Therapeutic lying. The phrase might sound counter-intuitive, but in today’s memory care facilities the practice is widely used to promote resident wellness and satisfaction.
Rather than explaining the practice as lying when training new staff, however, memory care experts have coined the term “validation therapy” for training purposes and to explain the process to new staff and residents’ loved ones.
Validation therapy, a communication technique that allows caregivers to better relate to Alzheimer’s and memory care residents by connecting with them where they are at mentally on any given day, makes a strong impact on resident behavior, said Stella Hatcliffe, director of professional education for Mather LifeWays Institute on Aging, during a recent webinar.
“Validation therapy a much more positive way to describe being with a resident in the moment,” Hatcliffe said. “We have found that validation therapy is effective in avoiding possible confrontation and the resident is less likely to feel denigrated.”
Additional advantages include “less risk of sending the wrong message and encouragement of reminiscence, or review of life events,” she said.
Evanston, Ill.-based Mather LifeWays has four senior care locations in Arizona and Illinois — including two continuing care retirement communities (CCRCs) —along with its other aging-related ventures. All of its locations have staff who are trained to use validation therapy when communicating with residents who have cognitive impairment. In addition, Mather works with residents’ family members to educate them about validation therapy.
As senior living providers adapt to what the Alzheimer’s Association expects to be a doubling, or even tripling, of those with Alzheimer’s disease between now and 2050, providers are spearheading new practices to help care for this incoming population.
Yes is Best
At the heart of the technique is validation, contrary to past practices that often employed the word “no,” Hatcliffe said.
“You want to avoid negative messages,” she said, noting that “no” statements can increase anxiety and stress, and reduce self-esteem for those with dementia. “For example, ‘No, you can’t go home. No, you can’t see your mother because she is dead. No, I already told you that.’”
Instead, agreeing with residents can encourage positive emotions and help those with memory impairment review life events.
“If a resident thinks it’s Saturday, but it’s not, it’s OK,” she said. “You’re going to want to validate what she thinks.”
Empathy is Key
Other best practice strategies to promote person-respected care for residents with cognitive challenges include using memory aides, reducing noise and distractions and keeping a calm mood and tone.
“If a resident senses our agitation, he’s going to get more agitated,” she said. “Greet them by their preferred name and make sure to speak to them at eye level.”
Smiling, appropriate touch and avoiding patronizing comments — such as “Don’t you remember?” — are also powerful but simple tools to employ when working with residents.
While the needs of those with cognitive impairments varies by degree of impairment severity, a smile and word of encouragement go a long way in promoting a positive environment, she said.
“Always recognize and honor the person despite their cognitive impairment,” she said. “Staff having an understanding of what residents are going through will allow them to deliver the best care.”
And the results are two-fold: not only do residents benefit, but staff do too.
“We have found that validation therapy lowers the stress of our care providers, residents with dementia and their families,” she said. “It has also promoted collaborative team work as staff share validation strategies that have worked with residents.”
Written by Cassandra Dowell
Editor’s note: There is a distinction between the terms used in this article and the technical term Validation method. The Validation method, as developed by Naomi Feil and furthered by the Validation Training Institute, disapproves the use of therapeutic lying with seniors having dementia.