Join the Revolution!  How Montessori for Aging and Dementia can Change Long-Term Care Culture by Bourgeois, Brush Elliot & Kelly


“The purpose of this article is to outline the findings of several systematic reviews of this literature, highlighting the areas of improvement needs, and to describe a new person-centered care model, DementiAbility Methods: The Montessori Way. This model focuses on the abilities, needs, interests, and strengths of the person and creating worthwhile and meaningful roles, routines, and activities for the person within a supportive physical environment. This is accomplished through gaining the commitment of the facility’s leaders, training staff, and monitoring program implementation. The potential for a culture change in long-term care environments is dependent on the development and rigorous evaluation of person-centered care approaches.”

Read more at https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0035-1554802

Reminiscence and Dementia

The power of reminiscence is a tool that should not be underestimated in dementia care.

Long-term memory involves the retrieval process and permanent storage of an unlimited amount of information and the ability to retrieve this information again at another time.  One type of storage system is called non-declarative memory. Non-declarative memory begins to develop in early childhood and includes habits and skills that are practiced with much repetition.  This involves unconscious and nonverbal recall of past experiences and is less impaired in many forms of cognitive impairment.  Because this memory system is usually less impaired, non-declarative memory-based tasks have the potential to generate positive effects for people with dementia. Reminiscence is the recall of memories and events from the past. Reminiscence activities can be part of a person-centered approach to caring that improves the wellbeing of people with dementia. By using stimuli such as music and pictures, reminiscence therapy leads to improvements in depression, loneliness, and overall mental well-being. In addition to these benefits, reminiscence therapy can also improve the care partner’s relationship with the person with dementia by connecting on a more personal level.

Here are some great programs and organizations that promote reminiscence as a tool:  

StoryCorps is an innovative organization with a program dedicated to record an individual interview session with a person with dementia. The ultimate goal of this is to preserve and store important and touching memories for both the family and the individual. The StoryCorps is unique in that the interview is stored in the United States Library of Congress for public access. Read more at http://storycorps.org/memory-loss/

The Timeslips program creates an improvisational storytelling workshop for people with dementia that is fueled more by imagination than facts or memories. New stories are formulated and told by participants that help them connect with staff, family, and friends in new ways. Read more at http://www.timeslips.org/

Music and Memory is an organization that strives to connect people with dementia and other mental/physical conditions to reconnect with themselves through the gift of personalized music. By having trained professionals set up distinctive playlists, music therapy is able to tap into deep memories. Read more at https://musicandmemory.org/

The Sporting Memories Network utilizes the power of reminiscence as a tool for people with dementia. By using sport icons, images, and conversations, this organization helps tackle, depression, social isolation, and dementia. Read more at http://www.sportingmemoriesnetwork.com/smn/

The “I CAN! I WILL!” project gathers hundreds of personal and informational stories from both people with dementia and their caregivers. This project has an expansive database of ideas for both support and awareness. Read more at http://www.alz.co.uk/icaniwill

The Memory Method is a program that assembles a group of people with dementia where they discuss memories amongst themselves. Volunteer coordinators sit in on this session and suggest new topics and subjects. The goal is to have the people with dementia talk without interruption and create a memory flow. Read more at http://www.globalaging.org/elderrights/world/2005/helping.htm

How can Task Breakdown help People with Dementia?

Task breakdown is the process of helping a person successfully participate in or complete an activity by making it a step-by-step process. People with dementia often become confused when there are many steps in a sequence. However, when we break an activity into its individual steps, and present each step one at a time, people with cognitive impairment are more likely to achieve success.

The best way to assist a person to complete a task is for you to demonstrate each step one at a time and then ask the person with dementia to follow before moving on to the next step. Task breakdown also helps people with dementia maintain control and dignity by ensuring they participate rather than having a caregiver do an activity for them.

For example, if someone with dementia was given a variety of ingredients at once and asked to “cook dinner,” the person might get started right away, or sit and stare, or leave, or say no.  A person in the later stages of dementia may find this request overwhelming. However, a person in the early stages may welcome the chance to cook a meal. That is why knowing the person is critical. Having an understanding of the person’s skills and abilities is essential in making any modifications they need to succeed. For example, if someone is having a hard time with the task of stirring cookie dough, for the first step, the care partner demonstrates picking up the wooden spoon. The care partner may then say to the person with dementia, “Now you try.”

 Successful Task Guiding Strategies  

1.     Tasks should be broken down into steps that are accessible for the person and the care partner should use a “demonstrate then follow” method. 

2.     Make sure the space you are working in is clutter-free.

3.     Only have the items needed for the task present.

4.     Lay supplies out in order of use from left to right and are to be used one step at a time.

5.     Two sets of supplies may be needed. For example, when setting the table, the care partner should place their items, one at a time, just like the person with dementia will do.

6.     Make sure the area you are working in is well lit, with no shadows.

7.     Contrast helps people see object more clearly.  Try placing all of the items needed for the task on a placemat that is a contrasting color from the work surface.

8.     Demonstrate the steps of a task- one at a time- for the person with dementia and then invite the person to follow after each step. This verbal invitation leads to the person following the guide, but often no words are even needed. Many people with dementia will follow the actions of their care partner when they are working on a task together. Often, following their care partner’s actions is easier than following written or verbal directions.