Use of Environmental Manipulation and Classroom and Modified Informal Reality Orientation With Institutionalized, Confused Elderly Patients

Reeve, Wayne; Ivison, David

doi:10.1093/ageing/14.2.119

Cited by 37 publications

(13 citation statements)

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“…Baines et al (1987) suggest that positive outcomes can be maintained to a degree when an intervention has ended, and lost gains can be retrieved when a further intervention is put into place. Reeve and Ivison (1985) demonstrated that effects following RO were maintained, at least for a limited period, although this was enhanced by further input. In this study, a group of people diagnosed with dementia received classroom RO for a month, and significant differences on cognitive and behavioural outcome measures were found in comparison to a control group.…”

Section: Reality Orientation Groupsmentioning

confidence: 96%

“…Returning to the study by Reeve and Ivison (1985), there are a number of problems that must be considered. One is that all three groups (the treatment group receiving continued input, the treatment group that did not receive continued input and the control group) received what was classified as 'modified informal reality orientation' and 'environmental manipulation' throughout the course of the study and therefore were all actually receiving some form of intervention.…”

Section: Reality Orientation Groupsmentioning

confidence: 99%

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Do people with dementia benefit from psychological interventions offered on a group basis?

Scott

Clare

2003

Clin Psychology and Psychoth

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Psychological interventions, whether directed at cognitive functioning or emotional expression, are frequently offered on a group basis to people with dementia. This paper aims to review the range of therapies offered and to evaluate the evidence for their effectiveness. Four categories of group therapy are identified: early approaches to enhancing well-being (reality orientation, validation and reminiscence); methods aimed at improving memory and cognition (cognitive stimulation and memory training); psychotherapy; and support. Although the review demonstrates the wide range of group work offered, and the creativity of practitioners in this area, relatively little formal evaluation has been undertaken. It is therefore difficult to reach firm conclusions regarding evidence for efficacy. There is a need for more research, and future evaluations should pay increased attention to the selection of appropriate methodologies and outcome measures, the question of clinical relevance and the issue of individual differences in response to intervention. In addition, it will be important to (Alberoni, Baddeley, Della Sala, Logie, & Spinnler, 1992). Cognitive changes make it much more difficult to take new information on board, relate to other group members and join in a group situation. For example, it will be harder to focus if several group members are conversing at the same time. Despite these potential difficulties, group-based interventions are widely reported (Cheston, 1998).In this paper we review a range of group-based psychological therapies for people with dementia and explore the evidence for their effectiveness. We begin with the therapies that first demonstrated the possibilities for psychological work with people who have dementia: reminiscence, reality orientation and validation. We then consider more recent developments in cognition-based therapies and psychotherapy, and discuss the rapid EARLY APPROACHES TO ENHANCING WELL-BEINGGroup therapies have played a significant role in fostering acceptance of the relevance of psychological therapy for people with dementia. The early development of group therapies for people with dementia reflects a tension between cognitionoriented and emotion-oriented therapies that is still evident in the current literature. The main approaches to be considered here are reality orientation, validation therapy and reminiscence. Reality Orientation GroupsReality orientation (RO) uses instruments such as the reality orientation board to improve orientation in the here-and-now situation. RO can be implemented on a 24-hour or a classroom basis: ideally the 24-hour approach and classroom RO are used in combination, the latter not being considered a sufficient intervention by itself (Jenkinson, 1992). Classroom RO is carried out in group sessions. One difficulty with the term RO is that it is used to describe a number of different techniques (Bird, 2000), and may incorporate elements of other types of intervention such as reminiscence or cognitive stimulation. Holden and Woods (1982) also...

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Section: Reality Orientation Groupsmentioning

confidence: 96%

Section: Reality Orientation Groupsmentioning

confidence: 99%

Do people with dementia benefit from psychological interventions offered on a group basis?

