If you have spent any time around dementia care professionals, you may have noticed something: they rarely correct their patients.
When your mother tells the nurse that they's waiting for their husband, the husband who died fifteen years ago, the nurse doesn't say "Mrs. Thompson, your husband passed away in 2009." They says something like "It sounds like you're really missing him. He must have been such an important person in your life."
This is not an accident. This is not avoidance. This is a specific therapeutic approach called validation therapy, and it is one of the most important things most families never learn.
KindredMind is built on validation therapy principles. You can read how we apply them to every call on our approach page.
What Validation Therapy Is
Validation therapy was developed by a social worker named Naomi Feil in the 1960s and 70s. Feil noticed that the standard approach to dementia at the time, trying to reorient patients to reality, correcting their mistaken beliefs, insisting on factual accuracy, consistently produced more distress, not less. Patients became more agitated, not less confused, not more grounded.
Feil proposed a different framework: rather than trying to pull a person with dementia into our reality, we enter theirs. We accept their emotional experience as real and valid, regardless of whether the facts that surround it are accurate.
The core principle: the feeling is real even when the facts are wrong.
If your mother believes it is 1975 and they is waiting for your father to come home from work, the emotion of that moment is real. The anticipation, the love, the slight anxiety of waiting, these are not confused. They are genuine emotional experiences. Correcting the facts does not resolve those emotions. It disrupts them, adds confusion and grief to what was previously, in its own way, a coherent emotional state.
Validating the emotions, "It sounds like you love him very much. He must be looking forward to coming home too", meets their where they is. The anxiety settles. The moment resolves.
What Validation Therapy Is Not
A lot of family caregivers, when they first encounter this approach, have an immediate reaction: isn't this just lying?
It isn't. And the distinction matters.
Lying involves creating false impressions to serve the interests of the person lying. Validation involves meeting someone's emotional reality with empathy rather than confrontation, prioritizing their wellbeing over factual correction.
Think about it this way. When your five-year-old was frightened by a nightmare, you didn't say "that wasn't real, so you have no reason to be afraid." You said "I know, that sounds really scary. You're safe now. I'm here." You validated the emotional experience without endorsing the factual claim. The fear was real. The nightmare wasn't.
This is what validation therapy does for people with dementia. It treats the emotional experience as worthy of a real, compassionate response, not because we endorse the factual confusion, but because the emotional reality is the part that matters most to the person in that moment.
The 11 Principles of Validation Therapy
Naomi Feil, the founder of validation therapy, identified 11 core principles that guide practitioners working with disoriented older adults. These principles form the foundation of the validation approach and directly inform how KindredMind is designed to communicate with people living with dementia.
The 11 principles are: first, all very old people are unique and must be treated as individuals. Second, all people are valuable regardless of their degree of disorientation. Third, there is a reason behind the behaviour of disoriented very old people. Fourth, behaviour in old-old age is not simply a function of anatomical changes in the brain, but reflects a combination of physical, social and psychological changes that take place over a lifetime. Fifth, old-old people cannot be forced to change their behaviours. Sixth, you must accept old-old people as they are and not try to change them. Seventh, listening with empathy builds trust, reduces anxiety, and restores dignity. Eighth, painful feelings that are expressed, acknowledged and validated by a trusted listener will diminish. Ninth, painful feelings that are ignored or suppressed will gain in strength. Tenth, empathy builds trust, reduces anxiety, and restores dignity. Eleventh, there is a reason behind the behaviour of people with dementia.
These principles explain why validation therapy for dementia phone calls is more effective than redirection, distraction, or ending the call. A person with dementia calling out of fear needs to feel heard and understood, not redirected. This is the clinical foundation on which KindredMind was built, alongside simulated presence therapy and the Alzheimer Society of Canada communication guidelines for dementia care.
For families, the most practical of Feil's principles may be this one: painful feelings that are not expressed will worsen. A person with dementia who is not heard does not simply stop feeling. They escalate. The calling becomes more frequent, the distress more acute, the behavioural symptoms more difficult to manage. Responding with warmth, validating the feeling, not the factual confusion, is not just kinder. It is more effective.
The Research Basis
Validation therapy has been in use in professional dementia care for over fifty years. Its use is consistent with person-centered care principles, which are now the standard framework for dementia care across most developed countries.
