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Reality orientation has been cited as a technique which may be used with elderly persons who have moderate to severe degrees of confusion.
Reality orientation has been popular in the literature since the late 1960s. It has been cited as a technique which may be used with elderly persons who have moderate to severe degrees of confusion. Reality orientation was first described by Taulbee and Fblsom1 and was the major undertaking of James C. Folsom, MD starting in 1959 at the Winter VA Hospital in Topeka, Kansas.
Major contributors to this program were Letcher, Fteterson, and Scarbrough,2 for their historical study of 125 patient records of persons who participated in a reality-orientation program in conjunction with other rehabilitation activities between the years of 1965 and 1970. This particular article was the one which received national attention in regard to this therapy.
Reality orientation is a two-part program which includes classroom orientation to time, place, and person, and 24hour-a-day, seven-day-a-week reality orientation on the unit. Total participation by all staff members is required to maintain consistency.
While this therapy has been promoted for its successes, there are studies which have found nonsignificant results of decreased confusion levels. Five studies have been critically reviewed in hopes of finding particular areas of weakness which may account for these discrepancies and focus on our need for further research in this area.
Individual Article Critiques
1. Hogstel MO: Use of reality orientation with aging confused patients. Nurs Res 1979; 28<3):161-165.
This investigation sought to determine if a specifically planned program of reality orientation wiil decrease the degree of confusion in elderly confused residents of nursing home. The investigation is significant to nursing since the majority of care provided to the elderly, especially in the nursing home setting, is provided by nursing. Identifying ways of decreasing confusion in the elderly will increase quality of life. The problem is clearly and concisely stated and it may be answered with empirical evidence.
The literature review is relevant to the study, yet it appears that the author is addressing the population she is interested in as confused with functional, reversible nature. However, she does not refer to this type of older adult subject specifically or directly anywhere else in her research. Literature review...