Validation for the Cognitively Intact

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Minstrel

I work on the dementia-care side of things.  One day an aide I was working with tried repeatedly to debate one of our dementia-unit residents about why she should just go and sit down and finish her lunch.  The resident left the table, the aide went after her.  The resident got up from the table again, again the aide brought her back, all the while scolding her.  This happened a number of times in the space of a few minutes.  I finally said to the aide, “Mary doesn’t want to sit at the table.  And we aren’t supposed to insist on keeping her there if she wants to leave.”  The resident was unhappy; her aide was unhappy.  Now I was unhappy with that aide.  And that aide was unhappy with me.  

I thought to myself, “I wouldn’t snap at a resident that way; why would I snap at the aide?”  I recalled something from my dementia training program.  One day the trainer asked, “Has anyone been able to use anything we’re learning, in your workplace?”  I thought of something that had happened that week on the train.  In front of me there was a little boy, three or four years old.  He was delighting in everything: in all he saw out his window, and in those of us sitting nearby.  Then his mother focused on this adorable, giggly little boy.  “Georgie, get over here.  Georgie, be quiet!  Georgie, sit still!”  In reality, little Georgie was actually pretty quiet and well behaved.  The only thing he was doing was enjoying his train ride!  But Mom kept on and on at Georgie for every little innocent move he made.  

Brimming with new knowledge, I was tempted to say, “Ma’am, scolding Georgie won’t work.  Repeating the scoldings won’t work.  Scolding him in a louder voice won’t work.  Georgie needs to be validated!”  [A common practice in dementia care.]  “Smile at Georgie.  Engage him; ask him what’s making him feel so happy.  Maybe give him a hug and tell him how glad you are that he’s so happy!  And soon Georgie may very well be focused on you instead of stretching backward to see all of us.”   

This was a Eureka moment for me: dementia-care training offers great lessons for relating to a child, to everyone, not just those with dementia.  This might sound condescending.  But dementia-care training is about how to transform resistance, stubbornness, and defensiveness in those who feel demeaned or threatened by us or confused by our demands — into cooperation.  We stay calm and positive.  We validate how the other is feeling.  We try to understand what the person is really trying to tell us when he rejects our attempts to get him to obey our wishes.  Instead of perpetuating the conflict, we try to discover—or create!—common interests.  Those who work among persons with dementia—and in any LTC setting that is most of us—become creative communicators.   Validating communication helps with dementia residents, and it might help us communicate more effectively with our families, our friends, our co-workers, even our supervisors.  (Now that would be sweet irony!)

 

2 thoughts on “Validation for the Cognitively Intact

  1. Rachell Holmes

    I have a burden to change the face of CNAS in long term care. There has to be exposure, accountability as well as change. We owe it to our mothers, fathers, Grans ,uncles etc. I have devoted my RN career to this very thing. Thank you for this blog. Your voice is powerful and the residents are needing our help. God bless you from Rachell Holmes. RN at New Beginning CNA Training in Stone Mountain Ga. The new culture of nursing assistance is on the rise so that not one more instance of mistreatment will occur Gd willing.

    Reply
  2. May

    That is a very well made point! I think more of this kind of education would be extremely helpful to caregivers!

    Reply

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