Why the neuroscience supports it
Dementia, particularly Alzheimer's disease, tends to preserve emotional memory longer than episodic memory. A person may not remember what they had for breakfast, may not recognize a photograph of their child, may not know what year it is, and yet they can feel love, fear, anticipation, loneliness, warmth, and safety as fully as they ever could. The emotional brain is more durable than the memory brain in most forms of dementia.
This means that emotional responses, connection, reassurance, warmth, continue to reach them even when factual communication no longer does. Validation therapy works because it operates in the territory that dementia leaves most intact.
How to Use It in Real Conversations
Here are the most common situations dementia caregivers face, and the validation therapy approach to each.
When they asks where their deceased spouse is
Don't say
"Dad died in 2009. He's been gone for fifteen years."
Say instead
"He was so important to you. You must miss him. Tell me something you love about him."
When they says they hasn't eaten and is starving
Don't say
"You just ate lunch an hour ago. I was there."
Say instead
"You're hungry, let's make sure you're taken care of. I'll check that they bring you something."
When they says they doesn't know where they is
Don't say
"You're at Maplewood. You've lived here for two years."
Say instead
"You're somewhere safe. I'm not far. You're looked after."
When they says you never visit
Don't say
"I was there on Tuesday. I visit twice a week."
Say instead
"I wish I could be there more. I think about you so much. You mean everything to me."
When they says they wants to go home
Don't say
"You can't go home. Your house was sold."
Say instead
"I hear you. Tell me what home feels like. What do you love most about it?"
In every case: respond to the emotion. Don't argue with the facts. The facts don't resolve anything. The emotional response does.
How This Connects to the Calls
When they calls and asks when you're coming, they's not really asking for a calendar date. They's asking: are you coming? Are you still there? Am I still important to you? Am I safe?
The validation therapy response to every call is the same: answer those questions. "I'm coming, and I can't wait to see you. You're always on my mind. I love you." Whether that's literally true in every specific detail matters much less than whether it addresses the emotional question underneath.
Validation in practice: what to say and what not to say
The gap between knowing about validation therapy and actually using it in the moment is significant. When you're tired, when it's the fourteenth call of the day, when they says something that isn't true and every instinct is to gently correct it, the theory is easy to forget.
Here are four real situations with a corrective response and a validation response side by side. The difference in how each lands is immediate.
They says: "I need to go home."
Corrective: "You live here now, Mom. This is your home."
Validation: "I know you miss home. Tell me what you love most about it. What's your favourite room?"
The corrective response triggers grief, they's being told they's lost something. The validation response opens a conversation. It meets the emotion (longing, displacement) rather than the fact (where they actually lives).
They says: "Where's Dad?" (Their husband died twenty years ago)
Corrective: "Dad died in 2004, Mom. Remember, we were all there."
Validation: "You must be missing him. He was such an important person. What do you love most about him?"
The corrective response delivers grief, again, to someone who will experience it fresh each time. The validation response honours the love without causing that fresh wound.
They says: "You never call me."
Corrective: "I called you this morning. And yesterday. I call you every day."
Validation: "I think about you so much. I wish I could be there more. You matter to me more than you know."
The corrective response is factually true and emotionally beside the point. What they's saying is: I feel alone and I miss you. The validation response answers that.
They says: "I haven't eaten anything today."
Corrective: "You had lunch two hours ago. I checked with the nurse."
Validation: "Let's make sure you're taken care of. I'll let them know you're hungry. You deserve to be looked after properly."
The corrective response wins the factual argument and loses the emotional one. The validation response addresses the underlying feeling, that they might be forgotten, that their needs might not be met, and turns it into action.
The pattern across all of these: respond to the emotion, not the fact. The emotion is always true. The emotion is always the real message. And responding to it, warmly, without argument, is what actually settles them. This is the same principle at the heart of simulated presence therapy and everything KindredMind is built on. The brain that dementia is most aggressively taking is the one that processes facts. The brain it touches last is the one that feels love.
This is also the principle that guides KindredMind's AI conversation design. The AI never corrects, never argues with their version of reality, never points out inconsistencies or errors. It responds to meaning rather than literal words, meets their where they is, and provides exactly what every dementia care professional is trained to provide: the emotional truth that they is loved and safe.