Encourage Positive Recollections in Seniors With Dementia

It is tempting to correct seniors with dementia when their version of reality conflicts with our own.  Many caregivers who are new to dementia care attempt to reorient the senior back to reality by challenging the senior’s belief and stating the actual version of events.  For instance, if a 90-year-old woman with dementia tells her caregiver that her father came to visit her yesterday, the caregiver may say “no he didn’t.  You were here yesterday.  Remember?”  This reorientation back to reality may bring temporary lucidity for a short period of time, but more often than not only aggravates undesirable dementia behaviors such as agitation, confusion, and disorientation.  How would you feel if someone was constantly challenging your genuine belief of what happened?  Wouldn’t you feel confused and disoriented?  Do you think your self-esteem would suffer?  What about the crushing blow of remembering that your father is dead; that he didn’t come yesterday, in fact, no one came yesterday.

Instead of reorienting seniors with dementia back to reality try encouraging positive recollections through validation.  The validation method encourages the caregiver to acknowledge the senior’s perception of reality, empathize with the emotion underlying their statements, and steer the conversation in a direction that elicits positive memories and emotions.  In the above example, the caregiver would say “that’s nice that your dad came to see you.  What did you two talk about?”

Some caregivers feel that the validation method entails lying and is therefore unethical.  In response it is important to remember that Alzheimer’s related dementia is degenerative; the senior with Alzheimer’s disease will not recover.  Therefore, reorientation has no lasting benefit but will elicit negative dementia behaviors such as confusion, agitation, and loneliness.  In contrast, validation focuses on the senior’s quality of life by eliciting positive emotions.