A common challenge in dementia care
Imagine this scenario in a dementia care setting. A resident approaches a staff member and asks, “Is my mum here yet?”, but their mother passed away many years ago. The staff member faces a difficult choice. Should they tell the person the truth, potentially causing distress and confusion, or should they provide reassurance without reinforcing false beliefs?
This ethical dilemma is common in dementia care, where reality and perception often do not align. Responding in a way that avoids distress while maintaining dignity and respect requires skill and understanding. This is where the VERA model, developed by Anglia Ruskin University, provides a structured and compassionate framework for de-escalation.
At Maybo, we integrate the VERA model into our de-escalation training for dementia care to help staff navigate such sensitive interactions effectively.
What is the VERA model?
The VERA model (Validation, Emotion, Reassurance and Activity) is an evidence-based approach designed specifically to support communication and de-escalation in dementia care settings. Developed by Anglia Ruskin University, it recognises the unique cognitive and emotional challenges people with dementia experience and gives staff a framework to respond with empathy, reassurance and redirection.
The four stages of VERA
Validation
Acknowledge the person’s reality without challenging it. Instead of correcting them, staff validate their feelings. In the scenario above, instead of saying, “Your mum has passed away,” the response might be, “You miss your mum, don’t you?” This affirms their emotions without reinforcing a falsehood.
Emotion
Identify and empathise with the feelings behind the request. Many dementia-related behaviours are driven by emotions such as anxiety, loneliness or fear. By focusing on the emotion rather than the content of their words, staff can build a stronger connection.
Reassurance
Offer comfort and a sense of safety. People with dementia often feel confused and vulnerable, so reassuring them with a calm and positive tone is crucial. A response such as “You are safe here, and we’re here to look after you” can help reduce distress.
Activity
Redirect attention to another meaningful activity or conversation. If the person is asking for their mother, talking with them about their memories of her or suggesting a favourite activity can help shift their focus in a respectful way.
The evidence behind VERA in practice
Research has demonstrated that person-centred approaches like VERA improve communication, reduce distress and enhance wellbeing in dementia care (Kitwood, 1997; Brooker, 2015). A study by Surr et al. (2021) found that staff trained in compassionate de-escalation techniques reported fewer instances of distress and aggression among residents, leading to a calmer care environment.
The Alzheimer’s Society (2020) also highlights the importance of validation therapy, a core principle of the VERA model, in reducing agitation and improving emotional wellbeing. By avoiding confrontation and validating emotions rather than facts, staff can build trust and strengthen relationships with people living with dementia.
Integrating VERA into dementia care training
At Maybo, we embed the VERA model into our training programmes for dementia care settings, equipping staff with practical de-escalation techniques. By applying VERA, staff can turn interactions that might otherwise lead to distress into compassionate and constructive engagement.
This evidence-based approach helps staff feel confident and capable in handling difficult conversations, creating safer and more supportive care environments.
Conclusion
The VERA model offers a structured, empathetic and effective approach to de-escalation in dementia care. By focusing on Validation, Emotion, Reassurance and Activity, staff can reduce distress, build trust and enhance the quality of care.
With strong evidence supporting person-centred and emotion-focused approaches, training in models like VERA is essential for compassionate dementia care. For care providers, adopting the VERA model, as part of training programmes like those offered by Maybo, means staff are equipped to respond with confidence and empathy in challenging situations.
References
- Alzheimer’s Society (2020). Understanding and Supporting a Person with Dementia.
- Brooker, D. (2015). Person-Centred Dementia Care: Making Services Better. London: Jessica Kingsley Publishers.
- Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Open University Press.
- Surr, C., Gates, C., Irving, D. and Oyebode, J. (2021). Developing Evidence-Based Dementia Training: Impact on Staff Knowledge and Care Approaches. Journal of Dementia Care.
