Encyclopedia of Gerontology and Population Aging

Living Edition
| Editors: Danan Gu, Matthew E. Dupre

Reality Orientation

Living reference work entry
DOI: https://doi.org/10.1007/978-3-319-69892-2_713-1



Reality Orientation is a broad-based, therapeutic technique designed to increase cognitive stimulation by orienting an individual with dementia to the present.


Reality Orientation was first described by Taulbee and Folsom (1966) as a treatment for disoriented older adults residing in assisted living facilities (Woods et al. 2012). The “Reality Orientation” approach was based on the view that individuals with dementia “withdraw” from their environment. As such, the goal was to re-engage and stimulate individuals to regain previous functions or develop new ways to compensate for cognitive deficits (Powell-Proctor and Miller 1982; Woods et al. 2012). The intervention consists of presenting information about current time and place and “orienting” the individual to recent events, as well as correcting individuals when they become disoriented (See “Cognitive Training”). The Reality Orientation approach takes...

This is a preview of subscription content, log in to check access.


  1. Camargo CHF, Justus FF, Retzlaff G (2015) The effectiveness of reality orientation in the treatment of Alzheimer’s disease. Am J Alzheimer’s Dis Other Dement 30(5):527–532.  https://doi.org/10.1177/1533317514568004CrossRefGoogle Scholar
  2. Camargo CHF, Ladeira MA, Serpa RA, Jobbins VA, Filho CRP, Welling LC, Teive HAG (2019) The effectiveness of reality orientation therapy in the treatment of Parkinson disease dementia. Am J Alzheimer’s Dis Other Dement 34(2):124–130.  https://doi.org/10.1177/1533317518802461CrossRefGoogle Scholar
  3. Chiu HY, Chen PY, Chen YT, Huang HC (2018) Reality orientation therapy benefits cognition in older people with dementia: a meta-analysis. Int J Nurs Stud 86:20–28.  https://doi.org/10.1016/j.ijnurstu.2018.06.008CrossRefGoogle Scholar
  4. Dietch JT, Hewett LJ, Jones S (1989) Adverse effects of reality orientation. J Am Geriatr Soc 37(10):974–976.  https://doi.org/10.1093/geront/40.2.206CrossRefGoogle Scholar
  5. Onder G, Zanetti O, Giacobini E, Frisoni GB, Bartorelli L, Carbone G et al (2005) Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer’s disease: randomised controlled trial. Br J Psychiatry 187(5):450–455.  https://doi.org/10.1192/bjp.187.5.450CrossRefGoogle Scholar
  6. Onieva-Zafra MD, Hernández-Garcia L, Gonzalez-del-Valle MT, Parra-Fernández ML, Fernandez-Martinez E (2018) Music intervention with reminiscence therapy and reality orientation for elderly people with Alzheimer disease living in a nursing home. Holist Nurs Pract 32(1):43–50.  https://doi.org/10.1097/HNP.0000000000000247CrossRefGoogle Scholar
  7. Patton D (2006). Reality orientation: its use and effectiveness within older person mental health care. J Clin Nurs 15(11):1440–1449. 10.1111/j.1365-2702.2005.01450.xCrossRefGoogle Scholar
  8. Powell-Proctor L, Miller E (1982) Reality orientation: a critical appraisal. Br J Psychiatry 140(5):457–463CrossRefGoogle Scholar
  9. Rabins P, Blacker D, Bland W, Bright-Long L, Cohen E, Katz I (1997) Practice guideline for the treatment of patients with Alzheimer’s disease and other dementias of late life. American Psychiatric Association, Washington, DCGoogle Scholar
  10. Spector A, Davies S, Woods B, Orrell M (2000) Reality orientation for dementia: a systematic review of the evidence of effectiveness from randomized controlled trials. The Gerontologist 40(2):206–212.  https://doi.org/10.1093/geront/40.2.206CrossRefGoogle Scholar
  11. Taulbee LR, Folsom JC (1966) Reality orientation for geriatric patients. Psychiatr Serv 17(5):133–135CrossRefGoogle Scholar
  12. Williams R, Reeve W, Ivison D, Kavanagh D (1987) Use of environmental manipulation and modified informal reality orientation with institutionalized, confused elderly subjects: a replication. Age Ageing 16(5):315–318.  https://doi.org/10.1093/ageing/16.5.315CrossRefGoogle Scholar
  13. Woods B (2002) Reality orientation: a welcome return? Age Ageing 31(3):155–156.  https://doi.org/10.1093/ageing/31.3.155CrossRefGoogle Scholar
  14. Woods B, Aguirre E, Spector AE, Orrell M (2012) Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev (2).  https://doi.org/10.1002/14651858.CD005562.pub2

Authors and Affiliations

  1. 1.University of FloridaGainesvilleUSA

Section editors and affiliations

  • Adam J. Woods
    • 1
  1. 1.Department of NeuroscienceGainesvilleUSA