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Their Reality


I studied a number of years ago under noted social worker Naomi Feil. Naomi developed Validation Therapy after working for years with the disoriented, old-old. As reported by Christine Kukka of the York County Bureau, “Old memories and unfinished business often rise to the surface when the very old lose their sight, hearing and physical abilities. Instead of imposing factual reality on a 90 year old, caretakers should validate them by listening to them, she (Naomi Feil) suggested.”


For about 8 months I cared for a hospice patient named “Jan”, who had cancer and dementia. She lived in a skilled nursing facility, but in Jan’s mind, she lived at home and worked at her parent’s diner.

I always approached Jan with a big smile and entered her reality, asking how her diner work was going. I would ask if she was working the tables today or the cash register. I’d also ask how her parents were doing. She would give me a rundown of the whole day. “Jan” became very animated during these conversations and even though she never remembered my name, I’m sure she remembered that she knew me from visit-to-visit.


I commented once to one of Jan’s caregivers that I found Jan’s “reality” fascinating, that she was always somewhere else. The caregiver said “Would you want to be here? Isn’t it more pleasant for her to live in a time and place that was more comforting for her?” Wise caregiver!


Provide comfort, validate their feelings and be in their reality. Remember that they may not be able to be in yours.



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