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Dementia care using Montessori principles
A brilliant idea whose time has come
By Kathy Pearsall, Concerned Friends of Ontario Citizens in Care Facilities (March 2013 newsletter)
If there is one thing that gerontologist Gail Elliot wants caregivers to know, it’s that people living with dementia have abilities that will definitely surprise you.
“I want to see a paradigm shift. Many people with dementia have spared abilities, such as reading, and I want people to know that!” Elliot told Concerned Friends in a telephone interview.
Elliot is the founder of Oakville-based DementiAbility Enterprises Inc. She provides workshops for dementia care that are based on Montessori principles. Prior to starting the company last year, she spent 17 years as the assistant director at the Gilbrea Centre for Studies in Aging at McMaster University in Hamilton.
Her book, Montessori Methods for Dementia™, forms the basis of her innovative interventions. These include a variety of materials and exercises, such as how to use large-font books that have been designed for aging eyes and dementia, aimed at reintroducing seniors to the joy of reading.
Elliot believes in the neuroplasticity of the brain. This refers to the ability to form new connections and restore past functions, even after brain damage has occurred. The ability of the brain to re-wire is well documented in the scientific literature. Using Montessori principles, people with dementia can become so engaged with their caregivers that real changes start to occur. Elliot has seen cases where people who have not spoken in months have started to speak again, and to feed themselves again, and to smile again.
Her methods are gaining traction in the long-term care community. Montessori Methods for Dementia™ is supported by Behavioural Supports Ontario which provided funding to train long-term care staff in 2012 and will continue through to the end of March 2013.
In the past year, Elliot and her staff of four teachers have trained nearly 2,000 people across Canada. Additional training is taking place across the world. The learners include personal support workers (PSWs), nurses, recreation therapists, doctors, psychologists, and educators. A workshop delivered in Hong Kong led to the textbook and materials being translated into Chinese, and the program was recently adopted by the Alzheimer Society of Australia.
One of Elliot’s earliest trainees was Kari Quinn-Humphrey, public education coordinator for the Alzheimer Society of Toronto.
“It was inspiring,” Quinn-Humphrey recalls. “I remember thinking that something big had been discovered and brought to Ontario.” She introduces some of the Montessori principles in the Dementia Care Training Program, including the UFirst! certification offered by the Alzheimer Society of Toronto.
Elliot acknowledges the challenges faced by PSWs and activity directors working in chronically under-staffed and under-funded long-term care homes, who struggle to deliver the minimum amount of personal care to each resident every day.
But Elliot is optimistic. While helping to feed a resident, for example, PSWs are encouraged to engage them in conversation, once they have taken the time to learn about the person’s past and present. She also encourages them to take time to connect with residents in other ways, such as taking time to play a game or providing a gentle hand massage.
For activity directors, she may suggest introducing a flash mob into the day. This involves all staff and residents getting together on each unit for 20 or more minutes a day to engage in activity. A PSW may be playing a game of “highest card wins” with one resident while another staff member may be running a reading group with four other residents. A variety of activities will be taking place at the same time, and all residents are engaged in something that connects to their interests and abilities. They soon look forward to their “event.” They may not remember what it is they will be doing, but they will remember there is something they enjoy doing every day at that pre-determined time. This is the power of routines and their connection to emotional memory.
Elliot is now working on incorporating her program into the training curricula for students in programs, such as PSWs within the community colleges. Mohawk College in Hamilton launched its first Montessori Methods for Dementia™ course in the fall of 2012.
Dementia Support makes a difference
At L’Chaim Retirement Home in north Toronto, residents are enjoying the activities led by caregivers using the Montessori-based principles developed by Gail Elliot.
In September 2012 L’Chaim owner Judy Cohen opened the Dementia Support Dov & Zipora Burstein Senior Centre just down the street — a full-day centre that delivers the same high level of activities.
“I love that I get to do this work,” says Rachel Hindel, administrative social worker at Dementia Support. Though she spends most of her day involved in the intake process, getting to know the families and their loved ones who live with dementia, she enjoys stealing a little time to engage with seniors during their day.
“I love it when I am there to see them have their moments.”
Hindel leads visitors through the specially designed areas, each one containing interesting things to do. There are areas for having tea and cookies, singing songs, reading books, doing exercises, rolling out dough, watering plants, creating art, doing puzzles, organizing tools, sorting mitts (and other familiar items), or just relaxing in a soft, leather recliner.
Recognizing that not all of the seniors are functioning at the same level, each activity is lovingly tailored to each one.
“Families are telling us that they are seeing changes in the seniors at home,” Hindel says.
“They are getting social stimulation as well, and they are experiencing being around others who understand. It’s nice for us too.”