Blog Post by Oran Aviv
This week, I had the good fortune of participating in the online Validation World Congress on the subject: The Person Comes First. I'd like to share with you today some of the important insights I gained from attending this conference.
The Validation World Congress
This was the second on-line Validation World Congress and the subject this year was "The Person Comes First".
Naomi Feil’s groundbreaking work using empathy and understanding towards older adults with cognitive changes is the basis of the Validation Method that she founded.
In this conference, panelists shared how Naomi Feil’s empathy concepts have developed and are changing the way how we relate to people with memory loss.
The dynamic panels of speakers shared a wealth of information that helped us gain a better understanding of what it's like to live with cognitive change and how we can better support these individuals.
I highly recommend watching the recording of this powerful conference, but from personal experience, I understand that finding the time to participate in online events or watch the recordings can be challenging. Therefore, I decided to share some of my key takeaways from this event and highlight specific sections of the recordings that you can watch even if you have limited time.
Below are some highlights from the first session.
The Need to Be Useful
Naomi Feil’s Validation method emphasizes the importance of examining the possible needs of an individual with cognitive change, recognizing that unfulfilled needs may be the reason behind a behavior.
During the Validation World Congress, Naomi Feil shared what it means to her to live her life to the fullest at age 90, expressing her desire to continue working and sharing her life's work.
Myra Garcia, another panelist, is living with young-onset Alzheimer’s and can no longer hold a regular job due to her memory issues. Today Myra educates people about dementia so others will understand that people living with cognitive change still have much to offer.
Myra shared her desire to continue to educate the pubic as this way she feels she is living her life to the fullest.
Despite their different backgrounds and situations, both women share the same basic human needs: to feel useful, to be recognized, and to be esteemed, despite any cognitive changes they may be experiencing due to old age or dementia.
As the session's moderator, Vicki de Klerk, the Executive Director of the Validation Training Institute and the daughter of Naomi Feil, aptly summarized:
"Those basic human needs don't stop."
You can view this 4 min discussion in the session recording.
The recording begins at 7:37 and you can stop at 11:45
It is unfortunate that due to the stigma often associated with cognitive change, many individuals with such conditions may feel marginalized or undervalued, leading to feelings of isolation and even despair.
However, by recognizing the importance of fulfilling these basic human needs and providing support that allows individuals to continue feeling useful and appreciated, we can help create a more inclusive and compassionate society for those with cognitive change.
Accept Me as I Am
At the Validation World Congress, Naomi Feil also shared that at 90, she has difficulty remembering things. For example she really enjoyed hearing fellow panelist Myra speak, but now at her age, she would not be able to summarize what she heard.
Naomi also explained the physical changes she has had. She used to walk fast, was active in sports, like volleyball and even was a baseball pitcher, but today she has difficulty just standing and needs a walker, which she explains is a difficult adjustment.
According to Naomi, when someone repeats a question, it is important to accept that they may have some memory loss. We should refrain from reminding them that they have already been told something nor complain that they don’t remember. Instead we should just
“Accept that they have some memory loss and that is OK.”
Vicki explained this concept further by stating that accepting someone for who they are and recognizing that they cannot change is essential. This means acknowledging their current reality as it is.
Naomi Feil also emphasizes that using reality orientation to attempt to impose our own reality on someone who has their own perception of reality is demeaning.
I have seen that accepting a loved one's cognitive change can be challenging for family members, as they may hold onto memories of the person before the change. However, it is crucial to accept the person as they are now in order to effectively communicate with them and understand their current needs and abilities.
Be Kind and Understanding
At the Validation World Congress, Vicki De Klerk asked the panelists, Naomi Feil who is now 90 years old and Myra Garcia who is living with young-onset Alzheimer’s, what we can do to support them to live their lives to the fullest.
Naomi answered that if carers would accompany her, so she can enjoy going out to see a show or if they can help her so she can give a lecture she would feel more fulfilled. Vicki noted that Naomi wants people to give her a chance to feel useful. Naomi agreed and added that this would also allow her to demonstrate her abilities.
Myra felt she was more in charge of her life and makes her own decisions to do the things that make her feel fulfilled, like singing in several choirs. Myra did add that she needs help with numbers and remembering names, as well as remembering things that were just said.
