Tirzah Wear
Activities Director
Arlington Court Skilled Nursing & Rehab

Montessori Method

Montessori MethodArlington Court is bringing Montessori-based activities to our memory care unit! The Montessori Method of education and learning was developed in 1939 by Maria Montessori.  She was an early childhood educator who believed that people would learn better and more independently if given the right materials and environment to explore on their own. Since its inception, the method has been successfully adapted to address the needs of patients with Alzheimer’s disease and other dementias. Our memory care unit has a desk with papers to file, adding machines and other office equipment.  There are simple household tasks and a folding table, a piano and a vanity is stocked with jewelry, hats and cosmetics. These stations are available at any time. Giving older adults the appropriate and safe environment to explore and discover on their own has been proven to soothe and de-escalate behaviors. It also fosters a sense of purpose and engagement in the world around them.

Theory:

Montessori method breaks down activities from complex tasks to a more simplified experience. (i.e household tasks such as completing laundry are broken-down to smaller steps of sorting and folding  until mastery is achieved.) The sense of completion provides sensory and cognitive stimulation and allows persons with the dementia to express their social skills. These tasks are generally self-directed with minimal influence by the activity staff. This breeds a sense of autonomy and allows the patient to feel relevant and in control of his/her environment. In a 9-month study of Montessori activities at an adult day care setting, patients showed significantly higher levels of constructive engagement than patients in the control group. The patients participating in Montessori activities also exhibited less passive engagement. (McConnell RN 2000; Orsulic-Jeras BA, Judge BA, Camp PhD.)

Practice:

Montessori activity programming works best when conducted in conjunction with more organized, traditional group activities. Montessori stations are set-up and made available to patients to explore in idle times of agitation or anxiety. Vrable Healthcare would provide several options for the idle dementia patient such as a working desk complete with type-writer (familiar to patients from previous generations), a vanity with accessories and jewelry to explore, a folding table with household items such as laundry, mutli-colored silverware for sorting and cleaning and other household items and a work bench with simple tools, sanding paper and sorting blocks. These stations would be available at all times and utilized by patients between group activities. They can be used as a behavior intervention for residents experiencing aggressive or other behaviors with simple cuing from nursing or activity staff.

Scenario:

Ethel is agitated and idle. She becomes triggered by another patient who is pacing back and forth. Ethel misunderstands the behavior of the other resident and becomes personally offended. “Why is Gertrude following me? She is always out to get me. She wants to take my job from me.”

The STNA and or nurse can intervene gently, “Ethel, you seem upset. Why don’t we get to work and organize your workspace?” Sometimes the act of filing papers at the resident’s level can be a soothing activity as well. This interrupts the situation between residents and gives Ethel a sense of accomplishment. The other patient in the scenario can be taken to another area and given a job as well (matching and sorting socks, for example). Not only does this diffuse a potential behavior, it also boosts self-esteem in the patient.

Conclusion:

Self-directed tasks can give our residents a sense of autonomy when much of their executive function has been compromised. The Montessori Method offers space and materials to explore and enjoy.  Our Montessori stations offer a wide array of activities available between more structured group activities and promote a sense of accomplishment and well-being in our residents.