Evaluation of a Yearlong Reality Orientation Program

Abstract

The effectiveness of Reality Orientation (RO) as treatment for disorientation and behavioral deficits in institutionalized elderly adults was assessed over a one-year period, with evaluations at 6-month intervals. Residents of a home for the aged with varying degrees of disorientation and disability were treated with a 24-hour RO program and were compared with a control group. A subsample of disoriented residents also attended RO classes and was compared with controls. Treatment effects were assessed with a Mental Status Questionnaire (MSQ) and ratings of Activities of Daily Living (ADL) and interpersonal behaviors. Compared with controls, who showed deterioration, the subsample attending RO classes showed slight, statistically significant improvement on the MSQ after 6 months. There was no favorable effect on ADL or other measures. Comparisons with other studies suggest that advanced age, severity of disorientation and disability limit the effectiveness of RO.

Reality orientation for the elderly: a critique

“…2 Class RO, like many behavoural interventions, does not appear to automatically lead to generalized change across settings and behaviours. However, the failure of 24-h RO to produce clinically significant changes in the studies by Citrin & Dixon (1977) and Zepelin et al (1981),…”

“…Two evaluations ofa full RO programme have been reported, by Citrin & Dixon (1977), and by Zepelin et al, (1981): both were carried out in the USA.…”

Reality Orientation, Validation and the Reality of the Disoriented Old Old

“…Citrin and Dixon (13) choose residents that were moderately disoriented. Zepelin, Wolfe and Kleinplatz (14) had severely, moderately and slightly disoriented residents in their sample group.…”

Clinical usefulness and feasibility of using Reality Orientation with patients who have dementia in acute care settings

“…10,11 From the list of studies presented in Table 1, only the study by Hanley et al 21 discussed the effect of 24 h RO as well as Formal RO. As the studies on 24 h RO were poorly designed with inconclusive findings, [22][23][24] the authors only used the information on the clinical feasibility of 24 h RO in acute care settings, and not the data on clinical usefulness. Consequently, discussion on the clinical usefulness of RO is limited to Formal RO.…”