Validation Breakthrough: Simple Techniques for Communicating with People with Alzheimer's-Type Dementia

by Naomi Feil

Cleveland, Ohio. Text for the families and friends of patients with Alzheimer's on reducing burnout for the caregiver and improving the life of the person with dementia.

Genres: Psychology, Nonfiction, Self Help

392 pages, Paperback

First published January 15, 1993

Reviews

[Erma · Rating 3 out of 5]

This book has some worthwhile suggestions, for example, centering of the caregiver, entering the reality of the person with dementia, recognizing triggers, rephrasing, using music therapy, and cultivating attitudes of respect and acceptance. Others didn't work for me as a caregiver. Feil says the caregiver should not try to calm an angry patient. She recommends mirroring the behavior and body language, and matching the facial expression and stride of a patient who is agitated or angry in order to "validate" him. I experimented with this technique and it just exacerbated the situation. I also question Feil's assertion that all difficult behavior in dementia patients is the result of unresolved issues or relationships in their past lives. The author advocates for asking questions of patients with advanced dementia. This may work in the early stages, but it quickly becomes ineffective as the disease progresses. In my experience, these individuals don't like to be quizzed.

[Michele · Rating 2 out of 5]

This approach to dealing with agitation in persons with dementia may have some merit, but I am not convinced by the underlying theory. Further, for the most part, the book is a series of anecdotes written in a somewhat self-congratulatory way that I did not find particularly scholarly. Nevertheless, the anecdotes are interesting.

[Dana Kraft · Rating 4 out of 5]

This seems like a great approach to communicating with people with dementia. There are obviously a lot more ways to mess up these communications than to do them right. I hope we can make this work in our family's situation.

For me, the book was difficult to read for a couple of reasons. First, the goal of validation seems to be to make things less bad as a person approaches the end of life. So a happy ending means that someone dies in a relative state of peace. I suppose that I mostly don't look forward to any of that with my parents. Second, the stories that she uses are admittedly composites meant to demonstrate the method. They were useful, but there are a lot of them and they started to feel a little contrived and simplistic. My uneducated guess is that the reality of implementing this is much more subtle and messy than the stories make it appear.

The concept of trying to put yourself into someone else's reality without judgment is always good advice when you're having difficulty communicating that person.

[Michael McQueen · Rating 4 out of 5]

This came highly recommended to me as my grandma enters dementia and I struggle to communicate with her. While I don't think this is the final solution for me, I fully appreciate the model and method. I took several key points from this book to move forward with, but much of the book I could not relate with as I'm not a professional caregiver, she is still living independently, and I am 1000 miles away. I will be passing this book on to other family members.

[Nakkinak · Rating 3 out of 5]

I think the great merit of this book is the shift from looking from a nurse's perspective towards the patient's perspectivce. The underlying theory is - as many people noted - kind unscientific (cynics would call it psychobabble), arguing that actions and comments by a person affected with Alzheimer's disease are attempts to deal with emotions that come from unresolved conflicts. I think this is perfectly possible for some actions, but others simply don't make sense and have no meaning - to validate the emotion however is a great approach that prevents aggression on the long term.

A Freudian and Jungian approach, but the method is valuable and pretty much the most effective and humanistic one found to date. It's a fallacy to say "who cures is right" but I can ensure it works way better than the (outdated, but still practiced) traditional way to talk people affected by dementia, which simply doesn't work: one has to understand that they cannot understand. The main point is: respect and empathy.

6.5/10

[Carol · Rating 3 out of 5]

There are some good tips on how to communicate with someone who is extremely agitated due to dementia. I am not sure I quite agree to the reasons provided for this agitation. The book suggests that there is some deep unresolved life stages that the person is working through. A part of me believes that changes in the brain probably cause some of that agitation, regardless of whatever psychiatric issues there might be. In any case, I am going to try the techniques and I can see why they would be useful.

[John · Rating 3 out of 5]

Needs to be revised to align with the last decade of research into the physiology of dementia. I felt that Feil’s methods are both more universal and less universal than she taught. More universal in that they describe an empathetic framework that has applicability beyond the boundaries of dementia care. Less universal in that she tries to cram both physiological effects and emotional effects into her single system, and strains the framework to do so.

The situation that fits least well into Feil’s framework is what she calls the vegetative phase. I interpret it as a reflection of the degree to which the physical process of neural degradation has consumed the person’s mind. But Fiel seems to be insisting that this phase is the end state of an emotional process, a state beyond what her method can reach.

[Kiersten · Rating 2 out of 5]

I appreciate the person-centred approach that this book displays, but the book and theory have many issues. For example, claiming that all behaviours of dementia are related to unresolved life issues is a huge claim - with no citations to back it up. Similarly, she claims specific information with no true data to back it up (e.g. the method producing significant results in only X minutes Y times per day). Much of this book is anecdotal evidence, and most of part one was re-imaginations of how patient situations MAY have gone if the validation method was used. I would not recommend this to co-workers or loved ones of people with dementia.

[Karen Shilvock-Cinefro · Rating 4 out of 5]

This book offer different techniques for communicating with People with Alzheimer’s and Other Dementia. Well written and helpful tips. It is important not to disagree with the person who has dementia but rather to communicate with them where they are at in their thoughts.

[Beau Raven · Rating 5 out of 5]

This book has been indispensable to me as a music therapist. I incorporate a lot of the principles detailed in this book into my practice, with amazing results.

[Carla · Rating 5 out of 5]

A much-needed insight to the needs of a caregiver dealing with a loved one who has dementia or another related disease. I learned quite a bit from reading this book

[Sue · Rating 4 out of 5]

A very enlightening concept that I want to experience. I’m going to look for places this approach is being carried out.

[Amber · Rating 4 out of 5]

3.5. Very informative and interesting concept. Wish I had read it when my Grandma was still alive.

[Maddie! · Rating 5 out of 5]

This is one of the most soul inspiring and powerful books I've ever read. Naomi Feil is incredibly knowledgeable, sensitive and compassionate. Her work is brilliant and it moves me to tears.

[Renah · Rating 3 out of 5]

I think this approach sounds fantastic-- but I also think learning to use it could be very challenging. I like the author's mindset that old and "old-old" people have wisdom and deserve respect. Our culture in general has way too little respect for the old, and this is a step in the right direction.

[Beth Shields · Rating 4 out of 5]

Great book by a woman who has been a pioneer in the best care for people with Alzheimer's. Applies more to very elderly people who develop dementia (ex., 80's and older) than for those who develop it at a younger age. My mother was diagnosed with AD at 70 and so much of this book doesn't apply to her situation. That said, I learned so much about AD by reading this book - I'll find it useful.

[Mary Narkiewicz · Rating 3 out of 5]

I actually have not read this book. I skimmed it. Important information for those working with or caring for people with Dementia. I kept it for a few months. It was a borrowed book..and I just did not get to it. May read it some day. I did read some of it.

[Elaine · Rating 3 out of 5]

Good book for those who have limited experience with dementia patients. Good those who have experience, I believe this is a tactic one naturally gravitates to when working with these patients.