therapy

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Validation Therapy - Page Text Content

FC: Validation Therapy | Simple techniques for Caregivers to use when working with People who suffer from Alzheimer's Disease.

1: Forward Validation Therapy was created by Naomi Feil; she was born in Munich, Germany and grew up in the Montefiore Home for the Aged in Cleveland Ohio, where her father was the administrator and her mother, the head of the Social Service Department. She graduated from the University of Columbia with a Masters of Social Work. She later began working with Elderly where she developed Validation as a response to her dissatisfaction with traditional methods of working with people who suffer from Alzheimer’s disease. Naomi Feil is the creator and founder of Validation Therapy and has Publish books and videos about the techniques of Validation Therapy and its impact which is well known around Europe. Throughout my experiences in the Special Care Counselling Program I have been introduced to many different approaches and techniques. Validation Therapy is an approach that was introduced to me in my Aging and Loss of Autonomy class and was a technique that I wanted to further explore. After using this Approach in past Fieldwork experiences, I knew that it was effective and should be introduce in all different areas where Caregivers work with individuals who suffer from advanced stages of Alzheimer’s.

2: Table of Contents What is Alzheimer's disease? ..............................................................Page 4 Types of Alzheimer's ...............................................................................Page 5 What is Validation Therapy?.................................................................Page 6 Why Use Validation?...............................................................................Page 6 The Principals of Validation ..................................................................Page 7 Validation and its components.............................................................Page 8 The Stages of Resolution......................................................................Page 9 Stage 1...................................................................................................Page 9 Stage 2..................................................................................................Page 10 Stage 3..................................................................................................Page 11 Techniques of Validation .............................................................Page 14 - 16 Benefits of Validation...................................................................Page 17-18 Common Behaviors, Quick Strategies............................................Page 19 - 20

4: What is Alzheimer's Disease? Alzheimer's disease is a disease that deteriorates the brain. It's also a progressive disease that causes damage and impairs the functioning of the person. Age is also an important risk factor in Alzheimer's disease, and based on research; “the number of people with Alzheimer's disease doubles every 5 years beyond the age of 65.” Family history is also another important factor for the causes of Alzheimer's disease and can be transmitted through the genes. Moreover, “Alzheimer's disease accounts for 50 to 80 percent of dementia cases. “ Causes and Risk Factors: Age- The risk of developing Alzheimer's disease increases with age. According to the Alzheimer's Association 10% of all people over the age of 65 have Alzheimer's disease, and as many as 50% of people over age 85 have it. Gender- Alzheimer's disease affects women more frequently than men. Family history- Fewer than 1% of people with Alzheimer's disease inherited the condition. Head injury- Some studies have shown a link between Alzheimer's disease and a significant head injury.

5: Types of Alzheimer’s Early Onset: This is a rare type of Alzheimer’s disease in which people are diagnosed before the age of 65. Late-Onset Alzheimer’s - This is the most common form of Alzheimer's disease, accounting for about 90% of cases, and usually occurs after age 65. Late-onset Alzheimer's disease strikes almost half of all people over the age of 85 and may or may not be hereditary. Late-onset dementia is also called sporadic Alzheimer's disease. Familial Alzheimer’s disease - his is a form of Alzheimer's disease that is known to be entirely inherited. In affected families, members of at least two generations have had Alzheimer's disease. FAD is extremely rare, accounting for less than 1% of all cases of Alzheimer's disease. It has a much earlier onset.

6: What is Validation Therapy? Validation Therapy 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. Why use Validation Therapy 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. By using Validation Therapy, we offer disoriented elderly an opportunity to express what they wish to express whether it is verbal or non-verbal communication. 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.

7: The Principals of Validation 1) All people are unique and must be treated as individuals. 2) All people are valuable, no matter how disoriented they are. 3) There is a reason behind the behavior of disoriented old-old people. 4) Old-old people cannot be forced to change their behaviors. Behaviors can be changed only if the person wants to change them. 5) Old-old people must be accepted non-judgmentally. 6) When more recent memory fails, older adults try to restore balance, in their lives by retrieving earlier memories. When eyesight fails, they use the mind's eye to see. When hearing goes, they listen to sounds from the past. 7) Painful feelings that are expressed, acknowledged, and Validated by a trusted listener will diminish. Painful feelings that are ignored or suppressed will gain strength. 8) Empathy builds trust, reduces anxiety, and restores dignity.

