RESEARCH TO PRACTICE
Montessori Techniques Piloted in Special Care Units
Camp, C. J., Judge, K. S., Bye, C. A., Fox, K. M., Bowden, J., Bell, M., Valencic, K., & Mattern, J. M. (1997). An intergenerational program for persons with dementia using Montessori methods. The Gerontologist, 37, 5, 688-692.
The two primary goals for this particular project were first to determine if older adults with dementia could successfully teach Montessori-based lessons to preschool children and second to determine if apathy, which was conceptualized as disengagement from the social and physical environment, could be reduced through participation in the program.
Montessori techniques appear to be compatible for persons with dementia in that activities used give immediate feedback, ensure success and involve repetition. Lessons are presented first in a simple manner with subsequent lessons increasing in complexity with a variation of previously mastered skills or concepts. Tools taken from a person's everyday environment are used in lessons and to help prepare for independent living. Some forms of learning and remembering occur without conscious awareness or effort. This type of learning appears earliest in the cognitive development of children and lasts the longest for persons with AD and related dementias.
Participants ranged in age from 70 to 96 with a median age of 88 (five were over the age of 90). Nine of these elders resided in special care units in the nursing home while the rest attended adult day care. Mini-Mental State Exam (MMSE) and the Direct Assessment of Functional Status (DAFS) were administered. In addition, seven Montessori-based tasks (finding hidden objects, using tools, gripping and fine motor coordination, matching, seriating, and sorting pictures into concrete or abstract categories) were presented as a baseline measure of cognitive, motor, and sensory functioning.
To more effectively fill the role of mentor, elders were paired with children who were at a lower ability level in the seven Montessori-based activities. The children ranged in age from 2.5 to 4 years. Two to three adult-child pairs were participating at any given time when programming was in session. Each child worked with a number of adults on a rotating schedule, usually twice a week.
Motor activities such as scooping, polishing and use of blocks were used. Sensory activities included such things as scent identification, matching colored objects and shapes, and recognizing differences between rough/smooth and hot/cold objects. Abstract activities consisted of sorting (living/not living, plant/animal, summer/winter, etc.), phonics (using sandpaper letters), and math (counting).
Intergenerational sessions for each elder took place once a week for 30 B 45 minutes. More than 75 sessions were conducted on a regular schedule, in the same settings and circumstances, (e.g., once a week (Tuesdays) from 9:45 a.m. until 10:15). The number of successfully taught Montessori lessons increased over the course of the study as both elders and children became familiar with the format and each other.
The first goal, to see if older adults with dementia could successfully teach Montessori-based lessons to preschool children, was accomplished with an average of 22.3 lessons successfully taught. The second goal of reducing apathy (disengagement) was striking. No instances of disengagement were seen in the 53 observation periods while elders were teaching the children. Additionally, no instances of persons with dementia becoming aggressive, disruptive, confused or anxious during any activity sessions with children occurred.
IMPLICATIONS: This study has implications for nursing homes with on site day care facilities and regularly scheduled intergenerational activities. It is possible to create effective intergenerational programming between persons with dementia and young children when the activities are meaningful to both generations and the activities are structured to accommodate cognitive deficits. This study finds that persons with early-to middle-stage dementia may best be viewed as normal adults who happen also to have memory and executive function disabilities. In situations where these disabilities can be remediated, as in the case of presenting Montessori lessons, persons with dementia can demonstrate normal and sometimes exceptional levels of competence (p. 691).