naomi feil workshop handouts handouts for a basic...

Naomi Feil Validation Workshop Handouts

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Naomi Feil Workshop Handouts

HANDOUTS for a BASIC WORKSHOP by

Naomi Feil Purpose

This workshop is designed for health and human services workers, families and volunteers who wish to learn how to communicate with disoriented “old-old” people. Its overall objectives is to restore dignity to the old person; to teach empathy, self-awareness of one’s own aging, and the applications of simple Validation® techniques.

Objectives ! List the physical, social and psychological characteristics that lead to change in very old age ! Experience an awareness of yourself and others ! Differentiate between the phases of disorientation in older people ! Identify specific Validation® helping techniques ! Formulate ways of preventing burnout and ways of reaching a wise old age Contents The course will include, not necessarily in this order, the following: ! Role play of the phases of resolution ! Workshop goals ! Characteristics of malorientation ! Viewing age-specific behavior: principles of Validation® ! Empathy ! Validation® techniques: centering and rephrasing with empathy ! Characteristics of Time Confusion ! The differrence between early and late-onset Alzheimer’s Disease ! The wisdom behind disorientation ! Use of symbols ! Why you don’t lie: Validation® principle ! Role play with audience: obstacles, what doesn’t work ! DVD: Communicating with Alzheimer’s-Type Populations ! Verbal Validation® techniques role play: “preferred sense”, “polarity” ! Erikson’s life stage theory ! Teen-age role play ! Non-verbal Validation® techniques for Time Confused people and those in Phase 3 and 4 ! Role play and exercises: ‘muscle memory-kinesthetic sense”, Say emotion with emotion”, “touch” ! Evaluation, questions ! DVD: Myrna, the Maloriented


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PHASES OF RESOLUTION

VALIDATION®

! An age-appropriate final life struggle – a developmental theory

! Resolution vs. Vegetation

! To validate is to respect their struggle

! Validation is also a method with 15 verbal and non-verbal techniques

PHASE 1 Malorientation (Unhappily oriented to life)

PHASE 2 Time Confusion (Loss of cognitive capabilities)

PHASE 3 Repetitive Motion (Repetitive motion replaces speech)

PHASE 4 Vegetation (Total retreat inward)


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WHAT IS EMPATHY? How does empathy differ from:

1. Sympathy

2. Confrontation

3. Insight-oriented therapy

4. Patronizing

5. Behavior Modification (i.e., extinguishing the behavior, reinforcement)

6. Diversion

7. Reassurance

8. Therapeutic Lie

9. Redirection

Techniques of Validation

1. Centering

2. Having empathy

3. Using non-threatening, factual words

4. Rephrasing

5. Using polarity

6. Imagining the opposite

7. Reminiscing

8. Maintaining genuine, close, eye contact

9. Using ambiguity

10. Using a clear, low, loving tone of voice

11. Observing and matching motions and emotions (mirroring)

12. Linking the behavior with the unmet human need

13. Identifying and using their preferred sense

14. Touching (exception: the maloriented)

15. Using music


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Universal Symbols and What They Can Mean Jewelry, clothing Worth, identity Shoe Container, womb, male or female sex symbol Purse Female sex symbol, vagina, itendity Cane or fist Penis, potency, power Soft furniture Safety, mother, home Hard furniture Father, God Napkin, tissue, flat object Earth, belonging, vagina, identity Food Love, mother Drink from a glass Male power, potency Any receptacle Food Picking the nose Sexual pleasure Playing with feces Early childhood pleasures A Few Typical Personal Symbols Used by the Old-Old A hand A baby A finger A parent, feet to walk, children to walk with A cloth Important papers, dough for baking, children’s clothes The arm of a chair A street Open space A hallway at home, heaven, hope Button, pebble Nourishment, love Clucking sound Safety, joy Rocking movement Mother, motherhood, safety, joy Liquid Male power Strong chair Penis, man, husband, sex Fork, knife Anger Handle Penis Low voice Male person Spoon or curved object Woman, female sex Sock, shoe Child, dressing as a child, or a sexual organ Removable piece of clothing Sexual act, feedom, defiance A nursing home floor A neighborhood The hallway A street in the neighborhood A wheelchair A car, bike, carriage


