What is Validation Therapy?

Communicating with someone who has dementia can become more difficult as the condition progresses. They may become confused about where they are, believe they need to go somewhere, repeatedly ask the same question, or talk about people and events from many years ago.

For families, the natural response may be to correct them. However, repeatedly explaining that they are wrong can sometimes make them more upset or confused.

Validation therapy is an approach to communicating with and supporting people living with dementia. It was developed by social worker Naomi Feil in the 1960s and 1970s, based on the previously established Reality Orientation therapy. Validation therapy focuses on acknowledging the feelings and experiences a person expresses, even when their understanding of a situation differs from what is actually happening.

Instead of focusing on whether what someone says is factually correct, validation focuses on understanding the emotions behind their words and responding with empathy. It does not mean agreeing with everything a person says. Instead, it means recognising that their feelings are real and helping them feel heard.

How To Use Validation Therapy

For example, someone with dementia may say:

“I need to go home. My mum is waiting for me.”

It may be tempting to respond:

“Your mum died years ago. You’re confused.”

Although this may be correct, it could leave the person feeling distressed or embarrassed.

Instead, a validating response could be:

“You sound worried about your mum. Tell me about her.”

This does not confirm that their mother is waiting for them. Instead, it acknowledges the emotion behind what they are saying and allows them to talk.

How Does Validation Work?

Validation starts with listening. When someone with dementia says something that seems confusing or doesn’t match what you know to be true, pause before correcting them. Consider what they might be feeling or trying to communicate. They could be:

• Frightened.
• Lonely.
• Anxious.
• Confused.
• Angry.
• Looking for someone.
• Missing a familiar place.
• Looking for reassurance.

If you have an idea of what they may be feeling, acknowledge it rather than immediately correcting them.

You might say:

“That sounds upsetting.”

“You seem worried.”

“You really miss home.”

“I can see that this is important to you.”

Simple responses like these can help someone feel heard rather than corrected, reducing agitation, irritability, and nighttime disturbances.

Why Can Validation Help Someone With Dementia?

Dementia can affect memory, communication, and a person’s ability to understand their surroundings. As these changes progress, someone may struggle to explain exactly what they are feeling.

A resident who repeatedly asks to go home may not be talking about a specific house. They could be feeling frightened, lonely, or unsettled and using the idea of “home” to describe somewhere that feels safe. Understanding the emotion behind their words can help carers respond to the underlying need.

It is important to distinguish between validation therapy as a specific therapeutic approach and the broader principle of responding to someone with empathy. Research into validation therapy itself is limited, so it should not be presented as a treatment that can slow or reverse dementia. However, listening carefully, acknowledging emotions, and communicating patiently are all consistent with person-centred approaches to dementia care.

The aim is not to stop the symptoms of dementia or convince someone that their memory is correct. Instead, it attempts to make them feel safe, respected, and understood.

Examples of Validation in Dementia Care

Validation Therapy vs Reality Orientation

Validation can sometimes seem very different from the instinct to remind someone of what is actually happening. Reality orientation focuses on helping someone understand the factual circumstances around them. Validation focuses more on acknowledging how the person feels about those circumstances.

For example, imagine someone says:

“I need to pick my children up from school.”

A reality-oriented response might be:

“Your children are adults now. They don’t need picking up.”

A validating response could be:

“You’re worried about your children. You always made sure they were safe.”

The second response does not confirm that their children need to be collected. It simply acknowledges the concern behind the statement.

These approaches do not always need to be treated as opposites. The most appropriate response depends on the individual, their level of distress, and the situation. There may be times when providing clear information or gently orienting someone to their surroundings is helpful. At other times, particularly when someone is distressed, correcting them repeatedly may make the situation worse.

When Should You Avoid Correcting Someone?

Not every misunderstanding needs to be corrected. If someone with dementia believes something that is harmless and they are not distressed by it, repeatedly correcting them may not be necessary. Instead, you could acknowledge their concern and gently redirect them towards something familiar.

However, validation should never ignore a genuine safety concern. If someone believes they can safely walk somewhere when they are at significant risk of falling, for example, their safety needs to take priority. You can acknowledge how they feel while still taking steps to keep them safe.

It is also important to remember that sudden changes in behaviour should not automatically be attributed to dementia. Pain, infections, dehydration, medication changes and other health problems can sometimes cause sudden confusion or changes in behaviour.

If a person’s behaviour changes significantly or suddenly, it is important to speak to an appropriate healthcare professional rather than automatically assuming that it is part of their dementia.

How Is Validation Used in a Care Home?

Validation can be particularly useful within personalised dementia care because staff have the opportunity to understand a resident’s history, routines and preferences.

A personalised care plan should contain more than information about someone’s medical needs. It can also include details about their previous life, family, hobbies, favourite music, routines and things that make them feel comfortable.

Knowing this information can help staff make sense of a resident’s behaviour when they become confused or distressed. For example, a resident may become particularly unsettled at bedtime. If staff know that they previously went to bed early every evening and preferred a quiet environment, they may be able to adapt the evening routine accordingly.

Rather than simply seeing the behaviour as a symptom that needs to be stopped, they can consider what the resident may be trying to communicate.

How Can Families Use Validation?

You do not need to be an expert in dementia care to use some of these principles when talking to your loved one. Try to:

• Listen before responding.
• Pause before correcting them.
• Consider what they might be feeling.
• Use simple, reassuring language.
• Give them time to respond.
• Acknowledge their feelings.
• Redirect the conversation when appropriate.
• Learn about their previous life, routines, and interests.

You will not always respond perfectly, and that is okay. Dementia can make communication frustrating and emotional, and there will be times when you don’t know what to say. What matters is continuing to treat your loved one with patience, dignity, and respect, even when conversations become difficult.

Supporting Someone With Dementia Through Communication

Validation is not about pretending that something is true or avoiding every difficult conversation. It is about taking a moment to consider what your loved one may be feeling and responding with patience and empathy.

For families and care staff, understanding a person’s history, routines, and preferences can make communication easier. When someone becomes confused or distressed, knowing what usually comforts them can help you respond in a way that feels familiar and reassuring.

There will still be difficult days, and you will not always get your response right. What matters is that your loved one continues to feel respected, listened to, and cared for.