Last month the FDA approved a new drug to treat agitation symptoms associated with Alzheimer's and other types of Dementia. While medications can provide temporary relief, they frequently fail to address the root causes behind the agitation.
It is through the power of using empathy for dementia that we can forge deeper connections with those who are experiencing distress, enabling us to identify the underlying reasons or triggers and make the necessary adjustments to alleviate their discomfort.
Empathy In the Validation Method
Naomi Feil's Validation Method is built upon the foundation of emotional empathy which offers a way of connecting and communicating with people living with dementia. In the Validation Method, we prepare ourselves to accompany the older person in their reality to create a safe, supportive, and trusting environment. At the core of the Validation Method is the recognition that individuals with dementia have a fundamental emotional need to be heard, understood, and accepted, just like all of us. We also recognize that a person’s behaviors and communication may reflect an unmet emotional need or a desire to express themselves. Naomi Feil's method uses various empathetic techniques to establish a genuine connection both verbally and non-verbally. These include focusing deeply by centering and recognizing non-verbal body language and facial expression cues. “Exquisite listening” as Naomi Feil calls it, is also important in promoting empathy within the Validation Method. By truly listening and observing, Validation Workers gain valuable insights into the emotions underlying the individual's words, gestures, and behavior. This deep listening allows us to respond appropriately to the emotions expressed with recognition and affirmation. Through empathy, Validation Workers enter the individual's world and connect on a profound level. This approach not only helps individuals with dementia feel worthwhile and understood, but it often reduces feelings of frustration, agitation, and isolation. After all, don't we all feel better when someone truly understands and accepts us?
How Would You Feel?
When faced with challenges in caring for a family member or a resident with dementia, I often suggest first asking yourself a simple question:
"How would I feel if I was in this same situation?"
By taking a moment to consider our own emotional responses, we can cultivate empathy and better understand the experiences of someone with dementia.
Contrary to popular belief, individuals who are living with cognitive changes experience the exact same emotions as all of us. Their desires, needs, and reactions are rooted in the same human experiences we all share. Even if someone is living with dementia, their emotions are absolutely the same as ours.
Imagine if today, when you are feeling fine, your family tells you that you can no longer drive, you can’t leave your home, or you need someone to live with you and wash you! How would you react? I think all of us would feel outraged, would fight for our independence, and most likely would not behave in a very nice manner.
When someone is exhibiting what seems like difficult behavior, if we take a moment to put ourselves in their shoes, we can develop empathy and identify with an individual’s actions and reactions. In this way, we can find the reason behind the behavior and try to help.
Understanding the Reluctance to Bathe
One common challenge reported by family members and care home staff, is the difficulty experienced during bathing routines. Individuals with dementia may refuse help for personal care and, in some cases, exhibit verbal or even physical aggression. Unfortunately, the prevailing advice often leans towards medicating the person to calm them. However, before resorting to such measures, it is important to explore what might be the underlying reason behind their behavior.
Let's take a moment and put ourselves in their shoes. Imagine a scenario where a stranger abruptly removes your clothes and starts washing you without any prior explanation or consent. Most of us would find this invasive and distressing, reacting not only with frustration but most probably with anger and aggression.
Similarly, an individual living with dementia may also strongly react when confronted with unfamiliar individuals or situations that infringe upon their personal boundaries. By acknowledging and identifying with this emotional response, we can approach individuals with empathy, recognizing their need for privacy and autonomy.
After ruling out any physical causes for their resistance to bathing (you can refer to our previous blog post on sensory changes for some insights), let's consider how we would feel in their position. Wouldn't we all desire agency in caring for ourselves?
In line with Naomi Feil's Validation Method, we suggest that caregivers build trust with the person they are assisting during bathing. By doing so, the individual can feel more at ease. Once there is trust, carers can ask questions to better understand a person’s resistance to bathing, such as:
“You don’t like taking a bath?”
“You don’t like other people telling you what to do?”
“You always used to do it yourself?”
When these questions are asked with genuine concern and the carer listens to try to understand, the person will sense that they are being understood. At this point, carers can explore with them ways to help the individual regain their sense of independence. For instance, they can offer a washcloth and ask if the person would like to wash themselves or inquire if they need assistance with hard-to-reach areas.
By approaching bathing routines with empathy and a commitment to preserving dignity, we may be able to create a greater sense of cooperation. Our goal should be to empower individuals living with dementia to actively participate as much as they can in their personal care, just as those of us not living with dementia would want.
In addition to memory loss, individuals living with dementia often struggle with recognizing people and places. As their memories fade, the most recent recollections tend to vanish first. This causes a person’s memories to become limited to those in the more distant past – but to the individual, they now seem like their most recent memories.
This can result in a parent no longer recognizing their own adult child who they think is still young To read more on this topic, you can refer to our previous blog post, "The Day She Forgot Who I Am"
Now, take a moment to imagine the emotional toll when you can no longer be certain if the person in front of you is someone you should know or a stranger you are meeting for the first time. Merely meeting someone becomes not only frustrating but also embarrassing. The stress involved in these encounters can lead individuals to withdraw from social interactions altogether. Also, stress can cause more cognitive decline in people living with dementia.
By empathizing with this predicament, we have the power to make each meeting a non-stressful experience by simply introducing ourselves every time. By consistently sharing our name and who we are, we prevent the person living with dementia from worrying about whether they should know us or not.
In my interactions with clients, I make it a point to introduce myself at every meeting. By doing so, I eliminate any potential discomfort caused by their inability to recognize me. In the worst-case scenario, they may respond with, "Of course, I know who you are!"
Remember, the act of introducing ourselves each time may seem repetitive, but it ensures that we provide a safe and supportive environment for individuals with memory loss. It enables our clients or family members to navigate social interactions without the anxiety of uncertain recognition.
Losing Confidence with Dementia
Picture a world where everything you believe and understand is constantly challenged and dismissed by others. It's no surprise that your self-confidence would eventually crumble, leaving you doubting everything you once knew.
Sadly, this is a common experience for individuals living with dementia. They face a constant barrage of corrections, being told they're wrong about their memories and relationships. Imagine being told that your mother has passed away when you believe she's still alive, or that you don’t have to fix lunch for your son because he is a grown adult, or that you haven’t worked for years when you think they are waiting for you at work right now.
Let me share a recent experience I had in our memory wing of the Savion Adult Day Care Center. I was sitting at a table with two women who happened to share the same name. To protect their privacy, let's call them both Rosie. One of the women didn't like the idea that someone else had the same name as her, so she confidently stated, "No, that isn't your name. Your name is Rose."
The second woman, whose condition had recently progressed, affecting her physical movements and thinking, responded, "Really? My name isn’t Rosie. I guess my name is Rose." It was heart-wrenching to witness her lose confidence in something as fundamental as her own name.
Instead of constantly invalidating everything individuals with dementia say, we can help rebuild their confidence by embracing empathy and entering their world, where their experiences and beliefs make perfect sense.
Some of the ways to do this are to: ✔️ Reminisce with people about their youth or childhood
✔️ Sing songs together that they remember,
✔️ Ask questions about their earlier life, inviting them to share their stories and experiences Every human being has a wealth of wisdom and unique perspectives to offer. If we connect deeply, we can learn so much from each person that we encounter.
By really caring about people who are living with dementia and entering their world with empathy, we can help them feel valued, heard, and more confident.
As we learn to understand the challenges facing people who are living with dementia, taking a moment to reflect on how we would feel in their circumstances can make us more aware of what the other person may be feeling. Connecting through empathy for dementia allows us to connect with a person on a deeper level, validate their emotions, and preserve their sense of self. ----
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