Myra shared that the way we can really help, is to speak to her and others who have cognitive changes the same way we speak to everyone else, especially in a group setting. There is no need to shout or yell, nor to be condescending.
Myra’s wish is that people will be kind and understanding.
Myra also volunteers at a Memory Center, and she explains how she treats all the people there like dear friends. Her volunteer work brings Myra much joy but she also knows that the people she works with really appreciate it. She explains that her work is an example of being there for them in a way that is appropriate for them.
You can view this 6 ½ min discussion in the session recording.
The recording begins at 18:11 and stop at 24:50
It is disheartening that we need to be reminded to be kind and understanding towards others, especially those who may be different from us. Whether it is someone with sensory changes, physical disabilities, special needs, or cognitive changes, many of us may struggle with how to react. However, we can always choose to approach every individual with kindness, respect, and empathy.
I started this year by selecting the word "kindness" as my word for 2023, and in my New Year’s blog post, A Year of Kindness, I emphasized the importance of being kind this year. Let's make sure to be inclusive and extend our kindness to everyone we encounter.
Are You Supportive or Taking Over?
During the Validation World Congresses’ first session with Naomi Feil and Myra Garcia, Vicki de Klerk mentions that it is a very fine line between being supportive or taking over.
Myra explained that it is very important for her to be able to do as much as possible of the “normal things” in life. She has taken up puzzling as an activity that she can do on her own. Myra says the puzzling is difficult for her and it takes a long time, but it’s important for her to be able to do puzzles on her own.
Vicki gave the example of the difference of saying “Can I help you?” or “Let me do that for you.”
I want to remind everyone that as carers, we often want so badly to help someone, that we don’t realize that we may be causing more harm by not allowing the person to remain as independent as possible. In the blog post Be Aware of Ageism, we discuss that we need to understand that everyone wants to retain their independence, at every age, including those who have cognitive changes.
Wendy Mitchell, a speaker and author, who has been living independently with young-onset Alzheimer’s for many years, shares her experience of living with dementia and how she has been able to outwit it. According to Wendy, living independently has allowed her to adjust to the effects of dementia and preserve her autonomy. In contrast, individuals who rely on family caregivers to handle all tasks may become dependent and experience a faster decline in their abilities.
You can read more about Wendy Mitchell in our blog post Understanding Dementia.
Life at 90
At 90 years old, Naomi Feil shared some of the challenges that come with aging.
During a discussion at the Validation World Congress, moderator Vicki de Klerk discussed the importance of voice tone and emphasized the importance of treating individuals with respect and not talking down to them based on labels like "old" or "Alzheimer's". She stressed the importance of treating people like the adults that they are.
Naomi echoed this sentiment, but explained how she has learned to deal with condescending voices by acknowledging her anger internally instead of responding aggressively. Unfortunately, she also shared that she fears being labeled as having dementia and being committed to a mental institution if she were to express her anger outwardly.
It is distressing to see that because of her age, Naomi must change the way she acts and responds. This is due to her fear of being labeled as aggressive and possibly be committed.
Naomi also expressed that she has encountered ageism from those who are younger than her, particularly those in their 60s or 70s, who often underestimate her cognitive abilities due to her age. She thinks those younger than her just don’t expect her to be able to participate in a cognitive way, even though she can.
This frustrates her, but rather than showing her anger, she tries to participate in cognitive activities to prove them wrong.
I'd like to add that Naomi has dedicated the past 60 years of her life to working with older people, especially those who have cognitive changes, by teaching how to connect through empathy and understanding. Now that she has reached the age of 90, she can offer us even more valuable insights into aging.
Just as Erik Erikson provided us with a better understanding of the last stage of life development as he aged, I believe Naomi Feil is guiding us towards removing labels and changing our perceptions of aging. She teaches us to see beyond someone's age or diagnosis and connect with them as individuals who still have much to offer.
Thanks to everyone who organized this conference and to the wonderful panelists. Thank you Myra Gracia for sharing your personal story so that all of us can have a better understanding of what it is like to live with cognitive changes and learn how we can help.
Although I had intended to cover all the major points discussed at the Validation World Congress in this blog post, the abundance of information requires me to create a part 2 that will be published in next week's blog post.
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