Reality Orientation Thirty Years Later: Are We Still Confused?

Bowlby, M. Carol

doi:10.1177/000841749105800303

Cited by 5 publications

(7 citation statements)

References 49 publications

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“…Reality orientation fails to provide a strong theoretical rationale for why it works (Bowlby, 1991). Reality orientation fails to provide a strong theoretical rationale for why it works (Bowlby, 1991).…”

Section: Discussionmentioning

confidence: 99%

A Review of Reality Orientation (RO), Validation Therapy (VT), and Reminiscence Therapy (RT) with the Alzheimer's Client

Gagnon¹

1996

Physical & Occupational Therapy In Geriatrics

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This paper provides a review of the literature on three common treatment approaches used with individuals with Alzheimer's disease: reality orientation, validation therapy, and reminiscence therapy. An operational definition is provided for the three modalities, all of which will be evaluated according to their theoretical rationale, intended therapeutic population, cost of training and implementation, effects of intervention on staff, intensity of interven-, tion, and observed behavioural, cognitive, psychosocial, and functional changes as a result of intervention. It was found that reality orientation and validation therapy fail to provide adequate observable changes in clients to support the cost of implementation, and that more research has to be done into reminiscence therapy prior to its wide-spread implementation. It is suggested that occupational therapists can provide activity groups and specific skills training which will elicit the same, or better, outcomes at a diminished cost.

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Section: Discussionmentioning

confidence: 99%

A Review of Reality Orientation (RO), Validation Therapy (VT), and Reminiscence Therapy (RT) with the Alzheimer's Client

Gagnon¹

1996

Physical & Occupational Therapy In Geriatrics

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“…One of the first psychological therapies that drew on person-centered approaches for dementia patients was reality orientation therapy (Bowlby, 1991; Spector et al, 2000), which involves repeating orienting information, such as the date or the weather, over a prolonged period of time each day (Wallis et al, 1983). This approach aims to re-orient patients with dementia to their environments and to increase their engagement (Bowlby, 1991). The literature contends that reality orientation therapy should occur within a person-centered framework in which care providers facilitate positive, quality interactions with patients rather than simply providing information (Dietch et al, 1989).…”

Section: Non-pharmacological Treatment Approachesmentioning

confidence: 99%

“…RCTs utilizing reality orientation therapy have demonstrated mild, short-term cognitive improvements; however, they have not shown that it elicits a significant reduction in overall BPSD (Hanley et al, 1981; Wallis et al, 1983; Baldelli et al, 1993; Onder et al, 2005). Unfortunately, one frequent method of delivering reality orientation therapy utilizes a classroom approach (Bowlby, 1991), but patients who exhibit aggressive symptoms or wandering are often excluded due to concerns about managing disruptions in a classroom setting (O’Connell et al, 2007). Consequently, no studies have specifically examined the effects of reality orientation therapy on behaviors within the HIDA domain.…”

Section: Non-pharmacological Treatment Approachesmentioning

confidence: 99%

The Hyperactivity–Impulsivity–Irritiability–Disinhibition–Aggression–Agitation Domain in Alzheimer’s Disease: Current Management and Future Directions

2019

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Behavioral and psychological symptoms of dementia (BPSD) afflict the vast majority of patients with dementia, especially those with Alzheimer’s disease (AD). In clinical settings, patients with BPSD most often do not present with just one symptom. Rather, clusters of symptoms commonly co-occur and can, thus, be grouped into behavioral domains that may ultimately be the result of disruptions in overarching neural circuits. One major BPSD domain routinely identified across patients with AD is the hyperactivity–impulsivity–irritiability–disinhibition–aggression–agitation (HIDA) domain. The HIDA domain represents one of the most difficult sets of symptoms to manage in AD and accounts for much of the burden for caregivers and hospital staff. Although many studies recommend non-pharmacological treatments for HIDA domain symptoms as first-line, they demonstrate little consensus as to what these treatments should be and are often difficult to implement clinically. Certain symptoms within the HIDA domain also do not respond adequately to these treatments, putting patients at risk and necessitating adjunct pharmacological intervention. In this review, we summarize the current literature regarding non-pharmacological and pharmacological interventions for the HIDA domain and provide suggestions for improving treatment. As epigenetic changes due to both aging and AD cause dysfunction in drug-targeted receptors, we propose that HIDA domain treatments could be enhanced by adjunct strategies that modify these epigenetic alterations and, thus, increase efficacy and reduce side effects. To improve the implementation of non-pharmacological approaches in clinical settings, we suggest that issues regarding inadequate resources and guidance for implementation should be addressed. Finally, we propose that increased monitoring of symptom and treatment progression via novel sensor technology and the “DICE” (describe, investigate, create, and evaluate) approach may enhance both pharmacological and non-pharmacological interventions for the HIDA domain.

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“…The practice of intervention programmes for persons with dementia was the most common practice. Such interventions included reality orientation (Holden & Woods, 1982;Bowlby, 1991); life review or reminiscence (Kiernat, 1979); purposeful activities and occupations (Baum, 1995;Borell, Gustavsson, Sandman & Kielhofner, 1994;Burton, 1980); music therapy (Casby & Holm, 1994); sensory integration (Robichaud, Hebert & Desrosiers, 1994); and environmental modifications (Gitlin & Corcoran, 1993). Most of the studies examined the effectiveness of a treatment intervention in enhancing the functional performance or reducing disturbing behaviours of persons with dementia.…”

Section: Dementia and Occupational Therapy Practicementioning

confidence: 99%

Focus on family care givers for individuals with dementia: implications for occupational therapy practice

Chung

1997

Occupation Therapy Intl

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Reality Orientation Thirty Years Later: Are We Still Confused?

Cited by 5 publications

References 49 publications

A Review of Reality Orientation (RO), Validation Therapy (VT), and Reminiscence Therapy (RT) with the Alzheimer's Client

A Review of Reality Orientation (RO), Validation Therapy (VT), and Reminiscence Therapy (RT) with the Alzheimer's Client

The Hyperactivity–Impulsivity–Irritiability–Disinhibition–Aggression–Agitation Domain in Alzheimer’s Disease: Current Management and Future Directions

Focus on family care givers for individuals with dementia: implications for occupational therapy practice

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