8: Validation and its 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 also known as the: Four resolution stages 1. Mal-orientation - Expressing past conflicts in disguised forms. 2. Time confusion - No longer holding onto reality; retreating inward 3. Repetitive motion - Movements replaces words and is used to work through unresolved conflicts. 4. Vegetation - Shuts out world completely and gives up trying to resolve living. ** Each stage has specific physical and psycho-social characteristics. 2.Validation is based on a basic, empathetic attitude that respects and values very old people without judgment. 3.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.

9: Using Validation with Individuals In Different Resolution Stages STAGE 1: MALORIENTATION Physical Characteristics: Emotional Characteristics: Muscles Tight Keeps social Control Eyes Focused Avoids Touch Movements Purposeful Avoids expression of feelings Speech Clear Hoards materials Repeats unresolved Issues; I.e Fear of being robbed, poisoned, blames others. How Validation can be used? Use Non-threatening exploring factual words: Example: who? what? How did it happen? Where? When? Repeat their key word or phrase. LISTEN WITH EMPATHY AND DO NOT JUDGE!

10: STAGE 2: TIME CONFUSED Physical Characteristics: Emotional Characteristics: Speech Unclear Loss of social Control They create new words Smears present with past time Loss of logical thinking Restores past to survive loneliness Responds to touch, close eye contact Shares feelings How Validation can be used? - Say Their Feelings Out Loud, Verbalize Their Body Language - Match Their Feelings - Repeat Their Key Words Or Word-Doodles - Link Their Behavior To Unmet Human Need: (1) Love, (2) identity, (3) to express gut feelings - Accept All Feelings That Are Given - Do Not Insert Feelings Or Push - Travel To The Past With Empathy - Use Ambiguity (Vague Pronouns, "He," "Someone," "It," to Keep Communicating when the Disoriented Are Not Clear

11: STAGE 3: REPETATIVE MOTION Physical Characteristics: Emotional Characteristics: Adult speech deteriorates Feelings become incontinent Motions Replaces words Withdraw, shut out external reality Rhythmic repetitive motions Primal behaviors return Movements are purposeful How Validation can be used? Nurturing Touch Nurturing Voice Tone Close Eye Contact Genuinely Mirror Feelings. Mirror Physical Motions Touch Will Limit Repetitive Motions Consistent One-on-One Validation can prevent Vegetation. Mirroring repetitive motions in a genuine relationship often restores dormant speech and triggers some awareness of present time and place.

12: In addition to affecting memory and other cognitive skills, Alzheimer's disease often affects the way people feel and act. Many people find that the change in behavior cause by Alzheimer's is to be the most challenging and stressful effect of the disease. In early stages, people may experience behavior and personality changes such as: -Irritability -Anxiety -Depression In later stages, other symptoms may occur including: -Anger -Agitation -Aggression -General emotional distress -Physical or verbal outbursts -Restlessness, pacing, shredding paper or tissues - Hallucinations (seeing, hearing things.) -Delusions (firmly held belief in things that are not true) -Sleep disturbances

14: The Techniques of Validation Centering – Caregivers must focus on their breathing in order to let as much anger and frustration as possible. By centering, it releases our anger and frustration and allows caregivers to open up and make communication with the person a lot more effective. In order to be able to help another person, it is crucial for caregivers to release their own emotions and frustrations in order to listen empathetically and provide support. Use nonthreatening, factual words to build trust – People who are in the stages of resolution do not want to be faced with the understanding of their own feelings. They do not want to know why and how they feel that why at that moment. When they are confronted with how they feel, they withdrawal themselves. In order to communicate effectively caregivers must avoid asking questions about how they feel. As an alternative, they should ask factual questions like who, what, when, where and how. Rephrasing – People who are in the stages of resolution find it comforting to hear their own words spoken by someone else. In order to rephrase, caregivers must repeat the phrase or sentence in the same tone of voice and way it was said. Using Polarity – Using polarity with someone in the resolution stages involves asking the person to think about the most extreme example of his or her complaint. By thinking about the worst case, the person being validated will express their feelings for fully, thus finding some relief.

