The effectiveness of 'classroom' reality orientation (CRO) for confused elderly subjects was evaluated. Experimental groups 1 and 2 (each consisting of five subjects) received CRO for 1 month with only group 1 continuing with maintenance CRO for a further 2 months. Both experimental groups and the control group (10 subjects) received modified informal reality orientation (IRO) and environmental manipulation (EM) for all 3 months. All subjects were assessed prior to the start of the study and after 4 and 12 weeks of treatment on cognitive and behavioural measures. Both experimental groups showed significant improvement on both cognitive and behavioural measures after 1 month compared with the controls. This improvement was maintained at 12 weeks for both experimental groups but there was a statistically significant difference only between group 1 and its matched controls.

The effectiveness, for confused elderly subjects, of modified informal reality orientation and environmental manipulation without any 'classroom' reality orientation was investigated with 10 experimental subjects in one ward and 10 control subjects in another. All subjects were assessed prior to the start of the intervention and after 6 and 12 weeks of treatment on cognitive and behavioural measures. While the control group showed decline on all measures except one, the experimental group improved in ward orientation and cognitive status and showed no decline on the behavioural measures.