Orientation – What to do if someone does not recognise where they are

Written by Active Minds on Tuesday the 10th of May 2016.

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If you know someone living with dementia then you will probably notice that they can get disorientated every now and then. Orientation is about someone’s awareness of themselves, their surroundings, those around them and time. Dementia can cause people to get confused by time and place and develop difficulties when trying to remember their immediate environment. The internal clock that people rely on and their perception of time can become disturbed by dementia, so people can lose a sense of perspective on a situation and think that someone has been gone for hours when it is only been a matter of minutes.

The main issue that disorientation causes is anxiety and someone can become agitated if they do not recognise their surroundings or feel as if there is not any structure to their day. Thinking that hours have gone past and that you have missed a social engagement or feeling uncomfortable in an unrecognisable environment are examples of the anxiety that can be caused.

Signs and Labels

If someone living with dementia is having particular trouble recognising where they are and getting confused by certain objects then putting helpful labels and signs around their home can be a source of reassurance. You could have labels on each room to let someone know where they are going or if someone has trouble reading then photos can be used to illustrate the function of each room, such as a photo of a toilet on the bathroom door.

Reassurance

Providing someone with reassurance when they are disorientated is one of the best things that you can do. Instead of just stating the time or where they are, try use emotive language and reassure someone that they are in a safe place and they are around people that love them. Do not challenge their perceptions or tell them that they are wrong, try to calm them down and make them feel that they are in a safe environment.

Identification

When a person does not recognise where they are, one of their first instinctive reactions can be to try and find somewhere that is familiar to them. This could be outside of the house, so this raises some safety issues. Making sure that someone living with dementia has some form of identification on them at all times when they go out of the house, such as their name, address and phone number, means that if they become disorientated, people will be able to help them. It is also important to make sure that a home is safe and secure. Making sure that their front door is secure at night means that someone living with dementia will not be able to leave the house if they wake up confused and agitated.

Neighbours

It can be useful to make your neighbours aware that your companion can get disorientated. They can notify you if they suspect they are getting disorientated or if they see them in a confused state outside.

Distraction

When someone is clearly becoming disorientated, try to distract them with an activity or engage them in conversation. If you have made a scrapbook full of memories and photos, this can help someone to feel more relaxed and see something that is familiar to them, but if this causes more distress then remove the book and try to find something else that acts as a distraction. Learn triggers for further agitation and try to avoid them.

Object Placement

Try to put objects that someone frequently uses in places where they can find them easily. This can help you to use objects to show someone that they are in a familiar environment, as they may recognise objects over place.

Trying to limit the anxiousness that can be triggered by disorientation is important and it is also crucial to remember that people that live with dementia are not all reassured or relaxed using the same methods, so learn triggers and assess the best ways to calm someone down.