Stephane Verhaeghe “Growing old with grace”

Stephane VerhaegheThere are over 300,000 Australians living with dementia and this number is expected to increase by one third to 400,000 in less than ten years (Access Economics, 2005). By the 2060s, spending on dementia is set to outstrip that of any other health condition. It is projected to be $83 billion (in 2006-07 dollars), and will represent around 11% of health and residential aged care sector spending (Alzheimers Australia, 2012).

There is need for a solution that will slow the increasing costs and improve the quality of support for people with dementia, their families and for the staff who provide care.

What is the Montessori Approach for Dementia?

Many of us are familiar with the term Montessori as it applies to education but only few are familiar with the application of Montessori for Dementia.

Dr Maria Montessori was the first female physician in Italy. She developed an educational system that was designed as an instrument for social change and improvement.

Dr Maria Montessori’s philosophy and mission was:

  • to enable individuals to be as independent as possible,
  • to have a meaningful place in their community,
  • to possess high self-esteem, and
  • to have the chance to make meaningful contributions to their community.

Nearly 80 years later, Dr Cameron Camp, a Psychology Professor, examined the Montessori Philosophy and Principles and discovered important connections to dementia care. This led to his research on Montessori approaches for dementia. Montessori Methods for Dementia provide the framework for realising the vision of independence, high self- esteem and a promising future for people living with dementia.

The focus of such an approach is on ‘doing’ with activities and roles being developed based on individual strengths, interests, needs and abilities. This leads to activities that are meaningful to the person and a subsequent enrichment of their lives.

Montessori Methods for Dementia focus on supporting both the person and the environment, which is adapted to support memory loss and independence. We are unable to change the devastating effects of dementia but we can incorporate strategies and alter the environment while providing meaning and purpose to the day – so that the person not only engages in life, but also has the opportunity to maintain, and even restore function.

The approach is flexible, innovative and grounded in research. Since memory is impaired, remembering information for any length of time is a challenge, so Montessori Methods for Dementia focuses on putting information into the environment (eg. on cue cards, labels or in memory books) and working with preserved abilities (eg. reading, which is spared in dementia).

Implementing a Montessori or rehabilitative approach to care has required a shift from a deficit focus to a strength focus. Staff and management have had to challenge long held beliefs and attitudes. This gets easier as residents flourish and the positive outcomes are witnessed by all.

No longer is it called a Secure Unit, or Dementia Care Unit or Special Unit, but rather a Memory Support Unit – a unit where the environment is set up to support a person’s memory loss and where through a Montessori approach, staff encourage residents to function to the highest level possible given their dementia. There is an understanding and acceptance that while a person’s level of dementia cannot be changed, nor the disease process halted, each person has the right to be assisted and encouraged to function to their highest possible level.

Montessori Methods for Dementia can be adopted and applied anywhere where people living with dementia live or are cared for; their own home, residential care facilities, day respite programs and acute care facilities.

This model is not difficult to implement and can be integrated into any community. It doesn’t require hospital or aged care facilities; just access to usual community centre type facilities where some group activities can take place. One benefit of the Montessori approach is that people participating are going about their daily life in the community with some assistance with trained practitioners. With the right culture, this model is absolutely appropriate for a community like Narara Eco Village and surrounding community.