Verbal and Nonverbal Validation Techniques to Use When a Senior Has Dementia

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The Validation Method is an empathetic way of communicating with older adults who are experiencing memory loss. Rather than redirecting your loved one or using white lies, caregivers should use Validation to step into the shoes of their loved one and truly feel the needs they are attempting to express.

This method of communication, developed by renowned social worker Naomi Feil, is based on three core components:

1. Elderly people may struggle to resolve past issues as they approach the end of life. The age-specific behaviors they often exhibit reflect basic human needs. There are four stages of behaviors: expressing past conflicts in disguised ways, time confusion and retreating inward, using movement to replace words, and eventually giving up and shutting out the world.
2. Having an empathetic attitude that respects and values the elderly. It is a judgment-free approach to working with and caring for older people.
3. Using specific individual and group techniques depending on where the older person is in the resolution process.

“Validation is so valuable because it gives the person the opportunity to really express their feelings and concerns, and that gives them relief,” says Rita Altman, senior vice president of Memory Care & Program Services at Sunrise Senior Living. “It’s just like with all of us—when we voice something that’s concerning us, we feel better.”

There are both verbal and nonverbal techniques you can use to effectively employ the Validation Method with your loved one.

15 Verbal and Nonverbal Validation Techniques

1. Use centering: Encourage a person to focus on the here and now. The goal is to take power away from negative thoughts and worries.
2. Have empathy: Instead of sympathizing with the elder, use empathy. Put yourself in another person’s shoes to better understand how they are feeling. Demonstrating empathy helps build trust, restore dignity, and reduce anxiety.
3. Ask nonthreatening, factual questions: Word choices have power. Some words lift people up, while others can demean or frighten. By sticking to factual words that don’t connote emotion, you can help an older adult who is confused or struggling. Use “who,” “what,” “when,” “where,” and “how,” and avoid asking “why.”
4. Rephrase words: Misunderstanding what someone is saying can be easy, especially when you are trying to communicate with someone who is confused or has limited verbal skills. Rephrasing what you think they are saying and repeating it can help ensure you understand what the elder is trying to say.
5. Use polarity: Polarity principles ask us to help the elderly person imagine the worst. If they are frustrated because a dental issue is making it difficult for them to eat, the senior might complain about the food. You can ask them if it is the worst cake they’ve ever had. It likely isn’t, but asking gives the elder an opportunity to vent.
6. Imagine the opposite: This technique can lead an older adult to remember a solution to a problem. If the senior is having trouble resolving an issue they believe is ongoing, caregivers and family members can ask if there were times the anticipated situation didn’t wind up happening and what might have prevented it. By imagining the opposite, they may come up with a solution.
7. Use reminiscence therapy: Confused elderly people might struggle with short-term memory. Even if they’ve enjoyed themselves recently, they may not remember doing so. However, they might remember happy times from the past. Reminiscence therapy helps connect the senior with those memories.
8. Maintain genuine, close eye contact: We all feel validated when someone we are speaking with seems genuinely interested in what we are saying. Maintaining eye contact and an expression of interest allows an elderly person to feel listened to.
9. Use ambiguity: When verbal skills are diminished, words become a struggle. A confused older adult might think they are making perfect sense even when their words have no meaning. Caregivers and family members can continue the conversation by replying with vague, ambiguous language.
10. Maintain clear, low, loving tone of voice: Tone of voice can speak volumes even when a person doesn’t understand what you are saying. A smile combined with a soft, soothing voice can help an elder feel heard and validated.
11. Mirror emotions and movements: Observing and matching the older person’s motions and emotions is another validation technique you can use. It helps them feel nurtured and connected, which helps reduce anxiety.
12. Link behavior with an unmet need: Love, feeling useful, and expressing raw emotions are three human needs. If an elder is repeating a behavior, such as pacing or rubbing their hands, they might be trying to express one of those needs. By linking a need to the behavior, you can validate their need for expression.
13. Identify and use their preferred sense: We all have a preferred sense, whether we realize it or not. Whether they prefer listening to soothing words or making close eye contact, identifying and using a confused elder’s preferred sense can help you better communicate.
14. Use appropriate physical contact: While touch isn’t always appropriate, it can help with communication for some confused older adults. Approaching from the front so they aren’t startled while talking softly and gently touching their arm may help the elder feel loved and needed.
15. Play music: Long after words are lost, the ability to sing and enjoy music usually remains. Playing music from the elder’s childhood or young adulthood can help them reconnect with happy times.

Validation Method and Sunrise Memory Care Communities

When you visit a Sunrise Senior Living memory care community, you’ll likely see these techniques being utilized. Each of our dedicated team members is trained in the Validation Method and how it can be used to improve communication with older adults who are confused. You can learn more about the Validation Method by watching this video featuring a Reminiscence coordinator at a Sunrise community.