Naomi Feil, who promoted empathy in response to dementia, dies at 91

Naomi Feil was only 8 years old when she moved to what was then known as a retirement home, where her parents worked. She lived there until she went to college and learned firsthand, through trial and error, how to comfort and communicate with older adults.

When she died on December 24 at the age of 91 at her home in Jasper, Oregon, she had devoted her entire career to finding ways to comfort disoriented elderly people and their caregivers.

Her daughter Vicki de Klerk-Rubin said she died of cancer.

Ms. Feil was a 24-year-old social worker who convened a group of patients who had been diagnosed as “senile psychotic” when a staff psychologist at the Montefiore Home for the Aged in Cleveland laid the groundwork for what would become the method she validated mentioned. therapy.

“He taught us that when feelings are 'empowered' they are alleviated,” Mrs. Feil explained on her nonprofit's website Validation Training Institute in Pleasant Hill, Oregon. “'You validate your residents and help them release their pain.' When social work students asked me what I did, I replied, “Validation.” And so a new way of interacting emerged.”

Her method calls on caregivers to empathize with disoriented individuals in an effort to reduce their stress and support their dignity, rather than trying to impose reality on them.

“When you validate someone, you accept them where they are and where they are not,” Ms. Feil (pronounced “feel”) often said. “If you accept them, they can accept themselves.”

While she refined her methods, she founded the nonprofit Validation Training Institute in 1982. She led this until 2014, when she was succeeded by Mrs de Klerk-Rubin, her daughter.

“She was a pioneer in this area of ​​person-centered dementia care,” said Sam Fazio, senior director of quality assurance and psychosocial research at the Alzheimer's Association, in a telephone interview. “What is essential in connecting with a person with a cognitive disability is to meet them in their reality, rather than expecting them to meet us in ours.”

Her theory, like a related theory called therapeutic deception, was not without criticism. The main objection is that it condones lying. The British Alzheimer's Society has said that “we struggle to see how systematically misleading someone with dementia can be part of an authentic relationship of trust.” Others argue that lying, or accepting a patient's delusion as reality, is justified if it is in the patient's best interest.

There is still no agreement.

According to the Validation Training Institute, more than 9,000 people in 14 countries have been trained to communicate with people with declining cognitive skills, especially dementia, by expressing empathy.

Ms. Feil wrote two books: “Validation: The Feil Method, How to Help the Disoriented Old-Old” (1982) and “The Validation Breakthrough” (1993). She collaborated with Ms. de Klerk-Rubin on a later edition of “The Validation Breakthrough.”

She and her husband, Edward R. Feil, a professional filmmaker, collaborated on a number of documentaries, including “The Inner World of Aphasia” (1968), which was placed on the United States National Film Preservation Board's Film Register in 2015 placed.

Gisela Noemi Weil was born on July 22, 1932 in Munich of Jewish parents. By the time she was five, her family had fled Nazi Germany for the United States, where her father, Julius Weil, became director of the Montefiore Home for the Aged in Cleveland, and her mother, Helen (Kahn) Weil, the was in charge of the home. social service department.

After attending Oberlin College in Oberlin, Ohio, and Western Reserve University (now Case Western Reserve University) in Cleveland, and receiving her master's degree from Columbia University School of Social Work in New York in 1956, she married Warren J. Rubin. Their marriage ended in divorce.

She then moved to Cleveland and returned to the Montefiore Home, this time as a member of the professional staff. She married Mr. Feil in 1963; he died in 2021.

In addition to Mrs. de Klerk-Rubin, her daughter from her first marriage, Mrs. Feil is survived by another daughter from that marriage, Beth Rubin; two sons from her second marriage, Edward G. Feil and Kenneth Jonathan Feil; six grandchildren; and a great-granddaughter.

She and Mr. Feil moved from Ohio to Eugene, Ore., in 2015 to live on their son Edward's farm, where Mr. Feil, who suffered from cognitive decline, received full-time home nursing, piano lessons, art lessons and painting lessons. validation therapy.

When she began working with disoriented people over 80 in the early 1960s, Ms. Feil realized that helping them face reality was an unrealistic goal, one that would frustrate both the caregiver and the disabled person.

“Each person was trapped in a world of his own fantasy,” she wrote in her first book.

“I have learned validation from the people I have worked with,” she added. “I learned that they have the wisdom to survive by returning to the past.”