Disorientation and Dementia

Any one of us can easily lose track of time, forget the date, not know what specific day of the week it is, or even find ourselves unsure of exactly where we are. When we go about our lives and find ourselves getting lost in the daily business of existence, it is normal to find ourselves a little disoriented here and there.

Even so, when our brains are healthy and functioning normally, we always maintain a steady, general sense of time and space, and our place in it. While you may wake up not knowing exactly what day of the week or month it is, you’ll still know that it’s spring, that it’s the first half of May, whether it’s a weekday or the weekend, and what year it is. And if you wake up momentarily forgetting where you are, a quick look around the room will remind you, if it even takes that much. Brain diseases that cause cognitive decline, such as Alzheimer’s or other forms of dementia, can seriously impair that anchoring and grounding sense of general orientation. It is for this reason that healthcare workers will ask what the date is, where we are, and other questions meant to assess one’s grasp on the present as part of a cognitive evaluation.

People suffering from dementia often have problems orienting themselves to time and place. They will forget the date, the month, the year, find themselves unable to remember the name of the town they’re currently in, or even the type and purpose of the building they’re inside. These problems speak to something much deeper than a simple lack of attention and indicate a loss of general orientation.

For individuals suffering from this, it can leave them left floating in a terrifying limbo of questions like “where am I?” or “why am I here?”. This leads to confusion and disability. When we have no idea where, when, or who we are, our capacity to think and act is fundamentally affected. Orientation for self is the hardest to lose and is a sign of particularly serious brain pathology.

Remaining oriented means an individual with dementia is less severely afflicted by the disease, and also less disabled. In fact, helping an adult with dementia regain a sense of orientation has trackable benefits on overall cognition. This sort of treatment is called “reality orientation”. People with dementia are given tags of orientation, such as the day of the month, the weather, etc. They may be able to use these tags to build upon, and function better.

It can be monotonous or frustrating to constantly remind a loved one with dementia about the date or the place. However, stick with it and you’ll find the effort is worth it. Here are some tips:

• Approach in an empathetic manner. Do not correct harshly but make gentle suggestions.
• Show sensitivity. Don’t further confuse them or scare them.
• Choose your words carefully. If someone doesn’t know what time it is, saying something will happen in a half hour is meaningless. Changing the way you address a loved one can help them feel better oriented.
• Emotional content is easier to associate times and places with.
• Create a stable and consistent environment.