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VERBAL PRESUPPOSITIONAL PATTERNS

- PREDICATES-

VISUAL AUDITORY KINESTHETIC Picture Clear Focus

Perceive See

Flash Bright

Outlook Glimpse Spectacle Preview

Farsighted Discern

Peep Illustrate Delineate

Paint Cloud Clarify Graphic Dress up

Show Reveal Expose Depict Screen

Colorful

Red, blue.. Retrospect

Frame View Draw

Outline Shadow

Peak Magnify Examine

Hue Sparkle Twinkle Foggy Hazy

Horizon Vista

Illuminate Light Watch

Display Vivid Image Style

Rainbow

Tune Note

Accent Ring Shout Growl Tone Sing Hear

Sound Clear Say

Scream Click Static Rattle Ask

Chord Amplify

Harmonize Key

Muffle Voice

Compose Alarm

Screech Discuss

Resound Listen Quiet

Attenuate Discuss

Talk Argue Loud Quiet

Resonate Pitch Listen

Negotiate Speech Digitize

Utterance Language Laughter

Echo Predispose

Assume Response Translate Vocalize Predict

Touch Handle Throw Finger Shock

Stir Strike

Impress Hit

Move Grope Impact Stroke

Tap Rub

Clash Smash

Sharpen Tangible

Crawl Irritate Tickle Sore Grab Carry Flat Feel

Warm Land

Joyous Gentler Kinder Lips

Impact Pulse Flow

Arrive Open

Contact Tickle Solid

Foundation Strength

Join Melt

Arrange Block

Wound Heal

Motive Sense

Absorb

POSITIVE EFFECTS OF VALIDATON Measurable Effects ! Patients sit more erectly ! Keep their eyes open more ! Display more social controls and less aggression ! Cry, pace and pound less ! Less need for chemical and physical restraints ! Increased verbal and non-verbal communication ! Gait improves Non-Measurable Effects ! Less anxiety and withdrawal ! Improved sense of self-worth ! May assume familiar social roles in groups ! Improved awareness of reality and sense of humor


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Certification in Validation® The four levels of certification are: VALIDATION® WORKER VALIDATION® GROUP PRACTITIONER VALIDATION® TEACHER VALIDATION® MASTER Successful completion of the respective Validation® course, led by a Certified Validation® Teacher, is required for certification. More information about Validation is available at the website, www.vfvalidation.org

ValidationResearch NaomiFeilValidationWorkshopHandouts

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Validation Research (1)• Research on Validation has found positive results for caregivers and

older adults with some forms of dementia :

• increased communication

• increased positive affect

• reduced aggressive behavior

• caregivers feel more capable of handling difficult situations and have

more pleasure in their work

• less need to use psychotropic medications

•

Validation Research (2)• Randomized experimental and quasi-experimental studies include

–Tondi and colleagues (2007) – summarized in next slides

–Toseland and colleagues (1997) – summarized in next slides

–Peoples (1982) – summarized in next slides

–Brack (1996)

–Babins and colleagues (1985)

–Canon (1996).

• While many of these studies have limitations (e.g. low sample size),

this research illustrates the empirical evidence supporting the

effectiveness of the Validation therapy.

• More information and articles:

https://vfvalidation.org/research-on-validation

–

Tondi et al. (2007) • 50 patients with severe AD (Mini-Mental State Examination, MMSE <

13) in Italy

• Two groups: (a) individual and group Validation or (b) control.

• Measures: Neuropsychiatric Inventory (NPI) & Bedford Alzheimer

nursing severity scale (BANSS) administered at pre and post.

• Results showed a marked decrease of the average NPI symptom

score in Validation group (from 22.0 to 9.5) vs. a rise in the control

group (from 21.7 to 24.1).

• NPI Agitation, apathy, irritability and nighttime behaviors improved with

Validation

• Significant improvements (i.e. large effect size) on BANSS with

Validation while control participants increased or maintained their

severity ratings.

