Maria Montessori was one of Italy’s first female physicians. In 1907, she developed a new type of school—designed for challenging students who were once considered “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.
The principles used in Montessori schools—which are still in use across the world today—have begun to show good results when applied to dementia care. Here are a few of the principles of Montessori schooling—and how they work for patients with dementia.
Environment is key.
In dementia care communities that use Montessori principles, the environment is very carefully designed to be familiar and ordered, and to promote a feeling of safety. The environment should be small and manageable, without a lot of clutter or mess, and as soothing as possible.
A no-judgment zone.
Many caretakers who do not have Montessori experience in caring for dementia patients fall into a familiar pattern: one of attempting to “correct” dementia patients who exhibit inappropriate behaviors or who say “wrong” things.
Under the Montessori philosophy, nothing the patient says or does is “wrong.” It is the caretaker’s job to work creatively within the patient’s version of the world, rather than to attempt to correct the patient’s memory or perceptions.
Valuing the patient.
In the Montessori philosophy, it’s important to promote that dementia patients still have intrinsic value—and to introduce activities that foster that feeling. For instance, dementia patients who are higher-functioning may be asked to teach others with lower functions how to do certain tasks—promoting the idea that they still have useful skills to teach others.
Engaging the senses.
Montessori activities are specifically designed to appeal to all five senses, helping dementia patients connect to the world around them in a safe and nurturing environment. Caretakers often use art and music therapy, mild physical exercise, and group activities that focus on the individual abilities of each patient. These activities are designed to give patients positive emotions—and help them reconnect with the world around them.
Encouraging connection to long-term memory.
While more recent memories are often destroyed by dementia, many patients retain their long-term memory. Using the Montessori method, caretakers create opportunities for dementia patients to reconnect to positive long-term memories, a tactic that can help draw dementia patients out of states of withdrawal, isolation, or paranoia.
Rebuilding motor skills.
Physical activities can help dementia patients regain or preserve motor skills, ad help them maintain a certain level of independence for longer. For instance, patients might play games that involve using a spoon to search through a container of dry rice for a “prize,” or attach a series of zippers or buttons—skills that help the patients retain the skills they need to feed and dress themselves. Other simple activities include laying out a basket of clean towels to fold or socks to match; simple puzzles and sorting games; or simple baking activities in a clean and safe kitchen.
One of the most important aspects of Montessori dementia care is maintaining an attitude of respect toward the patient at all times. This means respecting and honoring their current perceptions and memories—even if those are “wrong” by objective standards. It also includes trying to meet the patient where they are, offering activities that start with their capabilities and gently push the envelope to help them build new skills, and honoring the abilities and achievements the patients are still capable of.
Caring for dementia patients can be a challenge, both for family members with no prior caregiving experience and for trained caregivers. The Montessori method offers a kinder, gentler way to care for dementia patients by reaching and communicating with the person who still exists, communicating and interacting with them in their world without trying to correct the patient’s perceptions.
With its focus on respect for the patient, a safe and nurturing environment, and activities that promote engagement on a level that’s possible, the Montessori method can help build self-worth in dementia patients—and help them connect with the outside world despite their dementia.
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