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Validation versus Medication

At Luxurycare, our Care Homes, have introduced the Dr Gemma Jones ‘behavioural staging’ model for meeting the needs of older people with memory difficulties or dementia. This is possibly quite different to the methods used in many care homes. Here, you will find a brief guide to help you understand the guiding principles behind what we are trying to achieve. The diagrams and information contained in this document are based on Gemma Jones’ training course, ‘Communication and Care-giving in Dementia: A Positive Vision’.

Validation v Medication - Dorset Care HomeDr Gemma M.M. Jones is a freelance educator about care-giving in dementia issues and a consultant on the design of specialist dementia care facilities, a guest lecturer in psycho-geriatrics at the Hague University, and a founding member of the first Alzheimer Café in the UK, in Farnborough, Hampshire. Gemma Jones has a background in cell biology, gerontology and nursing; she qualified as a Validation Therapist in 1985. She is a member of the workgroup for the Nuffield Council, currently examining ethical issues related to dementia. Her interests involve making a link between visuo-perceptual deficits in Alzheimer type dementia and finding the best ways to provide accurate and useful information about dementing illnesses.

She has taught extensively in the Netherlands, UK and Canada; publishing over 40 articles. With Dr. Bere ML Miesen she has co-edited volumes 1-4 of Care-giving in Dementia and translated Dementia in Close up, to help identify a knowledge base for supporting the professionalization of dementia care.

Behavioural Staging.

Since the process of dementia usually consists of slow but progressive changes and can last up to 20 years, it becomes necessary to have reference points along the way. ‘Behavioural staging’ is used as a kind of ‘shorthand’ way of describing this, so that the person’s current needs and abilities are seen within the larger context of what is happening to them. Behavioural staging is also a method of helping carers focus on the many ways in which a person with dementia tries to adapt to their own changing circumstances. It does not take away from the individuality of how a person experiences or reacts to their illness, but only makes care is aware of where someone is in this complex illness. In this sense, the staging is the same as for any other illness, from chickenpox to cancer, which are also described as having a start, middle and end. We can then utilise helping strategies that are most appropriate to each particular stage, to help our residents to live as full and enriched lives as possible.

Behavioural staging helps us to anticipate what we can expect to see as the person’s illness progresses through the different stages and to identify when changes might be about general ill health or those associated with old age rather than the person’s dementia.