[Reality orientation and the reality of the nursing home resident]

In this article the objectives of Reality Orientation Therapy (ROT) and its applications to demented elderly people are analysed. Opinions on the effectiveness of ROT are more optimistic than specialised literature and case studies seem to justify. Until now ROT has, in theory, been considered suitable for all stages of dementia. New developments mentioned in literature and actual experience on a psychogeriatric ward changed ideas on how to approach demented elderly people. Partly ROT arises from aversion of healthy people to very severe decay. Particularly in the advanced stages of dementia the approach advocated by Validation Therapy seems to be more appropriate. Cooperation between professional nurses and psychologists can contribute to a more differentiated treatment of demented patients in geriatric hospitals.