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Use of the Montessori Method with Clients With Dementia

Kathleen Weissberg, OTD, OTR/L

February 5, 2020

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Question

How do you use the Montessori method with clients with dementia?

Answer

The basics of the Montessori method are as follows:

  • Use Everyday Materials
  • Match Interests & Skills (group/individual)
  • Use Past Experiences & Preferences
  • Adapt According to Cognitive & Physical Status
  • Simplify as Much as Necessary

The first is using everyday materials. We just talked about this. Now, when we talk about materials, they are not designed to be toys, but rather they are tools to practice independent living. These are things taken from the everyday environment and that are familiar to that person in terms of sight, touch, and smell. We want the person to not only interact with them and use them functionally, but we want it to also have a sensory component so they have the opportunity to reminisce. It could be measuring cups and they could talk about how they used to bake. In a later slide, I have some spices. You could use these to ask, "What did you use to make with these?" They could smell something and it might invoke a memory.

Next is matching interest and skills. This is a unique aspect of this approach. It is modifying that activity based on not only their cognitive and their physical ability but also their background and their interests. When Maria Montessori was working with her students, she always started with their capabilities and needs. What were they able to do? What do they like to do?  You do not want to frustrate them, but you need to make the task just a little bit beyond their comfort zone. They still have the opportunity to improve.

You also want to use their past experiences and preferences in trying to determine what those activities are. Obviously, if the person can tell us, we are going to solicit that information. As we get into those later stages of dementia, that may not be the case, so we may have to go based on what we know. If the person traveled a lot, maybe you do a matching activity with cities in Europe versus cities that are not in Europe. Or, if they enjoyed geography, you could do something with countries. If somebody enjoyed gardening, you could have them sort pictures or words into categories like fruits versus vegetables. You base your activities on their preferences and what you know.

You are also going to adapt activities based on cognitive and physical status, and that makes perfect sense. We need to tailor it to something that they are actually able to do. If it is something that is past their abilities right now, we are only going frustrate them if we push that narrative.

We simplify it as much as necessary. This is very familiar to us. We break down that activity into smaller steps that can be mastered and then sequenced and put together in order to engage.


kathleen weissberg

Kathleen Weissberg, OTD, OTR/L

Dr. Kathleen Weissberg, (MS in OT, 1993; Doctoral 2014) in her 25+ years of practice, has worked in rehabilitation and long-term care as an executive, researcher and educator.  She has established numerous programs in nursing facilities; authored peer-reviewed publications on topics such as low vision, dementia quality care, and wellness; has spoken at numerous conferences both nationally and internationally, for 20+ State Health Care Associations, and for 25+ state LeadingAge affiliates.  She provides continuing education support to over 17,000 therapists, nurses, and administrators nationwide as National Director of Education for Select Rehabilitation. She is a Certified Dementia Care Practitioner and a Certified Montessori Dementia Care Practitioner.  She serves as the Region 1 Director for the American Occupational Therapy Association Political Affairs Affiliates and is an adjunct professor at both Chatham University in Pittsburgh, PA and Gannon University in Erie, PA. 


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