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Living in Their World: Navigating the Benefits and Risks of Reality Orientation in Dementia Care

Updated: Dec 15, 2023


Do you ever wake up in the middle of a dream and wonder, just for a minute, if what you were dreaming about was real? It can feel so disorienting until you open your eyes and take in your familiar surroundings. Such an experience gives you just a short peek into the ongoing disorientation for someone with dementia. When confusion about time, place, and even identity settle in for someone you love, you're faced with two options for responding: either stepping into their reality with them, or utilizing reality orientation in dementia care.


Which Reality Is Best?

In a nutshell, each approach has a role in dementia care. However, there are specific cautions to be familiar with when using reality orientation. It’s important to first understand what is involved in both options and when they may be most beneficial.

Accepting Their Reality


Living in an alternate reality is quite common for someone in the mid to later stages of dementia. The individual may believe they are a young adult engaged in their previous career (or a different one altogether), with a spouse and young kids to care for. Going along with their perception of reality helps them maintain a sense of self-worth and purpose. It instills comfort and peace, and it is often the recommended approach.


Reality Orientation

Reality orientation, on the other hand, involves providing cues and prompts about the current date, time, and place. Research indicates that it can enhance cognitive functioning, especially when paired with donepezil, and help with a number of the more challenging facets of dementia.


Reality orientation in dementia care, however, should be handled gently and with compassion, skill, and attention to the individual's emotional state. For instance, if the person asks where their mother is, it could be incredibly harmful to respond, “Why, she died 40 years ago! You are 95 years of age, so there’s no way your mom could still be alive.” In contrast, reality orientation may be useful in ordinary conversations. For instance, if the individual wakes up and asks what day it is, you might say, “Today is Friday, the day you have your doctor's appointment and then dinner with Sally.”

If the person appears to become anxious or agitated with reality, it’s always best to join them in the perceived reality that feels comfortable to them.


The Care Company’s specially trained caregivers are pros at knowing how to effectively engage someone with dementia and make each day the best it can be. We use innovative, customized approaches that help with communication, memory, safety, and comfort, while promoting independence and a feeling of self-worth and purpose.


Contact us online or give us a call at (416) 422-2273 for more information regarding our dementia care in Toronto, Markham, North York, and the surrounding areas.


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