Orientation Aids for Memory Loss: Clocks, Calendars and Labels

What orientation means

Orientation is knowing who you are and who others are (person), where you are (place), and when it is (time). It also includes knowing what happens next. In early dementia, orientation to time often fades first, then place, and person last. Orientation aids support all three. For background, see memory and brain health and dementia daily routines.

Principles for using aids

1. Keep it simple. One clear cue is better than five cluttered ones. 2. Keep it consistent. Put cues in the same place and keep the same routine. 3. Make it visible. Large print, high contrast, at eye level, well lit. 4. Make it familiar. Use words, pictures and objects that mean something to the person. 5. Use it kindly. Do not quiz or correct. "Today is Tuesday" is a gift; "What day is it?" is a test. 6. Watch the response. If an aid causes distress, change or remove it. 7. Involve the person, if possible, in choosing and using the aids. 8. Review regularly, because needs change.

Orientation to time

Clock with day and date. A large, clear clock that shows the day of the week, the date and the time of day; see talking clocks for low vision and dementia. One main clock, in the main room, plus one in the bedroom.

Large calendar. A wall calendar with big squares and large print, in a place the person passes often. Cross off each day, or move a marker, as part of a morning routine. Write appointments and visitors in bold.

Whiteboard or daily planner. A board beside the clock, showing the day, the date, the weather, the meals and today's plan: "Tuesday. Sunny. Breakfast, walk, doctor at 11, Anil visits at 4." Update it each morning.

Daily timetable. A simple chart of the day's routine, with times and pictures.

Light and dark. Open curtains by day and keep the room dim and quiet at night. A night light helps. This supports the body clock.

Seasonal cues. Pictures, festivals and seasonal foods mark the time of year.

Newspapers, radio and television programmes at consistent times can mark the day.

Orientation to place

Labels and signs. Put clear signs on doors: "Bathroom", "Bedroom", "Kitchen", with a picture. Use large letters in a contrasting colour. Hang a sign at eye level.

Colour and contrast. A toilet seat in a contrasting colour, a coloured bathroom door and clear paths help; see dementia-friendly bathroom.

Glass-fronted or open cupboards, or labelled cupboards with pictures of contents, so the person can see where things are.

Clear pathways, well lit, with no clutter.

Photographs on the bedroom door or a personal object to mark "my room".

Familiar furniture and arrangement. Avoid rearranging.

Reduce mirrors, which can confuse some people, if the reflection is distressing.

Safe outdoors. A name tag, a card with the address and a contact number, and a plan for getting home; see wandering and dementia safety.

Orientation to people

Name tags and photographs. A photo board in the living room with names, such as "Priya, your daughter", helps with recognition. Label family photographs on the back or front.

Introduce yourself each time: "Hello Papa, it is Rahul, your son." Do not say "Do you remember me?"

A memory book or life story book, with pictures and short notes about the person's life, family and favourite things. It supports conversation and identity.

Visitor schedule, written on the whiteboard.

Caregiver information, with a photograph and name of each carer.

Orientation to routine and tasks

Pictures and steps. For tasks such as dressing or making tea, a short sequence of pictures or large-print steps.

Laid-out clothes in order; see dressing after a stroke and dressing aids for approaches.

Medicine cues. A pill organiser, an alarm and a chart; see pill organisers and medicine reminders for a forgetful parent.

Meal cues. Regular times, a laid table and a familiar smell.

Reminder notes in key places, such as "Lock the door" beside the front door, written in a calm tone.

A "what to do next" board for activities.

Technology

• Digital day-date clocks and automatic reminder clocks.
• Voice assistants that announce the time and reminders.
• Photo frames that show family pictures.
• Phones with picture buttons for calls to family.
• Door sensors and GPS trackers for safety; see door sensors and GPS trackers for seniors.
• Video calls with family at the same time each day.

Technology helps only if the person finds it easy. Start simple and add one thing at a time.

What orientation aids cannot do

• They cannot restore memory. As dementia progresses, some aids stop working, and others become more important.
• They cannot replace company and care. People need reassurance and human contact.
• They can cause distress if used as a test or if the person cannot make sense of them.
• They should not be used to control. Notes that restrict or threaten are not acceptable.

Handling confusion with kindness

Even with aids, confusion will occur. Good practice includes:

• Respond to feelings, not facts. If your parent says "I want to go home" when at home, acknowledge the feeling: "You miss home. Tell me about it."
• Avoid arguing and correcting.
• Use calm, simple language, one idea at a time; see communicating with someone who has dementia.
• Offer gentle reorientation where it helps: "It is evening, time for dinner."
• Distract and redirect when upset, with a drink, a walk or music.
• Watch for triggers, such as noise, tiredness, pain or hunger.
• Look after yourself; see guilt, grief and anger in family carers.

Making a memory board

A simple memory board is easy to build and often becomes the centre of the room. Use a large whiteboard or corkboard in the main living area. At the top, write the day and date in big letters, and the weather. Below, list the day's plan in three or four lines, such as breakfast, a walk, lunch and a visitor, each with a time. On one side, pin three or four photographs of the people your parent sees most, with their names and relationship in large print. On the other, place a small clock or a sign saying what time of day it is. Update it together every morning over a cup of tea, which becomes a pleasant ritual. Keep the board clean and uncluttered, and take down old notes. If your parent seems to find it distressing or ignores it, try a smaller version or move it. For some people, a single calendar page and a clock are enough.

When memory changes are new

If memory or orientation changes are new, worsening or sudden, see a doctor, since causes include infections, medicines, low sodium, thyroid disease, vitamin B12 deficiency, depression and delirium, which can be treated. Sudden confusion is an emergency; see delirium in older adults.

When to ask a professional

A doctor can assess memory and look for treatable causes; see mild cognitive impairment. An occupational therapist can assess the home and recommend orientation aids and routines. A dementia nurse specialist can advise on behaviour and support. Our care advisors can arrange assessments and trained companions. See caring for a parent with dementia at home.