Using the Montessori Method for Dementia Care

Can an educational approach developed in the early 20th for training disabled children be used to help dementia patients stay active?   Maria Montessori's revolutionary teaching method differs from classical education models by encouraging independent learning and self-discovery in a safe space with a wide range of ways of stimulating children to learn.   Now used in an estimated 7,000 pre-schools, primary, and high schools worldwide, the Montessori method can accomodate children from birth to the age of eighteen.

As the number of elderly patients suffering from Alzheimer's Disease and other dementias continues to rise, providing specialized care has already strained existing geriatric programs worldwide to the limits.   As a result, family members are often left to deal with the financial and emotional burdern with few alternatives.   With the number of dementia patients  expected to triple by 2050, developing more innnovative ways of helping patients stay mentally active longer has become a critical health issue.  

Inspired by Maria Montessori's teaching methods, noted psychologist Cameron Camp developed the first  Montessori program for dementia patients in the late 1990s.   A past-president of the Adult Development and Aging Division of the American Psychological Association and a fellow of the American Gerontological Society, Dr. Camp currently serves as the Director of Research for the Center for Applied Research in Dementia.   Through research funded by the National Institute of Health and the National Institute of Mental Health, as well as the National Alzheimer's Association,  he has demonstrated the effectivenes of Montessori methods in helping dementia patients retain their dignity and independence.  

In the author's preface of his book, Hiding the Stranger in the Mirror, Dr. Camp wrote about the common humanity in dementia patients and their caregivers.  "We are not helpless in the face of Alzheimer’s disease and associated illnesses. We can best care for ourselves and our loved ones with dementia by embracing the humanity that exists, and has always existed, within each other." he says.    Through lecturing and training workshops, Dr. Camp has helped launch Montessori programs for dementia sufferers in Asia, Australia, Europe, and much of North America. 

Building on the principles he established, Gail Elliot has become one of the leading authorities on Montessori programs to help the elderly.   A former Assistant Director at McMaster University's Gilbrea Centre for Studies in Aging, she is now the Founder and CEO of DementiAbility Enterprises Inc. which provides training and certification  in Montessori methods for dementia.   In a recent interview with the Globe and Mail, Elliot stressed the importance of finding clues to help dementia patients slow their decline.  "Find the story and see the person: Who is that person today and how can we bring that person out?” she said. “Memories aren’t all gone. Let’s find out what still exists and capitalize on it and enhance the quality of life."  

While it is important not to regard dementia patients as infants despite using methods traditionally associated with pre-schoolers, there are still parallels.   “It’s so basic,” Elliot says. “When you’re doing something with your child, you’re thinking what are the needs of this child? What does he like to do, what is he able to do? You don’t challenge him to do too much because he’ll be frustrated and gives up. But you make it a little harder than what he can do so he can improve.”

In most programs using the Montessori methods, dementia patients are encouraged to engage in familiar tasks along with various brain-boosting games and discussion groups.  The point of the program is to provide a safe environment to provide mental and physical stimulation and help patients stay active.  Familiar tasks can be anything that the people attending the program once enjoyed and for which they retain the cognitive and manual skills to carry out.   Whether it be baking bread or working on a computer, doing these tasks helps keeps people in the program focused.   The program workspace also contains a large calendar to remind participant of the right date, self-serve refreshments tables (with everything, including the sugar bowls, being well-marked),  carefully labelled bathrooms, and cupboards for extra supplies.   Also important is the need to camouflage exits to prevent participants from wandering off - always a concern with dementia patients, despite careful monitoring. 

When not working on their tasks, program participants can also work on puzzles, games, and sorting tasks.  As a contrast to regular daycare activities, Montesssori programs for dementia patients allow for work on prepared tasks such as folding towels, matching socks, or sorting familiar objects.    For the very low-functioning dementia patients, there is a connected room filled with baby dolls and clothes which participants can play with as they choose.   By keeping their minds occupied with meaningful activities, dementia patients can spend their day without engaging in many of the disruptive activities that can cause stress in caregivers, including grabbing at other people, asking the same question repeatedly or pleading for attention. 

According to the recent Globe and Mail story on a Toronto-based Montessori program for dementia patients, family members of dementia patients in the program report extremely positive results.   One woman described her mother, who had been attending the program for four months, as being much more engaged and active despite having been in a decline prior to entering the program.    Since the program allows patients to focus on their strengths rather than their weaknesses, they can stay active and preserve their remaining skills as long as possible.  

Though more research is definitely needed to see how useful Montessori programs are,  the testimony of family mebers remains positive.   



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