Beyond the Classroom: How the Montessori Approach Supports and Engages Adults with Dementia
Today’s guest post comes from Jennifer Brush who has been working for over 20 years to change the face of dementia care in hospitals, assisted living communities, nursing homes and home care. You can find out more about her in the author bio box at the foot of this post.
Those of us who have children in Montessori school, as I do, have seen firsthand the joy of learning that takes place in a Montessori classroom. We have watched our children be naturally drawn to the beautiful materials because they appeal to their instinctive drives. Their work leads to a feeling of accomplishment and self-respect. All of us, no matter our age, want to feel a sense of self-efficacy and purpose. So, could Montessori philosophies be successful for all of us, at any age?
Many of us are familiar with the term Montessori as it applies to education, but only a few of us are familiar with the application of Montessori methods for Dementia. Montessori for Aging and Dementia is a model of care which focuses on supporting the person in an environment that is adapted to support memory loss and independence. The result is that people living with dementia are able to make meaningful contributions to their community, engage in meaningful activities in addition to having the opportunity to maintain, and even restore function. The approach is flexible, innovative and grounded in research. Here are a few ways to incorporate Montessori methods into care for an adult with dementia, which will not only benefit him or her but all members of the family.
In a Montessori classroom, children have freedom to move from one project to the next in a constructive manner. The classroom setting, or what Montessori called the prepared environment, allows children to move freely and explore the materials they choose, when they choose. Adults with dementia benefit from freedom of movement as well and should not be expected to sit still all day. They are used to being in charge of the activities in their life, as they are adults who have lead productive lives. Rather than restricting movement, provide opportunities for walking and exercise, as well as an environment filled with items of interest to the person with dementia such as books, puzzles, crafts, and hobby supplies. Invite children and adults with dementia to work on activities together.
Structure and Order
An external environment that is ordered aids a child in building a sense of internal structure, order, and self-control. This structure and order in the classroom provides children with the opportunity to work according to their age and ability, thus building concentration and facilitating learning. Order brings a sense of predictability and security. People with dementia experience a reduction in the ability to process stimulation. As a result, a home environment with significant amounts of clutter can be over-stimulating and create difficulties in locating needed items, such as phones or wallets, which can lead to frustration and anxiety. Try placing commonly used items in clearly visible containers with prominently displayed labels. Clean up any clutter, and organize the environment by giving everything a home. Organizing items by category, such as putting the cup, toothpaste, and toothbrush together in one place, can serve as a useful reminder. Placing a labeled basket or other container by the door for keys or mail reduces the likelihood that these items will be misplaced. Labeling the kitchen cabinets with a list of contents will help the person with dementia find things more easily in the kitchen.
Nature and Reality
In a Montessori environment, children use child-size real objects that fit their hands and are appropriate for their age. This encourages proper use of tools and allows for the completion of activities without frustration. In the classroom, the furniture is child-size so the children are not dependent on the adult for movement. Adults with dementia should have adult-size real objects that fit their hands and are appropriate for their abilities. Objects should be familiar to them, as they will find it difficult to use a tool they have never seen before. Children and adults can work together, each helping the other while using their own appropriate tools and supplies.
When children socialize with others they develop a sense of compassion, empathy and respect. Montessori multi-age classrooms encourage work in groups and provide older children an opportunity to develop leadership qualities while helping younger children. People with dementia have the same desire as everyone else to communicate with others and enjoy the company of friends, yet the communication challenges that dementia brings often causes withdrawal and frustration. Look for opportunities for the person with dementia to spend time with friends, read to children, or help others. Try to keep all conversations calm and positive. You’ll have the most success communicating with someone with dementia if you speak with simple, clear, brief, and direct words; give one direction at a time and demonstrate exactly what you would like the person to do; and never quiz, argue, or confront a person with dementia.