Did you ever have an imaginary friend? I think everyone did. The invisible person that we called our friend went everywhere with us, being our confidant, our BFF, our security blanket that enabled us to never be alone. As adults, most of us can tell humorous stories about our imaginary friend, and even still call him/her by their name. Having him/her around all the time gave us a sense of security.
Dementia patients often revert back to a different time in their lives, normally their childhood, or young adulthood. I have one resident in my facility that calls me “Betty”, thinking I am her friend from the mid 1930’s. When I talk to this resident, I am Betty. I am whoever she needs me to be, simply because it brings her comfort and gives her a sense of identity. In a way, I, “Betty”, am her imaginary friend. The resident will often ask me about “how Earl and Eula” are doing. I tell her that Eula was over at Carol’s getting her hair fixed and doing great. I have no idea who Carol is. It’s somebody I simply made up.
The technique I am using when playing the various roles assigned to is called Validation Therapy. I am validating and confirming whatever is needed to the resident. By playing the role of Betty, this particular resident is put at ease, knowing that Betty is close by. What I have learned over the years is that reality orientation is a moot point for most dementia patients. I could tell this resident that the year is 2013, and that I have no clue who Betty is, and that my name is Jessi, and that she is a memory care facility…..but why? Her reality is not the same as mine. All I would accomplish by arguing with her about reality, would be a more confused, upset and fearful resident. Again, different realities.
When a dementia patient begins asking about when the bus is coming or explaining to me how they have to get home to take care of their children, I express my most sincere concern. I make imaginary phone calls, using my cell phone to call my cell phone;, have imaginary phone conversations with myself, checking in on Betty’s children, checking the bus schedule only to learn that the snowstorm has canceled bus services for the day ( even though it’s 101 degrees outside). I have a lot of imaginary friends every single day. Some people, who oppose Validation, rant about how we are lying to the residents and not bringing them into a realm of reality. My question is this. Why? What is the harm in bringing the same comfort to a dementia resident that we had as a child, with the imaginary friend concept? Comfort, peace, security and companionship are the feelings felt by knowing that our “friend” was with us when we were younger. Why can we not have that same relationship in the latter years of life?
I encourage anyone who is working with a dementia resident to try Validation. Go along with whatever the storyline is. Play out your characters part. Become the imaginary friend that you once had and see the difference it can make. Validate, validate, validate.