Tondi, L., Ribani, L., Bottazzi, M., Viscomi, G., & Vulcano, V. (2007).

Validation therapy (VT) in nursing home: a case-control study. Archives

of Gerontology and Geriatrics, 44, 407-411.

Toseland et al. (1997)• Randomized control trial in four skilled-care nursing homes

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2

3

4

5

2

3

4

ValidationResearch NaomiFeilValidationWorkshopHandouts

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group (from 21.7 to 24.1).

• NPI Agitation, apathy, irritability and nighttime behaviors improved with

Validation

• Significant improvements (i.e. large effect size) on BANSS with

Validation while control participants increased or maintained their

severity ratings.

Tondi, L., Ribani, L., Bottazzi, M., Viscomi, G., & Vulcano, V. (2007).

Validation therapy (VT) in nursing home: a case-control study. Archives

of Gerontology and Geriatrics, 44, 407-411.

Toseland et al. (1997)• Randomized control trial in four skilled-care nursing homes

• 88 in-patient elderly with Alzheimer's randomly assigned to one of 3

groups: (a) Validation (b) attention control condition & (c) usual-care.

• Nursing staff blind to condition rated participating patients’ behavior at

baseline, 3 months and I year.

• Residents in the Validation group were reported to have fewer

incidents of physical and verbal aggressive behavior on the Cohen-

Mansfield Agitation Inventory (Cohen-Mansfield, 1986), a 30-item with

good interrater reliability (Cohen-Mansfield, et al., 1989).

Toseland, Diehl, Freeman, Naleppa & McCallion (1997) The Impact of

Validation Group Therapy on Nursing Home Residents With Dementia

•

Peoples (1982)• 30 elderly patients with dementia

• Randomized to one of three groups: (a) Validation, (b) Reality

Orientation or (c) usual care.

• Patients randomized to the 2 intervention conditions (Validation and

Reality Orientation) participated in daily group meetings for 30 minutes

per day for 6 weeks.

• Results showed that patients in the Validation condition significantly

increased communication, decreased aggressive behavior, and were

more responsive to staff than patients in other conditions.

Peoples, Marlene (1982) Validation Therapy Versus Reality Orientation

as Treatment for the Institutionalized Disoriented Elderly

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The Validation Training Institute

What is Validation? Validation is a method of communicating with and helping disoriented very old people developed by Naomi Feil. It is a practical way of relating to a person that helps reduce stress, and enhance dignity and happiness. Validation can be used by family members as well as professionals. Validation is built on an empathetic attitude and a holistic view of

individuals. When you “step into the shoes” of another human being and “see through their eyes”, you step into the world of disoriented very old people and understand the meaning of their sometimes bizarre behavior. Using Validation techniques, family members and professional practitioners offer disoriented elderly the opportunity to express what they wish to express, whether through verbal or non-verbal communication. Mirroring, using anchored touch and rephrasing with empathy are some of the important skills that help caregivers connect and communicate. Validation practitioners gain new insight, new relationships and more joy in their interactions with people with dementia. Who is Naomi Feil? Naomi Feil is the developer of Validation. She was born in Munich in 1932, and grew up in the Montefiore Home for the Aged in Cleveland Ohio, where her father was the administrator and her mother, the head of the Social Service Department. Between 1963 and 1980, Mrs. Feil developed Validation as a response to her dissatisfaction with traditional methods of working with the severely disoriented old people who were her clients. In 1983 she then formed the Validation Training Institute to spread information about Validation. Feil’s two books Validation: The Feil Method and The Validation Breakthrough are updated regularly and translated into French, Dutch, German, Italian, Finnish, Danish, Spanish, and Swedish. What is the Validation Training Institute? Naomi Feil formed the Validation Training Institute in 1983 as a U.S.-based not-for-profit organization.

VTI’s mission is to spread information, gain acceptance and inspire people to become trained in Validation. We want very old people with dementia to be treated with respect and to keep communicating with the people who care for them - all over the world. We want families and caregivers to feel the joy and love of communicating with disoriented elderly and enjoy new ways of connecting to them.

