When researching reality orientation therapy, there is plenty out there to support that there is benefit to the therapy.
Reality orientation is providing the person living with dementia reminders, tools, and constant correction to reorient to the reality that we live in. If it’s Wednesday, and the person living with dementia believes it is Sunday, reality orientation would include correcting the person, showing them a calendar, and other devices to prove that it is Wednesday. Some believe reality orientation will improve a person’s cognitive functioning, jog the memory, and stunt cognitive decline.
The alternative to reality orientation therapy is validation therapy. Utilizing validation therapy, we focus on the feelings and jump into their reality, offering the person living with dementia active listening and compassion. When you hear a 91-year-old adult living with dementia asking for his or her mother, reality orientation would be to tell the person that his or her mother is dead. In this situation, that comment has done more damage than you can imagine. You have just thrown that person into a state of grief and sadness. Please understand that the person is hearing that for the first time.
Instead, by using validation therapy, we focus on creating positive feelings by stating; “Please tell me about your Mom;” “Which of your Mom’s recipes is your favorite?”
The decision to use reality orientation or validation therapy is completely dependent upon the individual and where they are at. If the person asks, “did my Mom die,” that is your cue to answer truthfully and offer understanding and comfort. Early in the dementia disease process, utilizing calendar reminders, notes on a white board, and technology to provide reality orientation makes sense for that person. When the person loses the ability to utilize these interventions, it is best to stop.
The lesson is MEET THE PERSON WHERE HE OR SHE IS AT. This will create positive feelings, increase self-esteem, prevent power struggles, and provide relief to both you, and the person living with dementia. Insisting that the person be in your reality only creates anger, frustration, arguments, low self-esteem, and negative feelings. Be mindful of what the person is saying and where you think their reality is in the moment. Know that one person can be in and out of your reality so it is so important to LISTEN!
