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Validation Model

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Validation Model of Dementia Care: Naomi Feil
The Validation Model of Dementia Care was founded by Naomi Feil in 1982. She was a graduate from New York University. In her validation model there are 4 stages:
1. Stage 1 : Early Stage Experience
2. Stage 2: Disorientation
3. Stage 3: Repetitive Experience
4. Stage 4: Late Stage Intense Needs Experience

Stage One: Early Stage Experience:
• Awareness – a person becomes aware of failing memory and tries to hide it through jokes, excuses and making ‘light’ of the situation
• Appears to be orientated – aware of time, space and location
• Frightened of going mad – as increased awareness of loss of memory and changes occurring in their brain – fear for future
• Defends loss of memory or strange behaviour by making up stories for actions

Stage Two: Disorientation
• Visibly disorientated – markedly less orientated to time, place and setting
• Loss of sense of time – times of the day, month and year will be lost as person focuses on past times
• Disinhibition – Learnt social skills may lose their meaning and the individual may do or say things that are socially/morally unacceptable
• Less aware of loss – the individual ‘relaxes’ into their altered reality as they become less aware of their loss of memory and less able to joke about themselves and their changed behaviour.

Stage Three: Repetitive Experience
• Repeated movements and words – words, sounds or actions repeated over and over again e.g. asking the same question
• Language function deteriorates – language and ability to form words becomes more challenging. Individual focuses on certain words or phrases
• Poor vision and eye contact – may not maintain eye contact or look around their surroundings. The brain is confused by too much information so looking downwards will limit the field of vision giving comfort
• Less mobile – begin to struggle with life in general and confine themselves to a chair or bed

Stage Four: Last Intense Needs Experience:
• Withdrawn – severe brain damage prevents participation with the world around them, inability to communicate needs
• Eyes often closed – brain cannot cope with signals from the world surrounding them so eyes are often closed
• Little movement or vocalisation –
• Individual stops moving as freely as before and finds vocalisation difficult.…...

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