Yesterday afternoon in the secure unit for people with dementia, Betty* had been wandering around looking for a specialist for about an hour, asking everyone she saw where she should go to see the specialist for her appointment. I was doing other things so told her a few times that the specialist wouldn’t be in that afternoon, but that I’d make sure he saw her tomorrow morning and I think relatives and other staff members said similar things.
A bit later, I was sitting down in the dining room with a number of files in front of me, writing notes, it’s a new thing that my manager is pushing at the moment. Betty soon came and, probably seeing all the files, asked me if I was a specialist. I told her that I was and she asked me what kind, I told her I was a DT. She asked what it was and I explained it to her. I asked her why she had come to see me today and she told me she wanted to talk to me about her head. I asked her if she had a headache, and she said no, that she was worried about her head because she couldn’t remember where she was and what she was doing etc. I empathised and said that she must find it very frustrating and she nodded emphatically and continued talking about her concerns about her memory.
When I first started in DT, where I was working, the Reality Orientation Approach was where it was at. A quick google suggests that it was archaeic even at that point but to any theory there are always hangers on I suppose.
So of course the workplace had the once ubiquitous day/time/weather boards up everywhere (see below) and if Gladys* was looking for her mother, we were trained to say, “I’m sorry, Gladys, but your mother died in 1948 and it’s 2001 now” or something along those lines. Which never sat well with me.
The above anecdote is a good example of why. After a couple of mins of pouring her soul out and me trying my best to empathise, Betty told me that she had taken up enough of my time, said “thank you, doctor” and with that, went back to the lounge room where she sat contentedly watching Andre Rieu for the rest of the time I was doing my notes.
I’m not saying RO is completely useless; I’ve no doubt it is beneficial for some, but in my humble opinion blanket approaches and people mix like oil and water. We need to find unmet needs, people! Granted, they’re sometimes harder to find than others, but when you find them, Bingo!
*All names naturally changed for confidentiality.