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The Montessori Method and Dementia Care

Montessori BlogMaria Montessori was one of Italy’s first female physicians. In 1907, she designed a new type of school program for challenging students who were thought of as 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.

In 1995, Cameron J. Camp, PhD, began to experiment with the potential benefits of using Maria Montessori’s design for people living with dementia. For over three decades, Dr. Camp has dedicated his career to the applied and translational research of gerontology, dementia and cognitive interventions, creating Montessori-Based Dementia Programming®. Since its creation the program has become internationally known. Dr. Camp has trained and lectured across Asia, Australia, Europe, and North America on the use of Montessori Dementia Interventions, with writings that have been translated into six languages.

This innovative approach has been proven to successfully engage people across all levels of dementia, as well as serving as a means of implementing person-centered approaches to care. The focus of Montessori-Based Dementia Programming® is to create an environment that provides respect and dignity and to foster development of a genuine community for residents with dementia, their families, and the staff members who provide care for them.

The primary principles of Montessori-Based Dementia Programming® are:

Environment is Key: The environment is very carefully designed to be familiar, ordered, and promote a feeling of safety. Environments should be small and manageable, without a lot of clutter or mess, and as soothing as possible.

Create a No-Judgment Zone: Unknowing caregivers may attempt to correct a person with dementia who is exhibiting inappropriate behaviors or saying incorrect things. The Montessori philosophy is that nothing the resident says or does is wrong. It is the caregiver’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.

Focus on a Person’s Intrinsic Value: It is important to recognize that a person with dementia has intrinsic value and then introduce activities that foster that feeling. For example, a higher-functioning resident may be asked to teach others with lower-functioning skills how to do certain tasks, promoting the idea that they still have useful skills to teach others.

Engage the Senses: Activities are specifically designed to appeal to all five senses, helping a resident connect to the world around them in a safe and nurturing environment.
Encourage a Connection to Long-Term Memory: It is most often recent memories that are destroyed by dementia while long-term memories may be retained. Knowing this, the Montessori Method provides opportunities for residents to reconnect to positive long-term memories which can help draw residents out of states of withdrawal, isolation, or paranoia.

Rebuild/Preserve Motor Skills: Physical activities can help residents regain or preserve motor skills which will help them maintain a level of independence for longer. These may be large motor skills, like dancing, or small motor skills, like using a slotted spoon to search through a container of dry rice for a prize. Each can build or preserve skills that will transfer to things like eating or dressing independently.

Maintain Respect: One of the most important aspects of Montessori-Based Dementia Programming® is always maintaining an attitude of respect toward the resident. This means respecting and honoring their current perceptions and memories. The Montessori method offers a kinder, gentler way to care for residents with dementia by reaching, interacting, and communicating with the person who still exists without trying to correct them. With its focus on respect for the resident, a safe and nurturing environment, and activities that promote engagement on achievable levels, the Montessori method can help build self-worth in residents and help them connect with the outside world despite their dementia.

What does our use of the Montessori Method look like in practice at Spring Village at Dover? First, we learn all we can about our residents. Part of the Spring Village at Dover move-in packet includes a Personal Profile which inquires about a resident’s past and current personal information including lifestyle preferences, roles, skills, and abilities. We request that family members return the information before the resident arrives so that our staff can begin to learn about the resident.

Once the resident has joined the community, there is an assessment process that occurs as we simultaneously build a personal relationship with the resident. Information pertaining to the resident’s needs, interests, and strengths is collected. The assessment is then used to construct activities and create roles for our residents that are meaningful to them specifically. The more we know about a resident’s sensory, speech, language, reading, cognitive and physical abilities, the better we are able to modify the environment so that a resident can remain as independent as possible and have meaningful experiences in the community. We can also provide opportunities for the resident to make purposeful contributions, which affords our residents higher self-esteem and satisfaction.

The following are a few of the ways in which the Montessori Method can be witnessed at Spring Village at Dover:

  • Our staff always exhibit attitudes and behaviors of kindness, respect, calm, and patience with our residents.
  • Staff actively seek out and create opportunities for our residents to act independently, exercise choice, and move about with freedom.
  • Residents are invited to join in the daily tasks of the community as appropriate and with consideration of their level of ability. When necessary, staff provides as much support as needed to help our residents participate in the activities they find of interest.
  • Our staff are well-trained in the special communication needs of people living with dementia and use positive, supportive verbal and non-verbal techniques with our residents.
  • Our families are welcome to visit and join their loved one in activities as often as they would like. We also invite family members to become our partners in ensuring that our residents receive the support they need to allow them to feel safe, comfortable, and content.
  • Our environment is prepared, organized, and aesthetically pleasing. This entices our residents to engage in their surroundings.
  • An atmosphere of respect, calm, and meaningful activity pervades the environment with appropriate cues and modifications to support independence.
  • A variety of individualized and generic activity materials are accessible throughout the community that addresses the needs, interests, and abilities of the residents.
  • The environment offers quiet space and seating for reading or peaceful contemplation, as well as space to gather for more lively activities.
  • Meals provide opportunities for choice, social connection, and independence. Residents in need of more support during meals are treated with respect and patience while being encouraged to do as much as possible for themselves.
  • Our residents have easy access to safe, interesting, and inviting outdoor areas.

For more information regarding Montessori-Based Dementia Programming® visit:

YouTube video describing the benefits of a Montessori program:
https://www.youtube.com/watch?v=dYN7I87bXeY

Article by Dr. Camp recounting the origins of Montessori-Based Dementia Programming®:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600589/