Applying Montessori Concepts to Promote Person-Directed Care for Persons with Dementia

Caring for persons with dementia has been an interesting journey. As a pioneer in the field of activities for older people, I have had the benefit of being trained on Reality Orientation, Remotivation, Validation, Resocialization, Attitude Therapy and Creative Movement. In 1974 the knowledge about activities for people with dementia was very limited. In fact, research on Alzheimer’s Disease and other dementias was just getting started. Most people were labeled in a category of “Chronic Brain Syndrome/CBS.”  

In 1992, “Sensory Stimulation” as a technique to be used with severely cognitively impaired residents was becoming popular. I was asked to lead a workshop on this topic. However, I questioned the dignity and ethics and questioned the intent. I felt it was invasive, many of the supplies were childlike. I knew that social interaction, interest and response to the environment can be increased through sensory input and discrimination, that a meaningful relationship is a basic human need and that creating opportunities to utilize a retained ability are important. I went on a search for answers and found the answer for me in the book by Dr. Cameron Camp, Montessori Activities for People with Dementia. The words real life materials, dignity, supporting independence, sensory tools, prepared environment, simple to complex and tailor-made activities resonated with me. 

The original principals of Maria Montessori, “to create opportunities for children to become self-sufficient, contributing members of society who had respect for themselves and for their physical and social environment” have become the foundation of the Montessori Concepts in Dementia Care. “The more you do for me, the more you take away,” is a quote by Maria Montessori that has shaped my thinking. By supporting residents in the care of self, the care of the environment, the care for others and the reinforcement of their unique identity, holistic needs of the person can be met: the needs for self-worth, accomplishment, belongingness, purpose and security.

The Montessori Method or Concepts identifies the strengths of the person and builds on these. Activities that utilize the strength of procedural memory are the focus.

There are many different models of training available for learning to apply Maria Montessori’s principals in Dementia Care. I have taken several and have chosen to teach the required course for Certified Montessori Dementia Care Professional though the ICCDP. 

It consists of the following 9 modules:

Course Modules

1. Overview of Dementia

2. The Montessori Concept from Education to Dementia Care

3. Montessori Dementia Care: A Person Focused Philosophy

4. Infantilization, Dignity and Respect in Montessori Care

5. Effective Communication and Socialization

6. The Montessori Environment

7. Promoting Independence in Personal Care

8. Fostering Engagement through Meaningful Activities

9. Family and Staff Partners in Care

Use the following checklist to identify your program strengths in applying Montessori Concepts. In what area do you need improvement?

• Does the physical environment include safe areas to move about, an uncluttered prepared environment that supports independence, using visual and sensory clues?

• Do the activity materials provide opportunities for engagement in activities that promote care of self, care of the environment and meaningful activities for purpose? Do the materials promote dignity?

• Does the staff use respectful language? Do they follow specific guidelines for “prepared conversations”?

• Does the staff use observation as a method to evaluate a resident’s strengths?

• Are families supported in their efforts to connect? Are visitation recommendations available?

To learn more or become a Certified Montessori Dementia Care Professional through the ICCDP (International Council of Certified Dementia Practitioners) take the required 7-hour seminar. This course is one of the requirements for CMDCP certification. Click here for specifics.

If you would like to pursue Certified Dementia Practitioner Certification (CDP) click here.

If you are already certified as CMDCP consider expanding your knowledge through the Purple Thumb Club, click here.

EXTRA-A Sample Training Exercise for YOU! Try it!

One of the exercises that I feel everyone working with people with dementia MUST do is answer the following question for yourself (first person)

“What would I want someone doing with me if I cannot express myself?”

With tears rolling down my face as I thought of this reality, here is what I wrote in 1992 at the age of 41. After you read this, reflect for a moment. What “jumps out” at you?

“I’m Still Here”

• When I am old, and my physical body has withered, remember it still encases my spirit, I can still PRAY.

• Please TELL me about my children, remind me of what we used to do.

• Let me FEEL the sun’s warmth on my body, a cool breeze in my face.

• Let me enjoy the SIMPLE pleasures that have filled and enriched my life.

• If I can no longer hear, AMPLIFY the outside sounds for me, I love to listen to the world.

• Maybe, help me WATCH the movement of water, it has always comforted me.

• REFRESH my skin with a warm cloth, and please keep the hair back from my face.

• Let me PAT a bunny or CUDDLE a kitten or dog, they have meant so much to me.

• Let me enjoy the TASTE of cool frozen yogurt, it’s my favorite.

• Let me HEAR babies crying, children laughing, it will remind me of my own.

• Any before you go, please turn off the TV, I have never watched much.

  
  

Remember, that beauty is in the eye of the beholder,

when dull eyes no longer behold, only LOVE is in living color.