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Title: An evaluation of reality orientation procedures with the mentally impaired elderly
Author: Hanley, Ian George
ISNI:       0000 0001 3530 1127
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1981
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The studies to be presented here are concerned with investigating the effectiveness of Reality Orientation procedures in the institutional management of those suffering from the dementias of old age. The initial chapter considers the dramatic increase in the numbers of people suffering from dementia and points to the urgent need for research on management procedures. The second chapter examines dementia itself and briefly describes the range of psychological and behavioural disabilities that accompany the dementing process. The third chapter reviews the main psychologically based intervention strategies and describes the procedures of Reality Orientation (RO). An attempt is then made in the fourth chapter to relate these available approaches to both the disabilities presented by the disease process and the typical characteristics of institutional care settings. It is argued that Realty Orientation, as a package of procedures designed specifically for use in the care of the mentally impaired elderly, has the most obvious potential. The ai: 3 of the study are presented in the fifth chapter. The primary concern is to evaluate the effectiveness of Twenty-four Hour RO and Glass RO, both separately and in combination, with a lai-ge sample of dementing subjects dram from the two main types of care setting; a psychogeriatric hospital and a local authority ran old people's home. The effectiveness of these procedures isexamined in both the short and longer term and in relationship to the factors of residential location and degree of dementia. As well as examining the effects of these procedures on the demented elderly sample itself, an attempt is also made to evaluate the effects on care staff whose task it is to apply the procedures. Additionally an attempt is made to separate out and evaluate the effectiveness of two principal components of 24 RO, The sixth chapter describes the general design and methodology adopted in the experimental trials and then the seventh to twelfth chapters describe in turn each of the six experiments conducted, present the results obtained and discuss the basic conclusions that can be reached in each. The conclusion reached in the thirteenth chapter is that the effectiveness of Class RG and 24 RO can be summarized as conforming to the following models over the short term application Class RO appears to produce restricted cognitive improvement in the demented subjects. No behavioural improvements are evident and the level of engagement of subjects with their environment seems reduced. Over the longer tenn, there is no indication of Class RO having any positive or negative effectai Twenty-four Hour RO, on the other hand, seems to produce both moro extensive cognitive improvement and behavioural improvement when examined in the short term. This seems to be facilitated by the addition of Class RO, In the long term most of these gains maintain and are directly attributable to 24 RO working alone. Of the two components of RO examined, s .ff to patient interaction seems to have the most beneficial effect in facilitating discrete behavioural improvements. However, no evidence was obtained to positively indicate that staff generally changed their style of interaction with patients as a result of 24 RO implementation. Some of the implications of these findings are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Psychology