Montessori and Dementia: New Ways to Enhance Activity Programs

By Lara Belonogoff
What is Montessori?
In 1907, Maria Montessori, one of the first female physicians in Italy, began an experimental school where the students were considered unmanageable. One of her guiding ideas was to create a secured and ordered environment that was the antithesis of the slums the children roamed in during non-school hours. Her ideas caught on in Europe and eventually trawled across the Atlantic. Today in the US there are thousands of Montessori schools. In the last few years, an emerging trend in assisted living facilities is to apply some of these principles to structuring activities for dementia residents.

According to basic Montessori principals, learning will ensue as long as the environment is set up for it and is maintained. This “environment” includes the physical surroundings as well as the ambience created by group and internalized dynamics. Montessori-based classrooms often have the children immersed in a present and “centering” activity. The idea is to enhance their motor skills and memory—and push their minds from basic ideas into more complex or intangible ones, incorporating as many of their senses as possible. Another important aspect is that individuals are seen as a whole wherein emotional, mental, physical, social and spiritual needs and interests are intertwined conceptually. This idea also supports the concept of respecting others.

How Can Montessori Principles Be Used in Dementia Care?
These basic tenets translate into the assisted living environment, a type of long-term care setting, in a relatively seamless way. We’ve all seen or heard about lethargic dementia patients who are totally disconnected from themselves and their surroundings. This can happen even if they are not in the advanced stages. Digging into the Montessori treasure chest, activity directors work on creating familiar surroundings for dementia patients. Instead of activities taking place in a disordered room or having patients participating in activity with a shifting focus, the environment becomes nurturing and akin to a cocoon that can protect the individual from too much or the wrong kind of stimulus. As confidence and ability grows, he or she can push along the cocoon sides to create more room. Thus the dementia resident’s world gets bigger and safer to operate in.

Montessori-based activities eliminate judgment so that nothing is “right” or “wrong.” (In a previous post on caregiving, I pointed out an auxiliary and parallel trend, which is to stop “correcting” dementia patients when abnormal or inappropriate behavior occurs.) In the Montessori-based schema residents feel both worthy and successful; each attained goal can move into more complex activities. Obviously, dementia patients must still fight against the disease course, but the idea is that a person could retain more function if activities are relational to everyday needs. For example, an activity in which a row of zippers are closed could help foster keeping the ability to dress one’s self. Recreating ballistic movements like these is important when cognition and memory begins to fail.

Along with the move to create a smaller, more manageable world in which these individuals can thrive, the concept of respect is foremost. One facet of the Montessori philosophy has individuals with greater cognitive abilities teaching concepts to others. This is translated into the dementia community by having individuals with less impaired cognitive skills run specific activities. Although originally designed for schoolchildren, no one in this structure is “babied,” as patients in small groups all play a contributing role in an activity. This fosters a sense of worthiness. For example, one person could find items whereas another will then count them. These sorts of interactions fulfill the very human need to belong and contribute is factored into each activity.

Some of the Montessori principles have been integrated into care philosophies outside activity rooms—in an effort to keep the proverbial cocoon tightly closed. Montessori-trained staffers avoid anything that asks a resident to use their memory, and keeps in mind that invitation always triumphs over insistence and praise should be detailed and genuine. Some of these concepts seem like a reiteration of basic care philosophies, but thorough training helps staffers avoid any uncomfortable situations—and keeps residents content and immersed in the moment. Lucky for today’s caregivers a great deal of products, literature and training has brought this into the public focus. Sometimes the best ideas are the ones you already had—maybe they just needed some tweaking.

The Montessori Method and Alzheimer’s

The Montessori Method was developed by Maria Montessori, MD., PhD, over one hundred years ago as a tool to teach children who had learning disabilities. This method was very successful because it is based on muscle memory. Muscle memory is that part of the memory that is used in repetitive muscle movement, for example in remembering how to ride a bike, play a musical instrument or read. Muscle memory (sometimes called procedural memory) tends to be less damaged in people with dementia and Alzheimer’s. Because this procedural or muscle memory system may still be working properly in people who have dementia, the Montessori Method can be used very successfully as a means to reach and engage people with memory loss.

THIS METHOD WAS DEVELOPED FOR CHILDREN, WHY WILL IT WORK FOR OLDER PEOPLE?
Montessori materials are tools that help create the bridge to reconnect to people who may seem unreachable. Using these tools, Montessori programing gives older people the opportunity to use their hands and their five senses to activate and stimulate their minds. Being able to focus on the task at hand, and to experience success again helps people with Alzheimer’s feel more secure and confident and less angry and frustrated. The Montessori Method focuses on the use of remaining strengths and abilities. This positive approach to Alzheimer’s care is a source of creativity and comfort to people with dementia and caregivers alike.

The Montessori Method is based on the belief that the environment should serve the people using it. Whether living at home, or in an intentional community, the surroundings of a person with Alzheimer’s should be clutter free, easy to navigate, and filled with beauty and with living things.

Montessori programing stimulates the mind, encourages a comforting living space and also nourishes the spirit. While the mind and body of a person with Alzheimer’s may be failing, the spirit can still be strong. This program speaks to the spirit of each person by providing opportunities to engage in many art forms; writing and reading stories from real life, writing and reading poetry together, painting, singing and playing drums together.These creative experiences strengthen the imagination and the spirit. Hearing each others’ life stories, or playing in a drum circle can give people with Alzheimer’s the opportunity to experience again the bonds of friendship and love.

WHO CAN USE THIS METHOD?
Anyone who wants to keep their mind and body as strong as possible can benefit by using the Montessori Method. People who have dementia and Alzheimer’s (even those who are in a very advanced state of dementia) can benefit from this method. Medical staff, professional and family caregivers can learn the Montessori Method to help them care for older persons and persons with Alzheimer’s and dementia.

Montessori-based activities for persons with dementia. - Orlando Education Examiner.com

Montessori-based activities for persons with dementia. - Orlando Education | Examiner.com

Montessori-based activities for persons with dementia. - Orlando Education Examiner.com

CHILD CARE SEMINAR 2010

Child Care Seminar (CCS) 2010.CCS2010 is an annual seminar for early childhood practitioners and professionals, organized by Child Care Division, Ministry of Community Development, Youth and Sports.


Date: Friday, 1 October 2010
Time: 8am to 5.30pm
Venue: Suntec Singapore International Convention & Exhibition Centre,Ballroom 2, Level 2

KYDZ WILL BE THERE!

Playful Inventions and Explorations: What's to Be Learned from Kids?