Validation therapy is the best approach. I am the Dementia Care Coordinator in my facility and am constantly in-servicing staff and family members about the best approach to communicating with individuals with dementia. Sure, "therapuetic lying" is very easy if you're rushed and can get you short term results, but I believe that it is unethical and bases the relationship on deciet. It indicates a lack of respect for others and doesn't address the real issue--the resident who is looking for her mother or wants to go home to make dinner is feeling something; scared, abandoned, worried, lonely. Validation therapy explores this and validates a resident's feelings.
An anecdote: A resident named "Betty" gets anxious and agitated in the late afternoon and attempts to leave the activity group and try to go down the elevator to "get a recipe from her aunt". This behavior is dangerous because she usually falls right around the same time and is difficult to monitor outside of the activity group. I spent five minutes talking to "Betty" about the recipe, the aunt, reminiscing until somehow the conversation got to how "Betty" used to be a phone operator. By using validation techniques on her, "Betty" was left feeling validated, sat back and relaxed and exhibited no further behaviors for the rest of the evening.
I am sure most of you will say, "But I don't have time to talk to her for five minutes!" I will say that that staff don't have time to drag her wheelchair back to the activity every two minutes for 3 hours while she anxiously calls out and cries. The nurse doesn't have time to fill out the incident report when she falls which requires a call to the MD and family. Then I don't have time to fill out the incident investigation and interview everyone involved, update care plans
, ect.. It only took five minutes to make the resident feel better and save everyone else a lot of work.
As far as reality orientation, I will just say that it might work for some early stage dementia if the resident asks for it, "what time is it? where am I?" Subtle cues like calendars, clocks on the wall might have meaning for some early stage people.