December 6, 2023 by Dean Bellefeuille


Did you ever wake up in the middle of a dream and wonder, for just a moment, 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 can give you just a brief glimpse into the ongoing disorientation for someone with dementia. When confusion about time, place, and even identity settle in for someone you love, you have two choices in determining which dementia care approach is best: either stepping into their reality with them, or orienting them to yours.

Which Reality Is Best?

In a nutshell, each approach has its place in dementia care. However, there are particular cautions to be aware of in using reality orientation. It’s important to first understand what is involved with both options and when they might 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 person may believe they are a young adult engaged in their previous career (or a different one altogether), with a spouse and young children to care for. Going along with their perception of reality helps them maintain a sense of purpose and self-worth. It instills peace and comfort, and is often the recommended approach.

Reality Orientation

Reality orientation, on the other hand, involves providing prompts and cues about the current time, date, and location. Studies have shown that it can improve cognitive functioning, especially when paired with donepezil, and help with some of the more challenging aspects of dementia.

Reality orientation, however, must be handled gently and with skill, compassion, and attention to the person’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’re 95 years old, so there’s no way your mother could still be alive.” In contrast, it may be helpful in ordinary conversations. For instance, if the person wakes up and asks what day it is, you might respond, “Today is Monday, the day you have your exercise class and then lunch with Sally.”

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

Our specially trained caregivers are pros at knowing which dementia care approach is best in different situations, and how to effectively engage someone with dementia and make each day the best it can be. We use creative, customized approaches that help with memory, communication, comfort, and safety, while promoting independence and a sense of purpose and self-worth.

Contact us at (315) 579-HOME (4663) to learn more about our dementia care in Syracuse, Camillus, Clay, and the surrounding areas.