Seniors and Age-Related Memory Loss IV – A 6 Step Montessori Approach for Seniors
There is no single type of dementia. In fact, there are several. Some, like Alzheimer’s and vascular dementia, were mentioned in an earlier article. Though the common thread is memory loss, each form has its own particular set of symptoms. Having acknowledged that there is more than one type of dementia, it follows that there is no cookie-cutter treatment for this disease.
That’s where the Montessori approach is utilized. My name is Kacye Vanderplas and I am the Vice President of Operations for Sundance Memory Care. We operate four locations in Texas, each with the goal of helping every resident flourish to the best of his or her ability. By the time a person with dementia comes to our community they may be displaying many symptoms, but an official diagnosis as to which type may not yet have been made. It is up to our trained team to devise a program personalized to help that individual. The Montessori approach gives us the tools and guidelines to individualize each treatment plan.
This approach was developed by Maria Montessori, one of Italy’s first female physicians. In 1907, she developed a new type of school—designed for challenging students who were once considered “unteachable.” Most of these students came from poor backgrounds and lived in disordered, even dangerous environments outside of school. Montessori’s first step was to take them out of that environment and create a safe, secure, and tightly controlled environment that allowed them to thrive. The principles used in Montessori schools—which are still in use across the world today—have begun to show good results when applied to dementia care. Here are a few of the principles of Montessori schooling—and how they work for residents with dementia:
Environment is key
In dementia care communities that use Montessori principles, the environment is very carefully designed to be familiar and ordered, promoting a feeling of safety. The environment should be small and manageable, without a lot of clutter or mess, and as soothing as possible.
A no-judgment zone
Many caretakers who do not have Montessori experience in caring for residents with dementia fall into a familiar pattern: one of attempting to “correct” residents with dementia who exhibit inappropriate behaviors or who say “wrong” things.
Under the Montessori philosophy, nothing the resident says or does is “wrong.” It is the caretaker’s job to work creatively within the resident’s version of the world, rather than to attempt to correct the resident’s memory or perceptions.
Valuing the resident
In the Montessori philosophy, it’s important to promote that residents with dementia still have intrinsic value—and to introduce activities that foster that feeling. For instance, residents with dementia who are higher-functioning may be asked to teach others with lower functions how to do certain tasks—promoting the idea that they still have useful skills to teach others.
Engaging the senses
Montessori activities are specifically designed to appeal to all five senses, helping residents with dementia connect to the world around them in a safe and nurturing environment. Caretakers often use art and music therapy, mild physical exercise, and group activities that focus on the individual abilities of each resident. These activities are designed to give residents positive emotions—and help them reconnect with the world around them.
Encouraging connection to long-term memory
While more recent memories are often destroyed by dementia, many residents retain their long-term memory. Using the Montessori method, caretakers create opportunities for residents with dementia to reconnect to positive long-term memories, a tactic that can help draw residents with dementia out of states of withdrawal, isolation, or paranoia.
Rebuilding motor skills
Physical activities can help residents with dementia regain or preserve motor skills and help them maintain a certain level of independence for longer. For instance, residents might play games that involve using a spoon to search through a container of dry rice for a “prize,” or attach a series of zippers or buttons—skills that help the residents retain the skills they need to feed and dress themselves. Other simple activities include laying out a basket of clean towels to fold or socks to match; simple puzzles and sorting games; or simple baking activities in a clean and safe kitchen.
One of the most important aspects of Montessori dementia care is maintaining an attitude of respect toward the resident at all times. This means respecting and honoring their current perceptions and memories—even if those are “wrong” by objective standards. It also includes trying to meet the resident where they are, offering activities that start with their capabilities and gently push the envelope to help them build new skills, always honoring the abilities and achievements the residents are still capable of.
Caring for residents with dementia can be a challenge, both for family members with no prior caregiving experience and for trained caregivers. The Montessori method offers a kinder, gentler way to care for residents with dementia by reaching and communicating with the person who still exists, communicating and interacting with them in their world without trying to correct the resident’s perceptions.
With its focus on respect for the resident, a safe and nurturing environment, and activities that promote engagement on a level that’s possible, the Montessori method can help build self-worth in residents with dementia—and help them connect with the outside world despite their dementia.
The Montessori approach to caring for people with dementia is to support residents through self-selected, sensory experiences as they achieve higher levels of functioning to prevent excess disability. The Montessori approach draws its principles from the natural brain functioning and interests of a resident. The inherent flexibility allows the method to adapt to the needs of the individual with dementia, regardless of their level of ability, lifestyle, or stage of progression. Structured, person-centered activities are the goal of every Montessori interaction.
People with dementia who are apathetic show increased engagement when activities are matched to their interests and ability. A range of therapeutic activities can benefit these people. These include music, exercise, cooking, creative activities and Montessori methods. A common feature of positive non-drug interventions for these people is that activities are individually tailored to their needs and interests. Using the Montessori principles, every Sundance community is able to ensure and provide a safe haven for every resident. We do this by making sure the six structures below are in place.
- The environment is prepared so that residents are free to explore their natural drive to work and create a community in which they want to live.
- Residents choose meaningful activities under the guidance of a trained Montessori Program Leader, Care Partner and/or Resident Assistant.
- Through their inquiries, residents discover independence, motivation, persistence and dignity.
- Residents become inner-directed or self-directed rather than “other-directed”.
- Montessori activities focus on one concept at a time, making tasks simplified to stir interest and enjoyment within the spirit of a resident.
- The mixed setting allows residents to become part of a community that fosters respect and understanding of all residents living with dementia as they interact individually, rediscovering their purposes and joys in life.
Caring for someone with dementia is not for the faint of heart. It is quite challenging, but the rewards, for me, far outweigh the negatives. The Montessori approach, we at Sundance feel, is the best way to treat a complicated disease that has tragically devastated many families. Dementia, however, does not have to be a permanent negative. Given the proper love and support, sufferers can still thrive. If you would like to learn more about any of our communities, I am happy to visit with you. My contact information is below.
Vice President of Operations, Sundance Memory Care
Certified Montessori Dementia Care Professional®