Validation—the key to compassion and communication in memory care

Steve Klotz, Executive Director of Validation Education, joined Country Meadows in 1995. He was looking for a career change when a friend told him Country Meadows in York had an opening for a chaplain. He wasn’t sure he was the right fit, but he took a chance and soon fell in love with the residents. He holds a B.A. in religion from Lycoming College and a Master of Divinity degree from Palmer Theological Seminary. Steve also has completed four years of training in the Validation Method of communicating with individuals with dementia.

How did you become interested in working in memory care with seniors?

When I began here as a chaplain, working with residents with memory challenges was part of my responsibilities. I soon came to see them as individuals with a lot to offer. I really enjoyed this interaction and found myself working more and more with them. Now I work solely with these residents—both those living within our secure Connections neighborhood (for those with a higher degree of dementia) as well as ones residing in personal care (with less serious memory issues).

When did you first become aware of the Validation Method in memory care and when did you start putting it into practice at Country Meadows?

I learned about Validation as a method to facilitate communications with people in dementia care in the late ‘90s at workshops and in conversations with colleagues. I was one of the first people trained in Validation at Country Meadows. That was in 1999. I was hooked by the second day.

Around the same time, Michael Leader (Country Meadows President and CEO) had expressed concerns about how dementia care was approached at some senior living communities. He wanted to ensure that Country Meadows residents with dementia were treated respectfully in all communications with them.

Today, we use the acronym REACH to always remind us of the attitudes of Validation. We use respect, empathy, acceptance, caring and honesty—appropriate honesty—in all our contacts and communications with those with dementia.

Could you explain Validation and its use with individuals who have dementia?

Validation is a method of building relationships with people who have dementia. Validation enhances the attitudes, principles and techniques we adopt in helping people on their dementia journey.

The core principle of Validation with those who have dementia is to enter into their world rather than expect them to come into ours. Their view of reality is true and real to them due to changes in their brains. We can’t fix their dementia, and it’s counter-productive to try to get them to accept our world. Correcting their view of reality can upset them, so we tend to avoid that. There are usually strong emotions connected with a person who has dementia—perhaps unmet needs or unsettled business. They’re looking for peace and comfort.

Here’s an example: Martha wants to know why her husband, John, hasn’t returned home from work for dinner. Actually, John died seven years ago. Caregivers might be tempted to remind Martha that John died, but hearing that could upset and agitate her. Instead, they could engage her by exploring her relationship with her husband. They could ask, “How often do you worry about him?” and “What did you enjoy the most about dinnertime with him?” These questions help her to release and relieve her emotions, plus she can relive a beautiful moment with her husband.

What effects does Validation have in seniors with dementia?

Not only is it beneficial for them, but also for their loved ones and caregivers. For the seniors, it lowers their anxiety and stress and lessens their frustrations with communicating. All in all, it gives them more contentment and happiness. It’s a very different way—a better way—of relating with dementia residents than was used in the past. For family members, it provides some relief to have something else to try when communicating. Relating to loved ones with dementia is tiring and challenging, and Validation offers relief from guilt when having a hard time communicating. I have heard family members say, “I was doing things that make it harder; now I can try something to make it better.”

How does Country Meadows prepare its staff in Connections Memory Support Services to use Validation with residents?

Our health care professionals who provide direct resident care—our patient care assistants, certified nursing assistants and medication associates—use Validation all the time to communicate with our residents. Every memory care neighborhood  has a program manager and community life director who are specially trained in Validation, certified in utilizing one-to-one Validation methods and available to guide their staff in the use of Validation. Those who work in dementia care services and specialize in Validation complete an eight-to-nine-month course. This enables them to skillfully validate residents on their individual journeys.

Is Validation used by staff who work outside of memory support? How do they learn to apply it?

Yes, because at Country Meadows, Validation is part of our culture. It’s our way of treating those with dementia with understanding, respect and empathy. We now have eight co-workers at Country Meadows who are certified by the Validation Training Institute to teach Validation.

We have adopted a three-step process for our staff: 1) It is introduced as a communications method as part of our onboarding (orientation) process for new co-workers. 2) Everybody who works with residents with memory impairment and orientation issues takes a two-day introductory course on Validation. The last half-day is spent in the memory care neighborhood with a teacher and among residents who are more confused. The teacher observes interactions, coaches employees and demonstrates proper communications. 3) We provide ongoing coaching and mentoring as needed as co-workers continue to relate to residents with dementia throughout their employment.

Can families of your residents learn how to use Validation in their interactions with their loved ones?

Yes, and we encourage that. Validation makes their caregiving easier and more gratifying. I, along with our other teachers, instruct families quite a bit. We help them answer, “What do I bring into this conversation, and what do I leave out?” Our lives are so busy, but the lives of seniors with dementia are slowing down. When we’re with them, we need to leave our busy schedules and our “get-things-done” conversations outside. It can overwhelm them.

Instead, center or focus on them. What’s on their mind. What are they thinking? What are they feeling? What do they need, socially and emotionally? It’s not always easy for them to put that into words, but it can help them, so let them express their emotions. Doing that can be difficult at first and is a big step for a lot of families.

A lot of their lifetime of experience is still there and can be accessed and applied to their current situation. Reminiscing can be a coping mechanism. What helped them through some of the hard times in their life? For example, talking with someone, prayer, Bible reading—these are still available to them. Let the answer come from them and their experience.

Is there anything else you would like people to know about Validation?

I would like caregivers who use Validation to better reach their loved ones to know they are doing their best. Even those with dementia generally know that. They know their families love them and have their best interest at heart. They can sense the intention and know it is done in love. Caregivers should find comfort in that.

Naomi Feil, founder of the Validation Training Institute, referred Country Meadows to author and host of CBC Radio’s “White Coat, Black Art” Dr. Brian Goldman, who was seeking practices of empathy. He visited Country Meadows-York South to observe our team engaging with residents using Validation. In his 2018 book, “The Power of Kindness,” he was so inspired with what he observed and learned, he dedicated a whole chapter to Country Meadows titled, “Soul Whisperers.” The book can be purchased here.