When – and When NOT – to Use Reality Orientation for Seniors With Dementia

A caregiver points to a calendar, knowing that seniors with dementia may sometimes benefit from reality orientation.

Reality orientation can help seniors with dementia navigate the condition.

Have you ever had trouble bringing your mind back down to reality after a deep dream? It can be unsettling to deal with until you reorient yourself to your familiar surroundings. Such an experience gives you just a brief peek into the ongoing disorientation for seniors with dementia. When confusion about time, place, and even identity settle in for someone you love, you’re faced with two options for responding: either orienting them to your reality, or stepping into theirs.

Which Reality Is Best for Seniors With Dementia?

There’s a time and place for each approach in dementia care. However, there are particular cautions to be familiar with in using reality orientation. It is important to first understand what is involved with both options and when they may be most beneficial.

Accepting Their Reality

Struggling to get a grasp on reality is not uncommon for people in the mid to later stages of dementia. The person may believe they are a young adult engaged in their previous career (or a different one altogether), with a spouse and young children to care for. Going along with their perception of reality helps them maintain a feeling of self-worth and purpose. It instills comfort and peace, and is frequently the recommended approach.

Reality Orientation

Reality orientation, on the other hand, involves providing cues and prompts about the current time, date, and location. Research supports that reality orientation helps cognitive functioning, particularly when paired with donepezil, and can help with some of the more difficult aspects of dementia.

Reality orientation, however, should be handled gently and with skill, compassion, and awareness of the individual’s emotional state. For example, if the person asks where their mother is, it could be extremely harmful to respond, “Why, she died 20 years ago! You are 95 years of age, so there is no way your mom could still be alive.” In contrast, reality orientation may be useful in ordinary conversations. For example, if the person wakes up and asks what day it is, you might say, “Today is Thursday, the day you have your exercise class and then dinner with Janice.”

If the person gets frustrated or uncomfortable with reality, it is always best to join them in the perceived reality that feels comfortable to them.

Our specially trained caregivers are pros at knowing how to effectively engage someone with dementia and make each day the best it can be. We use imaginative, customized approaches that help with memory, communication, safety, and comfort, while promoting independence and a sense of purpose and self-worth.

Contact us online or call 919-426-7522 for more information regarding our dementia care in Raleigh, Cary, Wake Forest and the surrounding areas.