Over the past 25 years, VTI has created and delivered constantly evolving training programs in 23 countries, published 4 books in 12 languages, created films and built an international network of affiliated organizations. There are over 350 certified Validation teachers and a growing number of Master teachers to mentor and support them.

Who can practice Validation? ● Validation can be used by anyone who cares for very old

disoriented people. Both professionals and family members can use Validation with positive results. ● Validation can be used with elderly who are verbal and

non-verbal. ● Validation can be used with individuals and in groups.

There are 4 levels of certification. Each level builds on the

experience and knowledge gained from the preceding course. Level 1, Validation Worker: participants become skilled at validating individuals. Level 2, Validation Group Practitioner: participants become skilled at starting and leading Validation Groups. Level 3, Validation Presenter/Teacher: participants become skilled at presenting Validation and after successfully co-teaching a course with an experienced Validation Teacher, may become certified as a Validation Teacher. Level 4, Validation Master: the role of this level is to train and support Validation Teachers, review and authorize curricula and become a member of the VTI Education Committee. The results that you can expect after using Validation:

x Disoriented elderly sit more erect and keep their eyes open more. x Disoriented elderly display more social controls. x Disoriented elderly cry, pace and pound less and express less anger. x There is a decreased need for chemical and physical restraints. x Disoriented elderly communicate more verbally and non-verbally. x Disoriented elderly often move better and more often. x Disoriented elderly express less anxiety and withdraw less. x Deterioration is often slowed down. x Caregivers morale is increased and burn-out is decreased. x Caregivers express a greater sense of fulfillment. x Caregivers feel more capable of handling difficult situations. x Families visit more because they feel it is worthwhile.

Where you can get more information:

www.vfvalidation.org Authorized Validation Organizations in the United States:

Country Meadows for Pennsylvania Contact: Steve Klotz 830 Cherry Drive Hershey, Pennsylvania 17033 Tel. (1) (717) 533 2474 [email protected]

Volunteers of America National Services for Minnesota, Ohio & Arizona Contact: David Nilson 7530 Market Place Drive Eden Prairie, MN 55344 Tel. 763-971-6326 cell: 612-616-0357 [email protected]

Sunrise Senior Living Inc for Virginia Contact: Rita Altman 7900 Westpark Drive McLean, VA 22102 Tel (703) 854-0541 [email protected]

Copyright Sept, 2015

Naom

i Feil, th

e foun

der of th

e Validation

meth

odIn

spirin

g audien

ces with

Valid

ation sin

ce 1975

Interactive • In

formative • E

ngagin

g

Naomi engaging participants

Naomi dem

onstrating in the audience

Doing an exercise with a participant

Role play with a participant

Expressin

g the h

eart of V

alidation

Particip

ant o

utco

mes:

ØR

ecognize ph

ysical, social and em

otional traits

that lead to ch

ange in

old-old age.Ø

Recogn

ize the differen

t stages of disorientation

.Ø

Experien

ce the prin

ciples of Validation

.Ø

Practice specific techn

iques for h

elping elderly

diagnosed w

ith dem

entia.

ØLearn

the in

gredients of su

ccessful agin

g, and

how

to prevent bu

rn-ou

t.

Plann

ing In

fo:N

um

ber of participants: 20-1500

Hon

orarium

: $2,000 + travel, hotel an

d meals

Con

tact: Naom

iFeilWorksh

ops@vfvalidation

.org

mailto:[email protected]

Ed established E

dward Feil P

roductions in 1952. H

e is internationally recognized for his film

s on gerontology and rehabilitation.

Living for Yesterday, w

on the Silver

Medallion at the M

iami International Film

Festival, 1978; 100 Y

ears to Live won The

Bronze A

ward at the H

ouston International Film

Festival, 1981. My First 100 Y

ears, w

on an Emm

y Aw

ard, National Academ

y of A

rts and Sciences, C

leveland Chapter,

and the John Muir Film

Festival Top Aging

Aw

ard, 1984.

Naomi Feil, M

.S., A.C.S.W.

