Validation Therapy for Cognitive Impairment

February 18, 2020
There's a reason for every type of behavior displayed by a person with cognitive impairment. Thus, validation therapy promotes understanding, empathy, and humanity.

Are you close to a person with cognitive impairment? If so, you may wonder what the best way to interact with them is. How can you convey what you mean? What can you do if their tendency to forget, sudden mood changes, and lack of orientation progress and become more evident? There will come a time when you’ll be so frustrated and won’t know what to do. Thus, continue reading to discover validation therapy, one of the best ways to deal with a person with this condition.

There’s always a way, no doubt, and an excellent one is validation therapy. This therapy is a wonderful method of communication with Alzheimer’s patients or those with other types of cognitive impairment. Especially when it becomes more difficult for both patients and their caregivers.

This type of therapy is a great form of support when you’re dealing with people who are in advanced stages of cognitive impairment. Through this article, you’ll find out what it is, along with the main principles it addresses and some communication techniques.

“The way we communicate with others and with ourselves ultimately determines the quality of our lives.”

-Anthony Robbins-

The origins of validation therapy

Validation therapy is a form of communication for the advanced stages of cognitive impairment. In addition, it’s a way of assertively approaching people in pain.

Their feelings of frustration decrease with this kind of therapy. And this is due to the understanding of how to treat people with cognitive impairment because it facilitates communication and care. In turn, this kind of therapy guarantees they won’t be as altered because the approximation is adequate.

Naomi Feil was the creator of this form of therapy. Naomi dedicated all her life to the elderly thanks to the work of her parents. On one hand, her father managed a residence for the elderly in Cleveland. And, on the other hand, her mother was in charge of the social services of that center.

In addition, thanks to the close proximity she had with older people, Feil devised a way to treat older people who were quite disoriented. It later became what’s now known as validation therapy.

A man's head blowing into pieces.

Principles of validation therapy

Validation therapy promotes deep respect and empathy for the beliefs and experiences of a person with cognitive impairment. It doesn’t matter if their ideas and experiences are real, all you have to do is give them credibility.

It’s about accepting the reality of people in advanced stages of cognitive impairment. For this, you must take the following principles into account:

  • There are reasons behind any behavior, idea, or feeling of patients in advanced stages of cognitive impairment. This is maintained even if such changes involve irritability and aggressiveness. Thus, you mustn’t judge and be more understanding and compassionate.
  • Validation therapy promotes the fact that each person is unique. Each person is valuable and, therefore, deserves respect.
  • You must leave any form of criticism behind and interact lovingly with people who are cognitively impaired. They have no control over their behavior, so it’s important to be more tolerant.
  • Being empathetic and putting yourself in their place is a good strategy to perceive how they feel and understand what they’re going through. This will help you be sensitive and patient in your interactions with them and treat them with respect and affection. In addition, your empathy will increase their confidence and reduce their anxiety.
  • Help them express their emotions and thoughts, so their feelings of anger, pain, and frustration decrease.

Keeping these principles in mind and applying validation therapy techniques will help boost feelings of self-esteem and decrease depressive symptoms in people with cognitive impairment. In addition, these actions will improve the relationships between them and their caregivers. Therefore, it’ll also reduce the emotional overload of a caregiver.

Validation therapy techniques for communication

Validation therapy is available to everyone. Practicing it means greater well-being for people with cognitive impairment as well as their caregivers. Some of the techniques to achieve these goals are:

  • Redefinition. It’s about keeping the topic of conversation by changing the focus. That is, it’s about giving them the opportunity to tell you things differently when you don’t understand them.
  • Reminiscence. It’s highly productive to stimulate the senses of people with cognitive impairment to help them remember. You may use photos or songs that are familiar to them.
  • The tone of voice. Using a clear or low voice with affectionate tones promotes the well-being of people with cognitive impairment. In addition, you must eliminate any threatening tones or domineering words.
  • Contact. It consists of maintaining eye contact and healthy physical contact, such as hugs and hand-holding, among others. This is essential in the first experiences of disorientation in a person.
  • Find a relationship between their behavior and a specific need. That is, look for the link between what the person feels and the behavior they manifest. You can always ask them what’s wrong.
A nurse holding a patient's hand.

All of these techniques validate a person with cognitive impairment. Thus, they promote a better quality of life. This is due to the fact that feelings of discomfort decrease in both the caregivers and the person with cognitive impairment.

Final notes

This form of therapy is very useful because it helps you realize how a person with cognitive impairment feels and thinks. In other words, you put yourself in their shoes. Keep in mind that it isn’t a method to replace other forms of therapy. Instead, it’s merely a way to approach people with cognitive impairment that you can integrate or use as a supplement for other types of treatment.

It’s very frustrating to be around a person close to you who has become disoriented. A loved one with vague or aggressive memories who cries easily and displays other sad symptoms. However, you still care and, therefore, must work both on your way of relating to them as much as on your own well-being.

Connect with yourself and establish loving relationships that nurture those with cognitive impairment. Undoubtedly, validation therapy is a wonderful tool to make them feel safe, understand them and reduce their stress, as well as yours. In general, adopting a posture of love, respect, and tolerance will make everyone around you feel better.

  • Feil, N. (2014). Validation therapy with late onset dementia populations. Cregaving in dementia: Research and applications, 1, pp.191-218.