Understanding Psychosocial Approaches: Validation

Validation is a three-step approach used in dementia care to communicate an understanding of the emotional state of people with dementia (Feil, 2012).

Validation may help build the person’s sense of trust and security, while reducing their anxiety. Your DSA consultant may make further suggestions based on an understanding of the person and their situation.

The steps involved in validation are:

  • Respectfully acknowledging or validating the feelings the person is experiencing, e.g., “You sound upset/worried/angry..."
  • Offering to help the person with their concern by providing emotional support and reassurance, e.g., “I would be worried too if I could not find my daughter.”
  • Gently redirecting the person’s attention to something more pleasant by reminiscing, changing the topic of conversation, the activity and/or environment they are in.

Validation example 1
Validation example 2
Validation example 3
Validation example 4
More information

Validation example 1

Mary doesn’t always recognise her husband, Jim. She becomes quite scared when she sees him, thinking he is an intruder in her home.

 Things to say

“Mary, you seem scared.”
“Mary you don’t seem to recognise Jim. Let’s look at the photos of your wedding to Jim.”
“How did you meet Jim?” “What is your favourite memory of Jim?”

Things to avoid
“Stop it Mary.”
“I already told you that I am/he is Jim.”
“Surely you haven’t forgotten who you are married to.”

Validation example 2

Helen calls out and looks for her children, who are grown up and no longer live with her, becoming distressed when she cannot find them. 

Try saying
“You sound upset Helen.”
“I would be worried too, if I could not find my children.”
“You miss/love your children. You are such a good mother. Let’s look at some of the pictures of the children.” 

Avoid saying 
“Stop it. Don’t you remember, your children are grown up.”
“I don’t think she would want you to behave like this.”

Validation example 3

Carlo accuses others of stealing his belongings. He forgets where he has put things and mistakenly believes that his things are stolen.

Try saying
“I would be upset too, if I thought someone was stealing my things.”
“Carlo are you worried about where your [e.g. wallet] is?”
“Are you worried about where your [e.g. wedding ring] is? It is important to you.”
“Can I help you look? Where shall we start?”

Avoid saying
“No one is stealing anything. You just lose everything and blame it on others.”
“You don’t have a...”
“You have probably lost your keys in the house again.”
“Carlo, stop being paranoid.”

Validation example 4

Bill keeps looking for his car keys, rattling the front door and trying to leave. He is worried and insists he has to go to home or to work.

Try saying 
“You seem worried Bill. What is it you need to do at home?”
“You like to keep busy. Can you come help me?“
“Come and see if we can find some work over in the office for you to do” (e.g. set up a small space with suitable activities that are related to Bill’s work).
“Where did you have your keys last? Let’s look for your car keys in the lounge.”

Avoid saying
“You are not going anywhere.”
“You’re retired. Don’t you remember?”
“It’s Saturday and you don’t work on Saturdays.”
“You can’t drive anymore.”

Want more information?

Demonstration of validation by Naomi Feil, founder of Validation Therapy, with a woman with advanced dementia

 Feil, N (2012) The Validation Breakthrough. Health Professions Press: Baltimore.

This resource material is informed by literature and associate practice evidence. This guidance should be applied within your organisations policies and procedures.
 
©HammondCare Dementia Centre November 2018 (next review date November 2020)