Scott

Clare

2003

Clin Psychology and Psychoth

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“…Originalmente, el énfasis estaba centrado en administrar al paciente información a cualquier oportunidad. Más recientemente, se ha desarrollado una aproximación más ecológica en la que el staff responde directamente a las preguntas o dudas de los pacientes o les ayuda a descubrir las respuestas por ellos mismos 6,7 . Esta variante probablemente tenga menos riesgo de sobreestimulación para el paciente que cuando se le proporciona información que no es capaz de asimilar.…”

Section: Terapia De Orientación a La Realidadunclassified

Estimulación psicocognoscitiva en las demencias

Francés¹,

Barandiarán²,

Marcellán³

et al. 2003

Anales Sis San Navarra

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RESUMENLa enfermedad de Alzheimer es un trastorno neurodegenerativo que provoca una progresiva pérdida de memoria y de otras funciones cognitivas, con síntomas también en la esfera conductual y psicológica, pérdida de autonomía y todo ello con una importante sobrecarga para la familia y el entorno social. El abordaje de este trastorno y de otras demencias afines requiere una estrategia multidimensional que pueda afrontar las diversas necesidades que plantea el enfermo y su familia. En ausencia de un tratamiento farmacológico curativo, a lo largo de los años, han ido surgiendo intervenciones psicososiales dirigidas a optimizar la función del enfermo y apoyar a la familia en su cuidado, técnicas muy diversas en cada uno de los ámbitos de intervención (cognitivo, conductual, ambiente, familiar). En esta revisión, hacemos una descripción de las intervenciones más estudiadas en el campo de la estimulación cognitiva, desde las aproximaciones más globales (terapia de orientación a la realidad, terapia de reminiscencia, programas de psicoestimulación) a las más específicas en el campo de la rehabilitación de la memoria (entrenamiento de memoria explícita, téc-nica de recuerdo demorado, difuminación, aprendizaje sin error, entrenamiento de memoria procedimental y empleo de ayudas externas), y se muestran los resultados de algunos estudios realizados siguiendo estas téc-nicas de intervención.Palabras clave. Enfermedad de Alzheimer. Demencia. Entrenamiento cognitivo. Psicoestimulación. Terapias no farmacológicas. ABSTRACTAlzheimer's disease is a neurodegenerative disorder that provokes a progressive loss of memory and of other cognitive functions, with additional symptoms in the behavioural and psychological sphere, loss of autonomy and an important overburdening for the family and the social milieu. Dealing with this disorder and other related dementias requires a multidimensional strategy that is able to face the different needs raised by the patient and his family. Given the lack of a curative pharmacological treatment, psychosocial interventions have emerged over the years that are directed at optimising the function of the patient and supporting the family in caring for him, with very different techniques in each of the spheres of intervention (cognitive, behavioural, environmental, family). In this review, we make a description of the interventions that have been most studied in the field of cognitive stimulation, from the most global approaches (reality orientation therapy, reminiscence therapy, psychostimulation programs) to the most specific ones in the field of memory rehabilitation (training of the explicit memory, technique of delayed remembrance, vagueness, errorfree learning, procedure training of the memory and the use of external help), and the results are shown of some studies carried out using these techniques of intervention.

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“…A study by Reeve and Ivison (1985) involving 18 subjects with progressive dementia used classroom RO, modified informal 24 hour RO and Environmental Manipulation (EM), eg. sign posting and colour coding doors).…”

Section: Where Do We Go From Here?mentioning

confidence: 99%

Reality Orientation Thirty Years Later: Are We Still Confused?

Bowlby¹

1991

Can J Occup Ther

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Reality Orientation (RO) inte rvention 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 suppo rts 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 rearticulation, is proving to be both more nurturing for clients and more clinically significant.

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Use of Environmental Manipulation and Classroom and Modified Informal Reality Orientation With Institutionalized, Confused Elderly Patients

Cited by 37 publications

References 0 publications

Do people with dementia benefit from psychological interventions offered on a group basis?

Do people with dementia benefit from psychological interventions offered on a group basis?

Estimulación psicocognoscitiva en las demencias

Reality Orientation Thirty Years Later: Are We Still Confused?

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