Validation is a widely taught communication technique in dementia caregiving. It aims to make the person feel validated in their present moment experience, whatever that may be. Sounds good, doesn’t it? The problem is validation gets often perverted into a manipulation attempt to stop the person’s behavior. This is of course not intentional, but a result of the caregiver’s natural emotional reaction – felt fear and helplessness, in response to challenging behaviors. Such ‘surface’ validation does not work.
True validation needs to be rooted in mindfulness and experiential understanding of the person’s situation. Mindfulness-based role plays are one of the best ways to truly get into the other person’s shoes. To illustrate, I would like to share what happened during the course of one of my trainings.
Sue role played a situation that happened every night with her husband Jim, when he repeatedly asked to go to the ‘club’, meaning his adult day program. Such repetitions can wear out a caregiver’s patience, and Sue’s response, while overtly kind and reassuring, really stemmed from her need to redirect Jim, so that he could go to bed. During the role play, Sue played Jim’s part. Another caregiver played her role. Both were instructed to bring mindful attention into their role play, paying attention to thoughts, emotions, the overall feeling, and also body sensations.
The result was powerful. Sue got in touch with the reality of Jim’s emotions, and the truth of his wish to go to the day program. She switched from merely trying to appease him, to becoming convinced of the validity of his repetitive request. This happens every time with such role plays. The other positive outcome was a desire to truly address Jim’s request. Sue became open to exploring real solutions to Jim’s request. What did the day program offer that was missing at home? It turned out that Jim really enjoyed listening to his favorite music, and also feeling useful helping out with various tasks at the program. Sue went home and offered Jim to play his favorite music. She also came up with a list of chores that Jim could help her out with in the evening. Jim’s repetitive requests stopped.
When faced with a challenging care interaction, ask for a friend or two to help you. Play your loved one’s role, and have your friend play you. And pay attention to what comes up for each of you . . .
