Humans carry an inherent need to have their feelings recognized and validated by others. As we age, this need only grows stronger. For people living with Alzheimer’s-related dementia, this need for validation amplifies further as elderly adults try to make sense of their own confusion.
In its latest stages, Alzheimer’s can be emotionally and spiritually overwhelming. Memories from recent days fade away, while people and places from earlier years–parents, childhood friends, days spent in the schoolyard–grow in strength.
For people close to the end of their lives, it can be difficult to draw the line between memory and reality.
This is especially true when memory tends to be more appealing than reality.
For example, someone well into their eighties or nineties might suddenly call out for their mother, sister, or husband, even if their loved one passed away many years ago. In the Alzheimer’s mind, that person is still alive and well, and the expectation could be that today is just another day following a routine from a long time ago.
Validation Therapy vs Reality Therapy
When people living with Alzheimer’s slip into the past like this, caregivers have a choice to make. Do they try to ground the person in reality, using facts and questions to bring them back to present day? Or in an effort to avoid upsetting the person, do they go along with the person’s fantasy, and say that their loved one will be along in a few minutes?
Validation therapy finds a compromise between these two options. Someone practicing validation is not lying–they do not play into the fantasy, or let the person believe what they want to believe. They also minimize the risk of hurting the person with harsh truths, or of the person withdrawing completely because they are unable to face reality. Someone who practices validation therapy can empathize with the person’s emotions, validate their feelings, and open unexplored lines of communication that embrace memory without living within it.