Stepping into Your Loved-Ones Reality: Is it lying or compassion?
Who doesn’t enjoy being surrounded by people who make you feel understood and supported? The need to be validated is important to everyone, especially to those living with memory loss. But so often, care partners, friends, family, and even professionals who support people living with dementia or Alzheimer’s disease lack the understanding of the importance of recognizing that people with memory loss have thoughts, feelings, concerns, and wishes that need to be understood and validated.
At one time, “reality orientation” was the most common form of communicating with people living with dementia. The purpose of reality orientation is to disrupt cognitive decline by stimulating the confused individual by reinforcing name, date, time, and other facts. Trying to orient a person with significant memory loss is asking the person to do something they are not capable of. Early on, “nursing homes” used colorful calendars and large clocks in each room so every time staff or family member entered the room, the person was prompted to be “grounded” in reality. Unfortunately this only caused distress and behavioral symptoms, as the person was really being asked to be in our reality. This still happens today with family members or caregivers who do not understand the importance of entering their reality, and arguments are constant.
In the very early stage of memory loss, gentle reminders of the day of the week (reality orientation) can be helpful, but once the person becomes more confused and disoriented and believes and argues that it is Wednesday when it is Friday, validating their reality and redirecting works best.
“Validation therapy” is a proven, non-pharmaceutical method of communication developed by American social worker and gerontologist Naomi Feil. She was born in Germany, and her parents came to the US and she said she “was raised in a home for the aged,” where both parents held administrative positions. She recognized even as a child that taking a more empathetic approach when communicating with the more confused residents kept them calmer and happier. Using validation therapy is a much kinder and more effective way to communicate and causes less stress and anxiety for everyone.
But is it lying? Many family members and friends feel being untruthful is wrong and they continue to correct, scold and argue with their family members, repeatedly asking them “why can’t you remember it is it 2021, not 1941?” Trying to convince a person with cognitive decline who claims “Christmas is coming” and correcting them that it is February and we just had Christmas, only confuses and frustrates them and this will often result in arguments and conflicts. Using the outdated method to keep people in ‘reality’ is especially difficult for the person when he/she is told of the death of someone they love. For example, confronting a family member who can’t remember the death of their mother 30 years ago each time they ask when “when is mother coming to visit,” is harmful to the person. “Reminding” the person that their mother is dead over and over is not helpful because hearing the news of the death is always hearing it for a first time, and grief can be overwhelming. Instead, just reminisce about their mother by “recalling” wonderful stories. When they ask about a visit from the mother, they are likely thinking about her and just want to share some memories.
So is being “in the moment” with your family member and providing comfort and security by validating their feelings really lying, or is it just showing compassion? The next time you are tempted to argue, “remind” or correct inaccurate comments from your loved-one such as when he/she is thinking Christmas is around the corner, ask yourself if is it more important for you to be correct and tell them it is February, or step into their reality, validate how much you both love Christmas, put on some holiday tunes and just “go with the flow.” Joining them in their reality can be a caring and joyful moment to share that you will remember forever.
If you would like more information on our Memory Ministry, Memory Café, or our Virtual Family Support Group, please contact Vicky Pitner at vpitner@firstumc.org.