Do you ever wake up in the middle of a dream and wonder, for just an instant, if what you were dreaming about was real? It can feel very disorienting until you open your eyes and take in your familiar surroundings. Such an experience gives you just a short peek into the ongoing disorientation for a person with dementia. When confusion about place, time, and even identity settle in for someone you love, you’re faced with two options for responding: either stepping into their reality with them, or exercising reality orientation in dementia care.
Which Reality Is Best?
In a nutshell, each approach has a role. However, there are specific cautions to be aware of in using reality orientation in dementia care. It is important to first understand what is involved with both options and when they could be most appropriate.
Accepting Their Reality
Living in an alternative reality is quite common for a person 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 kids to care for. Going along with their perception of reality helps them maintain a sense of self-worth and purpose. It instills comfort and peace, and it is often the recommended approach.
Reality Orientation in Dementia Care
Reality orientation, on the other hand, involves providing prompts and cues about the current date, time, and location. Research indicates that it can enhance cognitive functioning, particularly when combined with donepezil, and help with some of the more difficult facets of dementia.
Reality orientation, however, should be handled gently and with skill, compassion, and attention to the person’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 is no way your mom could still be alive.” In contrast, it might be effective in ordinary conversations. For instance, if the person wakes up and asks what day it is, you may say, “Today is Friday, the day you have your physical therapy appointment and then lunch with Janice.”
If the individual appears to become anxious or agitated with reality, it’s always advisable to join them in the perceived reality that feels comfortable to them.
Serenity Home Care’s 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 feeling of self-worth and purpose.