An evaluation was made of reality orientation therapy utilizing 14 male patients with dementias of various types. The therapy is designed to improve memory and reduce confusion in elderly and demented individuals. Utilizing a group comparison with crossover design, it was found that the patients improved significantly over sessions on orientation items actually taught during those sessions. However, no significant improvement was found on a series of “generalization items” consisting of orientation-related questions that were not asked during sessions. Furthermore, there was no generalization to ward activities. It was noted that individual responses to the treatment were quite varied, and so three cases reflecting highly different responses are presented.