Reality orientation, validation and the reality of the disoriented old old

Approaches of disoriented elderly people can be distinguished in two main perceptions, Reality Orientation and Validation. Reality Orientation appeals to still existing functions and helps people to get oriented toward the reality. Validation goes with people into their inner world, where feelings dominate and facts are no longer important. In this article both approaches are explicated. Further, it is stated that measuring the effects of Reality Orientation or Validation have the same pitfalls, such as lack of adequate scales, unclear definitions of the behaviour and symptoms of patients involved, and the risk of measuring a Hawthorne effect. The author states that Validation meets the demands of disoriented people better than Reality Orientation. She argues to think in-depth about the aims of psychogeriatric care, in order to define what effects should be pursued and measured. Nursing diagnoses should be used instead of medical diagnoses.