Reality orientation? is it always appropriate.


Registered User
Oct 16, 2003
My wife is currently caring an elderly man suffering from Dementia.
His short term memory is very poor and he is constantly asking for his wife. his wife died recently and he becomes very upset when told this, he soon forgets the fact that she has died and when told again becomes very upset. My wife has been told by her supervisor that she must not hide this information from him and he must be told if he asks. She finds this very upsetting and questions the benefits of this practice. Any views on this matter would be helpful or any web sites giving advice on this matter would be appriciated.

Thank you.


Registered User
May 28, 2003
Now this is a tricky situation.
Unfortunately, from what you have said, the advice would have to be that your wife will have to follow the recomendations of her supervisor.
However, from my experiences, it is not always appropriate to use reality orientation with those suffering from a form of dementia. As you have said, each time the person is told that a loved one has passed away, because of their memory difficulties, you are effectively telling them for the first time, and this is often not done with as much tact as you would if you really were telling the person for the first time. with the repetitiveness of the questioning, even the most experienced and trained carer would reply quite hastily that that person has died.
Other advice that i give on a similair matter when the client is asking for their parents, is to gently encourage the client to work out for them selves that they must have passed the year is 2003, you are 81, how old would that make your parents?

A similiar situation was brought to my attention recently, a former nurse was employed as a carer at a day centre. The nurse insisted on telling a particular lady that her husband had recently passed away, obviously the poor woman would have a considerably amount of time grieving at hearing this terrible news, all be it, to be told this news not for the first time. The supervisor had a chat with the nurse who insisted that her training had taught her to use reality orientation, to which the supervisor advised that she was not to use it there with this type of clientele, and more so on an individual basis of knowledge. IE It is ok with one person but certainly not with another.
I would advise your wife to discuss the situation thoroughly with her supervisor, and possibly the clients family.
Im afraid I dont know of any other information on this matter but I will keep an eye out for you.

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