After graduating w

ith a Masters degree in

Social W

ork from C

olumbia U

niversity in N

ew Y

ork, she began working w

ith the elderly. B

etween 1963 and 1980 M

rs. Feil developed V

alidation as a response to her dissatisfaction w

ith traditional methods of

working w

ith the severely disoriented old-old people w

ho were her clients. In 1982

she published her first book, Validation:

The Feil Method and has gone on to

publish her second book, The Validation

Breakthrough. M

rs. Feil studied writing at

the New

School for Social R

esearch in N

ew Y

ork from 1958 to 1960. From

1958 to 1963, M

rs. Feil studied theater at the H

ubert Berghoff S

tudio in New

New

York.

She joined Feil P

roductions as a script w

riter in 1963. Naom

i Feil and her husband have m

ade many film

s and videos about aging and V

alidation.

Edward G

. Feil, Ph.D D

r. Feil is currently a Research D

irector at E

dward Feil P

roductions, Research

Scientist at O

regon Research Institute and

an Assistant P

rofessor/Research

Associate in the Institute on V

iolence and D

estructive Behavior w

ithin the College of

Education at the U

niversity of Oregon.

Meet the Staff

Edward Feil Productions

P

.O B

ox 2243 Jasper, O

R 97438

Phone: (541) 521-2411 Fax: (877) 582-1158

ed@edw

ardfeilproductions.com

or jana@

vfvalidaton.org

Price List for Validation Products

Edward Feil

Productions

Tel: (541) 521-2411

Edward R. Feil

Price List

Books V

alidation: The Feil M

ethod by Naom

i Feil, A

CS

W, R

evised with

Vicki de K

lerk-Rubin

2003 Edition

$20.00

The Validation

Breakthrough by

Naom

i Feil, A.C

.S.W

and Vicki deK

lerk-R

ubin 3rd E

d

$38.99

Validation Techniques

for Dem

entia Care:

The Family G

uide to Im

proving C

omm

unication by V

icki deKlerk-R

ubin

$22.95

DVDs Introduction to V

alidation: C

omm

unicating with

very old people diagnosed w

ith Alzheim

er’s-type dem

entia RT: 25m

in

Family or

Paraprofessional $50.00

Agency or Professional

$75.00

Com

municating w

ith the A

lzheimer's-type

Population: The

Validation

® Method:

Marge, The B

lamer,

and Muriel, The

Wanderer

RT: 19m

in

$75.00

DVDs cont Looking For Y

esterday R

T: 29min

$75.00

The Four Phases O

f R

esolution R

T: 8min

$50.00

The More W

e Get

Together R

T: 44min

$75.00

Myrna,

The Mal-oriented

RT: 25m

in

$75.00

CD

Naom

i’s Workshop

on CD

$25.00

Internet-based Educational Tutorial B

eginning Validation

1 – 4 yearly subscriptions

$25.00 C

ontact Ed G. for

more pricing options at:

[email protected]

Using film

s and recordings documenting

Naom

i Feil’s work w

ith the elderly in nursing hom

es since the 60’s, and books w

ritten by Naom

i and Vicki de K

lerk-Rubin, E

d R., with assistance from

N

aomi has developed a catalogue of

valuable resources for the practitioner of V

alidation.

The books w

ritten by Naom

i Feil and V

icki de Klerk-Rubin and are a valuable

resource for professionals, family

mem

bers and caregivers wanting to know

m

ore about using Validation to im

prove com

munication w

ith people with

dementia.

The aw

ard winning D

VDs are a great

way to introduce the V

alidation Method

to workshop attendees and staff, they are

also a great way to supplem

ent w

orkshops, courses and in-services.

Is a course or a workshop to far aw

ay to travel? Then you m

ight want to consider

the internet –based educational tutorial Beginning V

alidation. Learn the basics of the V

alidation Method in the com

fort of your ow

n home. Y

early subscriptions are available w

ith a variety of pricing options.

These products can be ordered on the V

alidation Training Website at:

https://vfvalidation.org/products/

Media Resources on

Validation

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