15: Techniques of Validation Cont'd Reminiscing – Exploring the past can often re-establish old coping methods that the disoriented person might have use in the past to help them when they feel stressed Maintaining genuine, close eye contact – Residents who are time confused or who are in the repetitive motion stage feel loved and secure when caregivers show affection through eye contact. Using Ambiguity – Often times people with Alzheimer's can use words that have no meaning, and do not make sense. They often communicate non-verbally and in ways that are difficult to understand. By using ambiguity caregivers can communicate with residents when they do not understand what is being said. When clients use words that have not meaning, Caregivers can use ambiguous words; like “he, she, it, “someone” or “something.” Observing and Matching the Person's Motion and Emotions (Mirroring) - People in Time Confusion and Repetitive Motion often express their emotions without inhibition. The caregivers should observe their eyes, facial muscles, breathing, changes in color, chin, lower lip, hands, stomach, position in the chair, position of the feet, and the general tone of their muscles to match these postures. When the person being Validated paces, the caregiver paces. When the person being Validated breathes heavily, the caregiver breathes heavily. Done with empathy, mirroring can be effective in helping to create trust. It allows the caregiver to enter the emotional world of the Time Confused person and to build a verbal and nonverbal relationship. Mirroring the sometimes bizarre motions of disoriented people can be an upsetting experience and not all caregivers will want to try this technique.

16: Validation Cont'd Using a Clear, Low, Loving Tone of Voice - Harsh tones cause disoriented people to become angry or to withdraw. High, soft tones are difficult for many older adults to hear. It is important to speak in a clear, low, nurturing tone of voice. Often, a nurturing voice triggers memories of loved ones and reduces stress. Touching Touching is a technique that is usually not appropriate for Mal-oriented people, but is often effective with people in Time Confusion. People in Time confusion no longer distinguish between people they have known all their lives and people they have never met before. The Validating caregiver can instantly become a loved person, since people in Time Confusion can incorporate strangers into their world. People in Repetitive Motion are no longer aware of where they are. To communicate with them, the caregiver must enter their world and touch them in the same way a loved one touched them. To use touch with a Time Confused person, the caregiver should approach the person from the front, since approaching the person from the side might startle the person. Touching another person is an intimate act and caregivers - both professionals and families - must respect that some people, even when their controls are damaged do not want to be touched. Any sign of resistance to physical contact should indicate to the caregiver that touching is inappropriate. The personal space of all people, whether they are disoriented or not; must always be respected.

17: The Benefit of Validation By using validation in these facilities, it has much to offer such as reliving physical and emotional drain caused by working with seniors suffering from AD. For caregivers, Validation therapy can: - Reduce Frustration - Prevent Burnout - Promote joy in Communication - Increase job satisfaction

18: Because the use of validation therapy, it created significant changes in the work environment and in staff behavior which led to caregivers in the facilities to continue to use validation with residents. Because of this, caregivers now: Call residents by name more often Used lower tones of voice in communication with residents Bent down to face residents in wheelchairs in order to establish eye contact. Touched disoriented residents more often Communicated frequently with residents’ families to share validation techniques. Help residents find lost articles more often Listen to disoriented residents Responded to cries of help from disoriented resident by validating them.

19: Wandering What to do? Look for an immediate cause. Reassure the person and distract him with another activity. Ensure regular walks and exercise. Put reminders (i.e., coat, hat) out of sight and reach. | Repeated Actions What to do? If the behavior does not bother you, do nothing. Distract him with simple activities (i.e., folding laundry, polishing the furniture, shoes, etc.) Change the subject. Stay calm. | Common behaviors - Quick Strategies

20: Aggression Be calm and reassuring. Look for an immediate cause. Give her space to cool down. Distract her. If your safety is threatened, leave. | Sexual Behavior Don't judge or scold. Provide affection. Look for unrelated needs (Does she need to use the toilet? Is she lonely or bored? Is she too hot or cold?) Distract with other activities. Stay calm. Provide privacy. | Common Strategies - Easy Strategies

21: NOTES _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _

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  • By: Brian D.
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  • Title: Validation Therapy
  • Information on Validation Therapy and Alzheimer's disease.
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  • Published: over 3 years ago

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