Anything But Bingo

Resources to enhance the daily life of people living with dementia

A 5 hour train journey home from York is a rare piece of thinking time to digest the course I have been on today - Montessori based dementia programming, and to consider how it might impact on my day to day work.

There were 9 people on the course; a selection on Occupational Therapists, Physiotherapists ... and me! I am quite sure that those professionals, everyone of them passionate about improving the lives of people living with dementia will have their own opinion of the methods we learnt about today. There is much about it that leaves me cold not least of which is the name. Montessori is so closely associated with the education of children, and dementia 'programming' sounds very rigid and impersonal. The creator of the techniques, Cameron Camp speaks passionately about how the word Alzheimers Disease has a negative impact and that it should be renamed Alzheimers Syndrome so he understands the power of words, and yet there is no acknowledgement of the impact of using the terms 'Montessori' or 'Programming'. I am sure that if nothing else the name will stop this menthod from becoming more widely used.

What is Montessori

The Montessori method shares some underpinning principles with other dementia approaches such as the Eden Alternative; the importance of meaningful activity that is person centred, and that a diagnosis of dementia should not be a signal to disengage, disempower or disenfranchise that individual. The practical application of Montessori seems more confusing. It is a mixture of implementing everyday living activities such as laying the dinner table and more therapeutic interventions like moving beans from one bowl to another. It is these latter activities which are more controversial. They are based on the first in / last out theory that skills we learnt first as a child are the last to go.

When it works

In my opinion it is the later stages of dementia that the therapeutic approach of Montessori comes into its own. The facilitator is encouraged to consider environment, demonstrate before expecting participation, start at a basic level before increasing difficulty, and to use minimal communication to avoid confusion. Tasks are straightforward and use everyday objects that are pleasing to the eye. All good so far. The concerns many people have with Montessori is the types of tasks suggested. They seem to rarely have purpose, they could be construed as childish and patronising.

 

I have tried some of these tasks, for example sock matching and putting pegs on a box, and I think this approach has a place; with an individual who is disengaging, is lost in the world around them, who finds every day activities challenging, confusing and distressing. The simplistic tasks can be really successful at providing someone with the occupation and achievement otherwise lost to them.

 

 

A word of caution

If possible try to retain some form of purpose. If you want to try shoe polishing find shoes that actually need polishing. If the task is to fold towels get freshly dried ones from the line or tumble drier. In other words, activity should be a spontaneous reaction to the environment around you rather than prescribed tasks pulled out of drawer. This is where Montessori and I part ways! Taking a pile of freshly folded napkins from the linen cupboard, shaking them out and giving them to someone to fold again undermines everything we are trying to change about dementia care..... and one day one of those people you are handing them to will catch you out and you will realise how wrong it is. I've been there.

 

PostScript

Something I learnt from my fellow students today was how difficult it can be to be spontaneous and instinctive about activities in some medical settings, and yet how much staff want to stimulate and enthuse their clients with dementia. Life on an acute medical ward, or even a rehabilitation unit is dictated by health & safety, budget and even space. Many of the ideas I have spring from my work in residential homes and what I hope is possible in people's own homes. The determination of staff in these roles is inspiring and I will try to consider some adaptations to my weekly blogs to inspire these lovely people too!

 

 

Posted by Jenny Trott Saturday, November 14, 2015 3:16:00 PM

Comments

Sunday, November 15, 2015 8:52:15 AM

re: Montessori based dementia programming

Hi Sarah, thanks for taking the time to comment.

Its makes uncomfortable reading that Alz Aus is pushing it so hard across the board. Like every 'method' in every sphere of our lives one size doesn't fit all. If someone is suggesting the Montessori is the way ahead for everyone living with dementia then they have forgotton the first principles of the person centred approach. Heaven help us if that is the case!

Jenny x

Sunday, November 15, 2015 1:59:27 AM
Sarah
View User Profile for Sarah

re: Montessori based dementia programming

Hi Jenny,

I applaud your comments and your blog! I am the manager of a dementia specific day program in Melbourne, Australia, and at thee moment the Montessori Method is being "pushed" by Alzheimer's Australia and other educators as the "be all and end all" of activity programming for people living with dementia - no matter the stage!

It has made me very uncomfortable - and several people I know living with Younger onset dementia are appalled at the thought of being asked to peg pegs to a bucket if they attend a dementia specific group!

Engaging people with dementia in meaningful activity is something that any quality person centred program does as a matter of course, (I can't believe that someone suggested taking folded serviettes and asking someone to refold them was even suggested!!). Caladenia has been providing a service for over 30 years now, and there should be nothing new about providing individualised and meaningful activities for people living with dementia!!

Thank you for saying what I have been thinking - and perhaps giving me the courage to speak out against it as the only way - but rather it is just one tool amongst many that can be considered.

Thank you!!

Sarah

 

 

               Who am I?

 

Jenny

I am a forty-something mother of two.

I love learning and creating, and do

what I can to improve the well-being

of people living with dementia.

I have worked in residential dementia

care for a few years and hope that I

have something useful to share.

 

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