Fingerprinting Kit

This morning, I had the pleasure of speaking about memory care to a virtual caregiver support group. I explained the various options for those living with dementia, including day programs, assisted livings, and nursing homes. We also reviewed how to know when it’s time to make a move, as well as different approaches to the transition itself. A recurring theme throughout our entire discussion was meeting the individual where they are cognitively and, perhaps most importantly, validating their feelings.

I’ve written about validation before: it’s the acceptance of the reality and personal truth of another’s experience (even if, as is often the case with dementia, it’s not accurate). Validation therapy aims to help individuals with dementia be as happy as possible; when their struggle is respected and validated by a trusted person, withdrawal is halted and dignity restored. According to the queen of validation therapy herself, Naomi Feil says:

Validation is a way of communicating with very old people who have Alzheimer’s-type dementia. … It’s a way of being with them, feeling what they feel. You pick up their emotions and reflect them back. People who are validated feel safe.” –Naomi Feil

I gave a few examples, one of which happens to be a favorite memory of mine. It involves a couple I’ve referenced before – they certainly kept me on my toes! 😉 Both husband and wife were living with dementia and when one had an idea in their head, they’d rile the other up and fixate on it together. To say they were willful would be an understatement. One afternoon, this headstrong nonno had an upset stomach and a subsequent accident, which was not common for him. It was both embarrassing and a bit rattling, resulting in a swift cleanup process and no further mention of it. Unfortunately, while receiving help to get washed up, his watch ended up in the trash along with his soiled clothes. We didn’t realize it was missing until it was too late and the garbage had gone out, at which time we apologetically explained the mishap and collectively moved on. Or so we thought..

The bathroom accident was (thankfully) quickly forgotten, but the watch itself was not. When gently reminded of the incident, my love vehemently denied that it could have possibly occurred. A few days passed, and both my spirited nonno and nonna were livid that his watch was “stolen”. I “conducted investigations”, searched the apartment on my hands and knees, and even recruited backup – their kids. It wasn’t enough. Finally, I asked two friendly police officers from town (and by “friendly” I mean the best of the best, clearly) to pop in and speak to him. In other words, I asked them to validate his feelings.

Let’s just say they well exceeded my expectations, and I (along with my favorite couple’s children) are forever grateful. The officers were greeted in the lobby by my angry, justice-seeking loves and explained how the process would work: they’d go up to search the apartment with their “fingerprinting kit” and track down the thief, who would obviously be arrested and charged. They didn’t have to spend much time at our community, nor did they need to follow up – it was enough. Their empathetic, genuine validation was more than enough. We never spoke of the watch again.

No Prescription Necessary

Although I’ve been here for nearly two months, most of my friends still crack jokes about the “work” I’m doing (or lack thereof). They affectionately laugh at how when I cry my eyes out on my last day, the patients will have no clue who I am or how long I’ve been with them. How much of an impact can I really have on those suffering from this disease while I’m here in Italy? Even my former boss, whom I admire, adore, and miss every day, asked before I left, “Won’t they just come up with a pill for that eventually?” My efforts, though maybe not entirely useless, couldn’t possibly make any lasting impressions or meaningful advancements.

I can’t blame them. Our world today revolves around pills, no matter the method of obtainment or administration; the stigma is on counseling, not prescriptions. “After all, you don’t go to the doctor for advice, you go to the doctor for a pill. Roots, fruits, and exercise don’t cure diseases – pills do. If you are sad and don’t want to be, take a pill. If you want to be happier, take a pill, or quicker yet, snort one, or the quickest of all is to inject it right into a vein. Pills, pills, pills.” Dr. Taylor’s sadly right.

Believe me, I’m not anti-meds – I have ovarian cysts and I’d sell my soul for a painkiller if I didn’t have one on me during a rupture (TMI?!). To have a pill that would reverse or halt the effects of Alzheimer’s would be beyond incredible, but for now it simply doesn’t exist. Discovering some miracle tablet isn’t that simple, either:

“The truth is that we do not know nearly as much as we think we do about how and why the ‘normal’ brain works. We have some ideas. We have some tests. We have some medications that seem to change behavior by changing the chemistry in the brain. How or why they work is, again, a matter of speculation. We don’t fully understand the chemistry in the first place. How can we figure out what is wrong when we can’t explain what is right?” – Dr. Taylor

According to Paula Spencer Scott, “It’s been 10 years since the newest FDA drug was approved. Even current medications for memory are modest in their impact.” She points out, however, that socialization is treatment for Alzheimer’s disease:

“Boredom is the enemy. If nothing is going on, it often leads to the challenging behaviors that we see – agitation, aggression, crying, wandering.”

I can’t offer a magic pill, but I can provide companionship. I can foster intimacy, closeness, and comfort. We are social by nature, and it is essential for human beings to regularly experience emotional intimacy in order to develop and maintain good mental health. Though of course to only a certain degree, I can empathetically cross the border into Alzheimer’s land:

“When people are very old and deteriorated, no one enters their world – they’re often just sitting there. They will withdraw inward more and more, their desperate need for connection all inside. Here’s a person who has worked his or her whole life, contributing their whole life, who needs that connection again to feel a sense of worth. They’re longing for closeness.

Validation is a way of communicating with very old people who have Alzheimer’s-type dementia. It restores a feeling of dignity and self worth. It’s a way of being with them, feeling what they feel. You pick up their emotions and reflect them back. People who are validated feel safe.” –Naomi Feil

When I laugh with my friends at my own expense, I’m comforted in the fact that I see improvements every single day. Even if you think you’re not making an impact, you are. Don’t ever feel as though your presence, forgotten or not, doesn’t matter. The mood boost of having seen you can in and of itself be huge; “your loved one may not know why she feels happy (from seeing you) but she does. Your presence is cheering, comforting, and de-stressing. A rose is still a rose, and smells as sweet, even if you don’t know what that pretty pink fragrant thing that cheers you up is called.” – Paula Spencer Scott