1 Presented by: Dianne M. Knettel, RN, BA, MS, CVT Corporate Director of Validation Training Volunteers of America National Services [email protected] 952-540-7951.

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Presented by: Dianne M. Knettel, RN, BA, MS, CVT

Corporate Director of Validation Training

Volunteers of America National Services

[email protected]

Breaking through the BarrierOf Dementia

Over 5.2 Million

5.85.7

5.35.1

1:9

2 (Alz, 2013)

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In 2030 Less than 20 years from NOW

U.S. Alzheimer’s number will more than DOUBLE

11 Million

(Alz, 2013)

1 out of 3

No effective long term treatment No cure

There is a PLAN

What about today?

How do we Communicate with---Provide ADL’s for---

Handle challenging behaviors---

While maintaining the dignity of cognitively impaired elderly people?

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One Successful Communication Method

Validation®

Developed by Naomi Feil, ACSW between 1963-1980

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Validation

Empathy

Theory & Principles

Specific Techniques

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Less anxiety, less aggression, behaviors decline.Improved sense of dignity and self-respect. Increased socialization and communication.Deterioration/Regression is slowed down. Increase in caregiver MORALE, reduced burn-out !

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Benefits of Using Validation

(Feil, 2012)

Phase 1: Mal-orientation

(Unhappily oriented to life)

Phase 2: Time Confusion

(Losing cognitive abilities)

Phase 3: Repetitive Motion

(Movement replaces speech)

Retrogenesis

Phase 4: Vegetation

(Total retreat inward) 8

Validation has Identified:4 Phases of Resolution

Long Term Goal Die in Peace

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Cultivating a Validating Attitude of Care

Creating an Environment of TRUST (Proactive not Reactive Approach)

Center YourselfAccurate Observation

Match/Calibrate Active Listening

Validation Practitioner Internal Preparation

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All older people are unique and worthy of Respect.

Our validating approach/tone shows respect.

Elderspeak (Kemper, 1994) Pilot Study (Swayden et al, 2012)

Validation Principles guide our actions

There is a REASON Behind the behavior of the mal-oriented/disoriented

1st Rule Out Physical Needs

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Try to figure out Emotional needs

LOVE: belonging: includes safety, security

PURPOSE: Useful, productive, accomplishment

BEING HEARD: expressing thoughts/feelings, identity as an individual

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Disoriented elderly can live on different levels of awareness, often at the same time.

Symbols are SIGNIFICANT

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The Validation Practitioner Role

Ask: What is this person trying to communicate?

Apply: Principles and appropriate techniques Allow: Expression of emotion and unmet needs Avoid: Temporary “Band-Aid” fixes

Goal Peace

Today’s Focus: Introduction

One day workshop

Associate course (4 classes span 2 months) (3) Certification Levels 1. CVW spans 8 months 2. CGP spans 8 months 3. CVT spans12 months VALIDATION MASTER

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Alzheimer’s Association. (2011) Alzheimer’s disease facts and figures. Retrieved from http://www.alz.org.

Bourbonnais, A, Ducharme, F, (2010). The meanings of screams in older people living with dementia in a nursing home. International Psychogeriatrics, Nov;22 (7) 1172-84. doi: 10.1017/S1041610209991670. Epub 2010 Feb 2.

Brown, A, Draper, P. (2003). Accommodative speech and terms of endearment: elements of a language mode often experienced by older adults. Journal of Advanced Nursing. 41 (1); 15-21.

Butler, R, (1989). Dispelling Ageism: The Cross-cutting Intervention. Annals of the American Academy of Political and Social science. American Academy of Political and Social Science. May; Vol . 503.

Butts, JB, (2001). Outcomes of comfort touch in institutionalized elderly female residents. Geriatric Nursing, 22 (4), 180-184, doi: 10.1067/mgn.2001.117914.

Committee on the Future Health Care Workforce for Older Americans, Institute of Medicine: Summary. (2008) Retooling for an Aging America: Building the Health Care Workforce. Washington, DC: The National Academies Press.

Eymard, A.S. & Douglas, D.H. (2012) Ageism among health care providers and interventions to improve their attitudes toward older adults: an integrative review. Journal of Gerontological Nursing, Vol. 38 (5), 26-35, doi: 10.3928/00989134-20120307-09.

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References

Feil, N. (2012) The validation breakthrough. Cleveland, Ohio.Feil, N., De Klerk-Rubin, V. (2006) Validation techniques for dementia care: The family guide to improving communication. Cleveland, Ohio.Feil, N., De Klerk Rubin, V. (2003) V.F. Validation, the feil method, How to help disoriented old, old. Cleveland, Ohio.Galloway, P, Bottorf J, Nixon, S. (2005). Nurse-patient communication in dementia: improving the odds. Journal of Gerontological Nursing, Apr; 31 (4); 43-52.Gross, J.J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39: 281-291. doi: 10.1017/S0048577201393198.Hart, B, Wells, L, (1997). The effects of language used by caregivers on agitation in residents with dementia. Clinical Nurse Specialist. Jan; 11 (1): 20-3.Kemper, S. (1994). Elderspeak: Speech accommodations to older adults. Aging, Neuropsychology, and Cognition.Neal, M, Briggs, M. (2000); Validation therapy for dementia. Retrieved from Cochrane Database of Systematic Reviews online library. (2):CD001394.Reisberg, B, Franseen, E, Souren, L, Auer, S, Akram, I, Kenowsky, S. (2002) Evidence and mechanisms of retrogenesis in Alzheimer’s and other dementias: management and treatment import. American Journal of Alzheimer’s Disease and other Dementias. July-Aug; 17 (4): 202-12. PMID: 12184509.Stern, Yaakov, (2006.) Cognitive Reserve and Alzheimer Disease. Alzheimer Disease and Associated Disorders. 20 (2) 112-117. Doi: 10.1097/01.wad.0000213815.20177.19.Swayden, K, Anderson, K, Connelly, L, Moran, J, McMahon, J, Arnold, P. (2012). Effect of sitting vs. standing on perception of provider time at bedside: A pilot study. Patient Education and Counseling: An International Journal for Communication in Healthcare. Vol 86 (2)166-171.US Census Bureau (2010) State populations .Retrieved from quckfacts.census.gov/qfd/states/27000.htmlUS Dept. of Health & Human Services (2012). Retrieved from http://aspe.hhs.gov/daltcp/napa. Williams, K, Herman, R, (2011). Linking resident behavior to dementia care communication: effects of emotional tone. Behavior Therapy. Mar; 42 (1) 42-6.

Website: voavalidation.org=Volunteers of America, Authorized Validation Org.

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