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Reality Orientation in Dementia: The Pro and the Cons

A caregiver helps guide a senior with dementia through reality orientation.
Reality orientation can help loved ones with dementia through confusion.

Have you ever woken up from a dream and had to ask yourself if it was real? It can be so jarring until you wake up and take in your familiar surroundings. An experience like this gives you just a brief glimpse into the ongoing disorientation for a person with dementia. When confusion about place, time, and even identity settle in for someone you love, you have two options for responding: either orienting them to your reality, or stepping into theirs.

Is One Reality Better than the Other?

Put simply, there’s a time and place to prioritize each reality in dementia care. Nevertheless, there are specific cautions to be aware of in using reality orientation. It’s important to first understand what is involved with both options and when they might be most appropriate.

Accepting Their Reality

It’s common for people in the mid to late stages of dementia to live in an alternate reality. The person may believe they are a young adult engaged in their previous career (or a different one altogether), with a spouse and young kids to care for. Accepting their perception of reality helps them maintain a sense of purpose and self-worth. It’s often the recommended approach because it helps maintain their peace and comfort.

Reality Orientation

However, reality orientation offers cues and prompts about the current date, time, and location. Studies have shown that it can improve cognitive functioning, particularly when paired with donepezil, and help with a number of the more difficult facets of dementia.

Remember though, that reality orientation is a sensitive approach that should be handled gently and with skill, compassion, and awareness of the individual’s emotional state. For instance, if the individual asks where their mother is, it could be incredibly harmful to respond, “Why, she died 40 years ago! You’re 95 years old, so there’s no way your mom could still be alive.” In contrast, it may be useful in ordinary conversations. For example, if the person wakes up and asks what day it is, you may respond, “Today is Friday, the day you have your exercise class and then lunch with Janice.”

Whenever the person seems to be frustrated or anxious with reality, it is always best to join them in the perceived reality that feels comfortable to them.

Home Sweet Home In-Home Care’s professionally trained caregivers are pros at knowing how to effectively engage someone with dementia and make each day the very best it can be. We use innovative, customized approaches that help with communication, memory, comfort, and safety, while encouraging independence and a feeling of self-worth and purpose.

Contact us online or at (866) 229-2505 for more information on our dementia care in Kalamazoo, Portage, Battle Creek and the surrounding areas.

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