A Study of Reality Orientation and Resocialization Groups With Confused Elderly

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Abstract
The articles prior to January 2008 are part of the back file collection and are not available with a current paid subscription. To access the article, you may purchase it or purchase the complete back file collection here Donna Voelkel The outlook for the elderly in nursing homes who exhibit various degrees of confusion is generally pessimistic. Insufficient thought and time has been given to reducing the confusion of such persons or to ways of improving their level of functioning in activities of daily living. Goldfarb1 pointed out that prolongation of life without prolongation of at least minimal social adaptability cannot be considered prolongation of living. Routinely, the care of the elderly in nursing homes has evolved around custodial care with little thought given to their psychological and mental needs. Maslow's hierarchy of needs infers that all individuals have five basic needs. The first two on the pyramid, physiological and safety needs, are provided in the nursing home. A clean, warm, environment does exist in most homes. Shelter, food, medication, bathing facilities, clean clothing, and a certain area which an elderly person can claim as his territory make up the environment of the nursing home resident. The final three needs, belonging, self-esteem, and self -actualization, are frequently denied the confused elderly. It is difficult for a person to have a sense of belonging if he does not know the name of the nursing home nor the names of the people taking care of him. Confusion in the elderly can result from chronic or acute brain syndrome but it need not be caused by a biological process. It can occur because of social attitudes towards the aged. Birren2 and Burnside3 have attributed confusion to environmental factors such as social deprivation or lack of sensory stimulation. Since it is predicted that more and more of the nation's aged will be institutionalized, emphasis must be placed on health maintenance and prevention rather then custodial care. Frequently, symptoms of confusion go untreated because the nursing home staff is not aware of steps to take to reverse the trends of confusion. Danger signals such as irritability, loss of concentration, physical complaints, insomnia, and finally depression are considered "par for the course" in old age. Reality orientation is a method for treating the confused person. It attacks the process of confusion, disorientation, and memory loss by continual, stimulating, repetitive orientation to person, place, and time. The literature disclosed that Nikolai4 and Letcher, Peterson and Scarbough5 are among the few who have done empirical studies on reality orientation (RO). These four investigators found that mental status does not improve but the ability to perform activities of daily living changed significantly. Other investigators, such as Settle,6 Oberleder,7 and Taulbee8 all concluded that confused persons who are exposed to RO will begin functioning with less assistance and will show signs of less confusion.… 10.3928/0098-9134-19780501-04

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