How To Communicate With Someone Who Has Advanced Dementia: Validation Therapy

Do you not understand why you have to continuously repeat the same thing to your family member with dementia? Does it bother you that they lash out for no reason, or that they get up and walk around while everyone is sleeping? Do you not know how to talk to your loved one with Alzheimer’s, and does it feel like all of your effort is for nothing? Sometimes talking to patients with Alzheimer’s or other dementia in the advanced stages can be frustrating and trying. We can start to feel like we’re useless, and it doesn’t take long to lose patience. However, we have to understand that aside from the cognitive problems that come with the disease (disorientation, long and short-term memory loss, apraxia, language difficulties…), dementia also has a series of psychological and behavioral symptoms, like depression, changes in personality, false recognition, agitation, irritability, pessimism, inappropriate behaviors, sleep problems, etc. How can we improve how we communicate with them? An easy way is to try these validation therapy techniques.

How To Communicate With Someone
How To Communicate With Someone

What is validation therapy?

Validation therapy is a communication therapy used in the advances stages of dementia. This therapy is based on accepting the patient’s reality as your own. In other words, when we talk to them, we should validate their altered reality and attempt to accept it for the moment.

You probably already do this naturally to some extent when you talk with your loved one. It is basically showing respect and empathy towards the beliefs of your family member, whatever their reality is, whether it is true or not.

Validation therapy is based on a few precepts:

  • We are all individual and we should be treated as individuals, even our aging loved ones. It doesn’t matter how disoriented we are or if our brain doesn’t work how it used to, we are all humans and we all deserve respect.
  • Behind every aggressive behavior or bout of anger, is an underlying cause (they may be agitated because they don’t know where they are, or because something hurts when you lift them to bring them to the bathroom).
  • We can’t make the elderly change their behavior. They will only change if they want to, and trying to force them to change will only make them resist.
  • We have to accept our loved ones for how they are, with love and without judgment.
  • Empathy increases trust and reduces anxiety.
  • Our pain can lighten if we are able to express ourselves.

Applying validation therapy has many benefits for the patient suffering from advanced dementia. For example, it has been shown that it can improve self-esteem and depressive symptoms. It can also improve interpersonal relationships with caregivers, and some studies have shown that it reduced aggressiveness and agitation that may accompany advanced dementia.

Validation Therapy Techniques

Validation therapy is simple, and you probably already apply some of the techniques naturally. If this is the case, keep doing what you’re doing. If you’re feeling a little beaten, try to follow these tips to improve your relationship and and well-being of your loved one.

  • Use comforting words, not threats.
  • Paraphrase what you say and repeat the important information.
  • Use a soft and calming voice.
  • Don’t contradict them.
  • Keep eye contact and be sincere.
  • Maintain physical contact.
  • Try to find a relationship between their behavior and a need they they have that’s not being met. Maybe they’re uncomfortable or angry because they’re hungry or because they have to go to the bathroom or because they feel lonely
  • Use music to help bring back positive memories from their past.