Reality Orientation Thirty Years Later: Are We Still Confused?

Abstract

Reality Orientation (RO) intervention represents the first significant attempt at rehabilitation programming for the disoriented, institutionalized elderly. Early anecdotal accounts reported sweeping positive effects. A first sign of hope for this severely disabled population, RO rapidly became widely implemented and continues to be a commonly accepted approach by numerous disciplines. However, careful examination of the research and clinical practice literature reveals many difficulties with the conventional RO classroom programme. Reliable research is limited and weakly supports a modest, temporary gain in verbal orientation after involvement in conventional classroom RO. The actual significance of these gains for these severely disabled elderly persons and their caregivers is doubtful. Although not yet clearly articulated, other approaches (eg. sensory stimulation, environmental manipulation) and a reformulation of RO itself are showing promise of effecting a broader range of functional behaviours (eg. self-feeding). Orientation information presented for reassurance, not re-articulation, is proving to be both more nurturing for clients and more clinically significant.