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MEMORY CARE


Q. How does this look in practice, in daily memory care? A. If someone says: You stole my wedding ring, and they’re accusing the staff and other residents—they’re very angry—she’s very angry at her husband and the world. The ring symbolizes the loss of her relationship. We use symbols a lot, you know; objects or


people in the present time that substitute for objects or people from the past. People bring the past to the present through symbols. The validation worker assumes the role


of the old person, with an exquisite listening and rephrasing. Look at their eyes: Are they squinting? Are their eyes heavy? What about their voice tone—is it high or


low? What about their facial muscles? What about the lower lip? It’s a lot of observation. You learn to do this quickly, of course,


so you don’t have to stand there for half an hour. You learn to take that person in intuitively…you can feel what that person feels for that moment that you’re with them. When you rephrase, and use the same voice


to respond to them, it isn’t mimicking—it is picking up the feeling tone: “You are so angry! You want to get out of this place!” The person says: “Yes, that’s right.” There’s a relief—the feeling that someone


out there understands what I’m going through. This creates an immediate relationship


between the worker and the old person. Next, you explore what’s going on. One good technique is polarity, which is asking the person the most extreme thing: What is the worst thing about this place that you can’t stand? Then you have to know centering: You


learn to do that automatically. Centering is probably the most important technique, because it lets you be nonjudgmental…You think, oh boy, she’s angry. And you put your own feelings away in the drawer—but not in the bottom drawer. Maybe in the top draw- er. Because after this interaction, you’ll have to get your own feelings out. Otherwise, they stay in you, and they prevent you for being open. You always want to be nonjudg- mental, so that you can receive that person and feel what they feel. You say, “You’re really angry. You really


want to get out of this place!” Instead of tell- ing them, “Oh, it’s fine, don’t be so angry.”


To have total empathy with that person


who’s accusing everyone of stealing her wedding ring, I put away my own feelings quickly, and I take a breath and center my- self. Then I take a look at the lady—and I see she’s terrified. She doesn’t know where she is. She doesn’t know what to do. She used to be in control, and now she isn’t, and she’s taking it out on everybody else. Then I can become empathetic to her.


And she senses that. She’ll know that through my voice and my eye contact—eye contact is very important when people lose their speech, because that way, you main- tain a very intimate communication, which is very soothing for that old person, who was really feeling so alone.


Q. This sounds like it would be very helpful for engagement in memory care, where that can be difficult to do. A. Actually feeling what that other person feels—you couldn’t get more engaged than that.


Q. How did you come to these revelations—was it through your training, your experiences? A. I think it was training as a social group worker. But I think a lot came from my own experience. My father was the director of the Montefiore Home for the Aged in Cleveland, Ohio, and my mother was a social worker, head of the Social Service Department. We lived right in the home; we had four rooms, and then across the hallway was another set of rooms. And right across


from my room was my good friend Mrs. Lou, who was in her eighties. And she used to be quite a lady; she was


very chic, but she would yell…and the nurs- es didn’t like that. When the lights went out, she would knock on my door three times, which meant the nurses were gone—we had it all set up. When I got the signal, we would go out to the local drug store and have an ice cream soda, you know, have a great time. Then one night, when we were sitting in


the drugstore, I heard the voice of the nurse, saying There she is! She was pointing to Mrs. Lou and me, and there were two policemen. The next time I saw her, I didn’t rec-


ognize her. They had restrained her [and given her drugs]. I knew old people well; they were my


friends. So later, when someone in our group would say you’re stealing my underwear!, I knew there was a reason behind this behavior. Mrs. Lou used to be a wonderful clothing


saleslady, and she couldn’t be that anymore. The clothes are a symbol—of her, of what she had lost. Her only way of getting this out was through projecting her anger on other people: You used my beauty. You stole all the men who used to love me. You stole my beau- tiful clothes. It was directed outward. Other people didn’t understand that; I did under- stand, because I knew these people so well.


Q. Does it take a special person or experiences to learn this method? A. No, but you do have to have an attitude of respect for the old person. But if you’re in the helping field, you hopefully have learned to respect your clients.


TO LEARN MORE


• The 2021 Argentum Senior Living Executive Conference features a presentation on “Training Memory Care Staff in the Validation Method” from Traci Wagner, director of engagement and program services at Sunrise Senior Living, to be held Sept. 14 from 11-noon. See argentum.conference.org/speakers.


• The Validation Training Institute (vfvalidation.org) has a wide range of materials in different formats, for different audiences, and for different levels of knowledge—including free resources. Caregivers and associates, for instance, can take an overview online course to find out about the general ideas behind the Validation method and becoming certified, and there is information for families as well.


44 SENIOR LIVING EXECUTIVE SEPTEMBER/OCTOBER 2021


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