Montessori for dementia and aged care

“She dwells with Beauty—Beauty that must die;
And Joy, whose hand is ever at his lips
Bidding adieu; and aching Pleasure nigh,
Turning to poison while the bee-mouth sips:”
– Ode on Melancholy, John Keats

Today I wanted to share a little about Montessori for dementia and aged care, a different age group than I usually touch on. Montessori is such a respectful approach and I’m so happy to see it now being applied in the care of our elders. I’m definitely no expert, but maybe one day…

When my children were very small, we would do volunteer work visiting a nursing home each week. We would sit with two of the residents and talk. I’d bring playdough or duplo for Oliver to play with and one of the residents would always join in with him. She remarked that she had never had these kinds of toys when she was a child. I guess this was kind of my first introduction to Montessori with the elderly.

There are so many similarities working with our youngest children and with the elderly. Here are a few of the principles which can be applied with the elderly and dementia patients. And I’ve added some extra resources at the end if you are interested to learn more.

Dignity

Everybody deserves to be treated with dignity. If you peed on the floor, how would you like to be treated? I know that I would really appreciate care and respect, to be treated with humility, and a lot of grace.

The Montessori approach with the elderly embodies this. It allows the person to be as independent as possible, to give them purpose, to feel seen and understood, and engaged in life.

The carers go slowly, offer their time, their guidance, and assist as little as possible but as much as necessary (sound familiar?).

Independence

One of the hallmarks of the Montessori approach – independence – is also applied in settings with the elderly.

Residents are invited to have choice, for example, what activity they would like to do (rather than sitting in a group activity they are not interested in) and serving themselves at a buffet for mealtimes (keeping their fine motor skills challenged as well as being able to choose for themselves). There are also snacks available any time where they can serve themselves throughout the day, as well as an area which is set up for them to make their own cup of tea.

These things help them to stay active and engaged for longer in their lives. It helps them to continue to live.

Some residents coming to a Montessori facility have re-learned skills, like walking without a frame, feeding themselves, and using the toilet. I enjoyed watching this video of Tren learning how to feed himself again. In the beginning, the carer would help his arm a little so Tren could bring the spoon to his mouth. They also show him practising fine motor skills like putting pegs around the edge of a container. After a week, the carer sits next to him to encourage him while he feeds himself, and then all by himself. It’s very sweet.

Prepared environment

A large part of the success from applying the Montessori approach with the elderly is a carefully prepared and beautiful environment. There is beauty in the space, clear coloured high-contrast signs so they know where they can find things (many residents are still able to read), and signage including pictograms around the building to help them get around for themselves.

There is a photo on their door so they can find their room and many places hang “10 things you need to know about me” in their room so that carers can understand the person’s preferences and who they are.

Carers and residents wear name tags with large print so that the residents can also initiate conversations with the carers, “Hello Elisabeth. How are you today?”

There are activities that they can be involved in with at any time of day. These include sorting buttons, folding laundry, helping with washing up, making the bed, caring for the plants, memory type games, and reading (using special books with large letters). Memory books can be made for the residents with photos and simple sentences that family and carers can read with them.

A playground is often available outdoors so that grandchildren have a place to play while visiting to enhance contact with the family. The placement of benches so the resident can enjoy watching them play is part of the outdoor prepared environment.

Purpose

The residents also enjoy to have a purpose. I’ve heard of an example of having a resident run the store in the facility by having the items well labeled with amounts that are easy to calculate and another of a former French teacher giving lessons to the carers who wanted to learn French.

They look for the resident’s strengths, for example, if they have a beautiful smile and can shake hands, they could be invited to welcome the residents coming into the dining area. I also saw one resident giving hand massages to others.

I love the idea of Montessori for dementia and aged care so much and hope to follow the training Montessori for Dementia, Disability and Ageing. Montessori really is about treating everyone with love, respect and understanding. I hope that more and more facilities continue to adopt these approaches and give more meaning to our elders lives.

Further reading

• Glimpse of aged care through a Montessori Lens, Anne Kelly and Susan Mayclin Stephenson
• Forgetfulness, Feelings & Farnarkling, Anne Kelly
• You Say Goodbye and We Say Hello: The Montessori Method for Positive Dementia Care, Tom Brenner
• Montessori for Elder and Dementia Care, 2nd Edition, Jennifer A. Brush and Margaret C. Jarrell
• AMI Montessori for Dementia, Disability and Aging website including videos here
• Hogeweyk – not Montessori-based but a village here in the Netherlands where the residents can go to the supermarket, the cinema etc, in a closed off village with no curbs or traffic on the streets.