If you put yourself in the shoes of someone with dementia, you’ll realize that it’s normal for them to feel afraid around everyone else’s persistence, and not know how to express what they feel or need. They might not understand what people say to them, they might not recognize the people who are around them every day, and they might not know what people expect from them at any given moment.
We rarely put ourselves in the skin of people with Alzheimer’s. But if you, you’ll realize just how terrifying and distressing day-to-day life can be for them. And then you’ll really understand the anxiety or other emotional reactions that you see as exaggerated from your “healthy” perspective.
The validation method: person-centered therapy
Over the last decade, there’s been a return in person-centered models for caregiving and communication. These therapeutic, relational models say it’s important for people with Alzheimer’s to have validating and stimulating environments.
That is, trying to empathize with people with dementia, maintaining their identity, and forming an understanding attitude towards the “altered behavior” that makes caretakers and people around them so uncomfortable.
The researchers who promote this caregiving model highlight the need to maintain all people’s basic dignity. That’s why you have to use empathy to tune into the internal realities of people with dementia.
The goal is to be able to give them security and strength. That way they’ll feel validated and able to express their thoughts. Only when someone can start to express themselves again, they’ll get their dignity back.
Why? Because validating them means recognizing their feelings. It means telling them their feelings are right. If you reject those feelings, you’re rejecting the person and destroying their identity. And by doing that you create a huge emotional hole.
Basic principles of the validation method
Let’s look at some of the basic principles of this method:
- Accepting the person without judging them (Carl Rogers).
- Treating them like a unique person (Abraham Maslow).
- Any feelings they express that are then recognized and validated by someone they trust will lose some strength. When we ignore or reject those feelings, they’ll get stronger. “A neglected cat will turn into a tiger” (Carl Jung).
- All human beings are valuable, no matter how disoriented they are (Naomi Feil).
- When their recent memory fails, we can balance them out again by recovering short-term memories. When their sight goes, they’ll use their mind’s eye to see. And when their hearing goes, they’ll listen to sounds from the past (Wiler Penfield).
People with Alzheimer’s or other kinds of dementia need to reconnect with the world
The Disney-Pixar movie, Coco, has a really great, emotional example of how you can reconnect with people who have Alzheimer’s, how you can turn to their skin, to their deepest feelings. This happens in the scene with “Remember Me”, a song that gives a wonderfully tender flavor to the emotional connection it creates.
The fact that someone loses their ability to verbally express things doesn’t mean they don’t need to. That’s why it’s so important to pay attention to the needs of people with these conditions. We have to connect with their moods and dive into those same exact feelings.
As Concetta M. Tomaino (2000) said, “it’s always surprising to see someone who’s completely shut off and distant from the world because of a disease like Alzheimer’s come back to life when someone plays them a familiar song. Their response can go from a small change in posture to excited movement. It can even go from sounds to actual verbal responses.”
And there’s almost always a response, an interaction. A lot of the time these responses seem delirious. But they can tell you a lot about how people always keep those small parts of themselves. It’s also a great reminder that they can still bring their personal stories to life in their minds.