A Discussion of the Suitability of Training on Validation Therapy Targeted Towards Staff in a Care Home and its Suitability as a Technique Involved in Interpreting a Person’s Behaviour and Therefore Supporting a Person Living with Dementia
Philip Harper*
Cumbria University, UK
Submission: June 15, 2017; Published: June 21, 2017
*Corresponding author: Philip Harper, University of Cumbria, UK, Email: philliusfoggl989@yahoo.co.uk
How to cite this article: Philip H. A Discussion of the Suitability of Training on Validation Therapy Targeted Towards Staff in a Care Home and its Suitability as a Technique Involved in Interpreting a Person’s Behaviour and Therefore Supporting a Person Living with Dementia. OAJ Gerontol & Geriatric Med.2017; 1(4): 555570.
Mini Review
This article aims to discuss the suitability of training on validation therapy targeted towards staff in a care home and its suitability as a technique involved in interpreting a person's behaviour and therefore supporting a person living with dementia. Validation Therapy is an alternative to Reality orientation, the aim is to validate a person's emotions by not correcting factual errors but empathising with their current feelings [1-3]. Validation therapy also has many references to theories in psychology to prove its validity [3].
In a study publish in partnership with Unison it was stated that there is a serious lack of training in care homes, in particular dementia care, it is common practice for only basic awareness training to be delivered [4]. According to [5] there is a lack of evidence based person centred care training in care homes. The study states that evidence based person centred care training assists to reduce agitation and the use of anti-psychotic medication in a care homes [5]; this therefore demonstrates the need for better, more appropriate, training in care homes. [6] also states that inadequate dementia training in care homes can lead to increased admissions in to hospital, hospitals are not an appropriate environment for people with dementia, and people with dementia and their cares often have very negative experiences while in hospital [7].
Hospitals also often cause an acceleration in the Cognitive decline in a person with dementia [7], therefore admission should be avoided. Validation therapy is concerned with validating a person's emotions, listening to the needs of the person with dementia and therefore empathising with the people involved [1-3]. In a study in Sweden it was found out that Validation Therapy does successfully improve communication between nurses and people living with dementia [8]. The study comprised of Validation Therapy Training and then videotapes of interactions with people with dementia. The Study demonstrated that the needs and behaviours of people with dementia were more successfully met [8]. All nurses in the Study improved their communication, but a very interesting point is that some improved more than others, this has been attributed to previous knowledge of dementia [8]. Therefore it would be expected that this would be part of a number of training sessions such as, non-verbal communication considerations as this form of communication is still considerably well preserved in people living with dementia [8]. This would then ensure the most suitable training that meet the needs of the care home sector.
Validation Therapy has a number of psychological theories that underpins the intervention. One of the most prevalent psychological theories in Validation Therapy is Erickson's life stage theory. Validation Therapy Discusses the life stages in particular the Integrity versus despair stage. In Validation Therapy understanding the Integrity versus despair stage allows us to understand the behaviour of the person living with dementia and therefore communicate and better support them [2,3]. An example is that if a person living with dementia is not coping with current losses, they might therefore be very emotional, this could be the person living with dementia being in the despair stage within Erikson's theory [2,3]. It is also stated that knowing that a person is not coping with recent losses such as losing friends and family, we might be able to more appropriately support the person with dementia, for example, social interaction would reassure the person with dementia and meet the underling need of feeling isolated.
Validation Therapy also develops on the theory of Gerotranscendence; this is a further stage, after the Integrity verses despair stage where we withdraw into a spiritual existence [3]. Validation Therapy develops this theory further into its own stage called resolution versus withdrawal. This last stage according to Validation Therapy is more specific to people living with dementia, and therefore not everyone enters this last stage of development [2]. In the last stage we have the deep human need to revisit any unresolved feelings [3]. In achieving Integrity Erikson also states that in older age ill health can cause self-absorbing behaviours, there is the need to address a person's past issues, this will assist a person to interact with the outside world [9], and this therefore demonstrates the link between the Resolution versus withdrawal stage of Validation Therapy and Erickson's teachings. Erikson’s theory does not come without its critics such as the criticism that the theory itself does not discuss in enough depth the benefit of developing successfully [9]. Erikson’s theory can however be applied to many situations due to is generality, this according to Coleman and O'Hanlon [9] is one of Erickson's greatest strengths, this is evident in the application in Validation Theory where it is adapted to demonstrate the need to develop successfully or re visit the unresolved stages of development.
Validation therapy also discusses other aspects of psychology such as Cognitive psychology, one of Validation Therapies principles is that new behaviours are harder to learn therefore earlier learnt behaviours may resurface [3]. This demonstrates that the person with dementia's memory is effected especially the aspects that are involved with learning new information, such as the transfer of information from the short term memory store to the long term memory store [10] This memory impairment is common in dementias such as Alzheimer’s disease due to short term memory impairment being a common symptom due to the effect on the hippocampus [11]. A criticism of Validation Therapy is that much of the research and evidence of its impact is mostly anecdotal[3],this however is changing,studies such as the study conducted in swedan is showing that there are positive impacts of Validation thetapy and its training in healthcare settings.
Validation Therapy training aims to teach care professionals how to understand behaviours and therefore more effectivly communicate with people with dementia. The hope is that though this increased knowledge, interventions and interactions would be more successful and help a support a person with dementia. Validation Therapy itself can be seen as an intervention that helps validate a person's emotions [1-3], as well as being a communication consideration that could be adopted to reduce agitation when interacting with a person living with dementia. Validation Therapy should not be the only dementia training but a useful tool that assists in supporting a person living with dementia. It is however important to remember that Validation Therapy is not successful all the time and it can be a very intensive me consuming intervention [3], other interventions such as Reminiscence therapy could work when Validation Therapy is unsuccessful.
References
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