Respected not rejected

Dagmar Erdkönig, Petra Makara and Claudia Reicher

In 2001, the team began Level 1 training in the ‘Validation’ method devised by Naomi Feil, and first published in book form in 1982. Feil’s aim was to help disoriented elderly patients to face reality and to provide them with opportunities for human interaction as part of a group.

Her ‘Validation’ is defined as:
• a developmental theory for very elderly people who are disoriented and suffering from cognitive impairment or depression
• a method to assess their behaviour
• a specific technique to help them to recover their dignity through individual validation and validation groups

and aims to:
• restore self-esteem
• reduce stress
• affirm life experiences
• resolve past conflicts
• reduce the need for chemical and physical restraints improve verbal and
• non-verbal communication
• prevent withdrawal into the final stage of ‘vegetation’
• improve mobility and physical well-being

Various psychological and philosophical concepts quoted in the validation method include:
• Accept your patients without judging them (Carl Rogers);
• A therapist cannot understand or modify behaviour if the patient is not ready to change or does not have the capacity to understand their own behaviour (Sigmund Freud);
• Regard your patient as a unique individual (Abraham Maslow);
• Each stage of life has its own specific task, which we must complete at a particular point in our lives. We must struggle to achieve this goal, before progressing to the next stage (Erik Erikson);
• Any task we skip will have to be resolved during a later stage in life (Erik Erikson);
• There is always a reason behind the behaviour of disoriented old people (Naomi Feil), and All people are valuable, no matter how disoriented they are (Naomi Feil).

Peter Fashing MD, head university lecturer at the Baumgarten Geriatric Centre, in Vienna, who presented the award, said that as the elderly population swells, thanks to medical progress, increasingly large numbers of very elderly people have unfinished issues to be resolved. ‘These people need someone to listen to them and to affirm their feelings.’ Feil, he pointed out, had created structured training models and documentation to aid the realization and spread of her ideas. The award winners, he added, are among the first in the German-speaking world - and probably internationally - to have implemented the Validation method as part of out-patient home care of disoriented elderly people.

The project focused on integrating Validation into daily work at the social centre in Judenburg, and its catchment area, where the team managed to involve the full range of healthcare and social services. Presenting the award, Dr Fashing said that the project had raised the image and understanding of elderly people, even if disoriented, and that this had been seen not only among healthcare professionals and involved groups, but also among local people. There was also a clear increase in the number of disoriented elderly people for whom the social centre in Judenburg could provide long-term care at home. Dr Fashing concluded: ‘The results of the project confirm the project leaders’ assertion in the final sentence of their submitted paper, that the experience has given them the courage to continue their work in the hope of further contributing to the creation of greater understanding for disoriented elderly people.’

01.03.2005

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