HJBR Sep/Oct 2024

HEALTHCARE JOURNAL OF BATON ROUGE I  SEP / OCT 2024 51 Daphne H. Dominguez, EdD Assisted Living Administrator Lambeth House tion can be found in a video on YouTube. 2 After Naomi Feil was diagnosed with ter- minal cancer, she left her readers with this quote, “My greatest wish now, as it has been for the past 50 years, is that ev- eryone keep using Validation, spreading Validation, teaching Validation – so that older adults around the world feel heard, respected and gain self-esteem.” I was first introduced to Jo Huey at the beginning of my career in 2000. She was the director of Alzheimer’s Residential Care Homes, which she implemented in New Orleans for many years. Huey has worked with individuals with Alzheimer’s and other dementia-related diseases since the mid-1980s. I had the privilege of work- ing with her during my time with the Al- zheimer’s Association many years ago and consider her a mentor. She has written two books, Alzheimer’s Disease: Help and Hope (2001) and Don’t Leave Mama Home with the Dog (2007), and is well-known for the invaluable tool for caregivers and profes- sionals, the “Ten Absolutes” (1996). 3,4 In reflecting on best practices for com- municating with individuals experienc- ing cognitive challenges, it is essential to consider Huey’s “Ten Absolutes.” 3 These guidelines provide a compassionate and effective framework: never argue, instead agree; never reason, instead divert; never shame, instead distract; never lecture, in- stead reassure; never say “remember,” instead reminisce; never say “I told you,” instead repeat/regroup; never say “you can’t,” instead do what they can; never command/demand, instead ask/model; never condescend, instead encourage/ praise; and never force, instead reinforce. These principles offer valuable insights for enhancing communication and fostering positive interactions. Recognizing the different responsibili- ties of families and legal guardians is es- sential for caregivers to deliver support that is best suited to their duties. In Huey’s book, Don’t Leave Mama Home with the Dog , 4 Huey shares 10 skills that she de- veloped while traveling on her own jour- ney with her mother who had dementia. Caregivers can practice these skills when interacting with their loved one: never as- sume, instead examine; never justify, in- stead authorize; never forget, instead re- member; never walk alone, instead accept help; never stop, instead progress; never endure, instead cry; never explain, instead act; never alter, instead persist; never quit, instead expand; never despair, instead en- joy. These skills focus on empathy, under- standing, and respectful communication. For caregivers, these skills can be used to enhance daily interactions with individu- als maintaining dignity and well-being. In contrast, for powers of attorney or legal guardians, these skills help inform deci- sions that respect the individual’s prefer- ences and emotional needs, ensuring that legal and financial choices align with com- passionate caregiving principles. n REFERENCES 1 Feil, N. “Validation Therapy.” Geriatric Nursing 13, issue 3 (1992): 129-133. https://doi.org/10.1016/ S0197-4572(07)81021-4 2 Memory Bridge. “Gladys Wilson and Naomi Feil.” YouTube, May 26, 2009. https://www. youtube.com/watch?v=CrZXz10FcVM 3 Huey, J. Alzheimer’s Disease Help and Hope: Ten Simple Solutions for Caregivers. Alzheimer’s Institute. Denver, CO : Alzheimers Institute, 2001. 4 Huey, J. Don’t Leave Momma Home With The Dog: Why Caregivers Do What They Do! Trafford Publishing, 2007 in 1992, emphasizes the inherent worth and individuality of each person, advocat- ing for caregivers to accept people with dementia without judgement, and recog- nize that behavior change occurs when people are ready. 1 Recognizing and vali- dating each person’s unique experiences can alleviate distress, while ignoring their feelings may intensify them. Feil also notes that unaddressed life stage tasks can lead to psychological issues. Validation techniques such as using fac- tual questions, allowing emotional expres- sion, reminiscing, and respecting personal space may help caregivers address the psychological needs of individuals with de- mentia, enhancing their overall well-being and improving their quality of life. Empa- thy from caregivers builds trust, reduces anxiety, and restores dignity. For late-onset dementia patients, Feil identifies four stag- es: malorientation, time confusion, repeti- tive motion, and vegetation. These stages represent a progressive cognitive decline characterized by increasing disorienta- tion, distorted perception of reality, and adaptive behaviors such as repetitive mo- tions. Throughout these stages, the need for validation, empathy, and non-verbal communication is crucial to ensuring the individual’s comfort, safety, and emotional well-being. Caregivers should assess the client’s stage and apply appropriate valida- tion techniques to ease anxiety, restore dig- nity, promote a restraint-free environment, and reduce caregiver frustration, fostering a nurturing relationship. 1 Feil recounts a pivotal communication with Gladys Wilson, a woman diagnosed with Alzheimer’s in 2000 who is almost entirely non-verbal. This touching interac-