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Tijdschrift voor Psychiatrie 23 (1981) 11, 689 - 699

Korte bijdrage

Training in realiteitsoriëntering - een benadering van de psycho-geriatrische patiënt

M. Mas , L. Migerode

Reality Orientation Training (R.O.T.) is described as a feasible way to tackle negative effect of mental deterioration and chronic hospitalization. During an experimental period, 1/2 hour's R.O.T. sessions were given to small groups (max. 4 patients), including all but the most disturbing or sensory handicapped patients of the psychogeriatric admission ward. A classroom was arranged, teaching material was gathered and nursing personnel was encouraged and trained to take part in the teaching. The most important outcome of this break in period was the experience that R.O.T. was feasible indeed, even with severely demented patients. By means of the records of every session, patients were then divided in threelevel groups, running from severely dement to slightly deteriorated. Every three-patients group got its own teacher. During a nine weeks' programme, 69 sessions were given (1,5 x week for all of the five 3-patients groups). For the lowest level groups, R.O.T. consisted mainly in catching their attention, naming persons and objects, repetition of date, hour, season and the like. In the highest level group, aside from time and place orientation, small conversations, quizz-like entertainment and explanation of geographical, technical and social data were possible. We did not consider the R.O.T. programme as a unique and well delineated experimental design but rather as a permanent and integrative part of the total approach of the ward. Although some patients showed clear improvement in orientation, knowledge and social ability, the major result lies in an overall increase of activity and participation in all kinds of therapies by the patients as well as by nursing personnel. It need not be stressed that these overall effects favor job satisfaction and, in turn, help to create a climate which tackles the hospitalization syndrome.