4. Module 3 · Communication & validation

4.3. Case, consolidation & transfer

Case, consolidation and transfer

Two cases and what to take away

Case study

Not correcting, but validating

Mr T. asks about his wife several times every day; she died years ago. A staff member at first answers with the truth (‘But your wife has died’) – each time Mr T. goes through the pain of the loss anew and is inconsolable. An experienced colleague validates instead: she responds to his feeling (‘You miss your wife very much, she was important to you’), lets him tell her about his wife (positive memories) and gives him closeness and comfort. Mr T. feels understood and calms down. The case shows how validation (instead of correction) avoids suffering and gives the person comfort and dignity.

Second case

Ms Lindqvist and the missing keys

Ms Lindqvist (fictitious), 83, searches her room every morning for her keys. She says, “Somebody has taken them. I cannot get out of here.” She has begun to accuse a young care assistant, Tom. Tom first replies, “You do not need keys here, nobody has taken anything.” Ms Lindqvist shouts. A nurse then sits with her and says, “It is awful not to find your keys. They are important to you.” She asks what the keys opened. Ms Lindqvist talks about her small shop and how she used to lock up every evening. After ten minutes she is calm and says, “Thank you, dear.” The nurse notes in the care plan that talking about the shop helps in the morning, and the team puts a small key ring with a few old keys in her bedside drawer.

Analysis. (1) The accusation is understandable from the inside: the keys stand for control and safety. (2) Tom’s answer was factual but ignored the feeling and made her feel unsafe. (3) The nurse named the feeling, asked an open question and listened. (4) The key ring was not a trick but an object with meaning. (5) Still, the team should check other causes, such as anxiety at night, poor sleep or pain. The case shows validation in a small, repeatable form and how a team can turn it into a routine.

🗂️ Flashcards – think first, then open
What are the five moves of a respectful approach?
Slow down, come into view from the front, get to eye level, say who you are, wait.
What does validation mean?
Accepting the person’s feelings and experienced reality with respect instead of correcting or refuting them.
Does validation mean lying?
No. You do not claim that the dead are alive. You answer the feeling and do not argue about the facts.
Why does correcting often fail?
The person cannot keep the information, feels rejected, may meet grief anew and may become angry or anxious.
What does section 1814 BGB say about the will of the person?
A legal custodian may not be appointed against the adult’s free will, and only where it is necessary.

Key messages

  • Communication begins with your manner: calm, from the front, at eye level, with your name and a smile.
  • Short, simple sentences, one idea at a time, with time to answer.
  • Non-verbal signals are read very precisely, so tone, face and touch matter more than words.
  • Validation answers the feeling. It does not lie and does not argue about facts.
  • Validation has limits: medical needs and safety come first.
  • German law links care to dignity and self-determination (section 2 SGB XI, section 1814 BGB).
Reflection (for yourself, nothing is submitted).
  1. Which of the five moves do you forget most when you are busy?
  2. Think of a time you corrected someone with dementia. How might validation have changed it?
  3. How would you explain validation to a colleague who calls it “lying”?
For your everyday work – checklist
  • ☐ I approach from the front, at eye level, and say my name.
  • ☐ I use short sentences and give time to answer.
  • ☐ I name the feeling before I answer the content.
  • ☐ I check pain, fear and safety before I rely on words.
  • ☐ I share what works with the team and write it in the care plan.
Transfer to practice

Exercise: Pay attention to whether you correct people with dementia. Practise validation instead: when someone makes an ‘unrealistic’ statement, respond to the feeling behind it instead of contradicting. Observe the effect.

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