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Finally…There’s a Way to Connect with a Loved One Who Has Dementia

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Henry had been diagnosed with early-onset Alzheimer’s and was quiet and withdrawn. When he was younger, he had collected vintage cars, so his caregiver gave him some old hubcaps and polish. After 30 minutes of polishing, Henry began talking with a great deal of emotion about his time as a soldier. Perhaps the process of polishing the hubcaps reminded him of polishing his boots, and an important memory was triggered. This activity enabled Henry and his caregiver to connect, even if only for a short time.

One of the most heartbreaking and frustrating aspects of caring for a loved one with dementia is the loss of meaningful interaction.

But there’s good news on this front: The Montessori Method for Positive Dementia Care, a nondrug approach (often used in combination with medication), is now being used by some caregivers in home-care settings and nursing homes with dramatic results.

Through basic Montessori principles, this method offers ways to be in the moment with a dementia patient and possibly have a deep connection. Patients become more secure, confident and calm. And caregivers are less likely to get frustrated and burn out.

Recent research: In a study involving nine residential facilities in Melbourne, Australia, dementia patients were two times more actively engaged when participating in Montessori-based activities than when they were not doing these activities.

Background: Developed more than 100 years ago as a method of teaching “unreachable” children with learning disabilities, the Montessori approach encourages the use of all five senses to stimulate different areas of the brain and the use of “muscle memory”* to develop small-muscle coordination and promote confidence. The Montessori method also advocates an environment that meets the specific physical and emotional needs of those using it.

Montessori classrooms for children are uncluttered but homey and filled with natural light and materials to promote use of the senses. Students are free to move about and engage in activities that appeal most to them. This sets the stage for focused and calm activity. Research has shown that Montessori pupils learn to excel at problem solving, adapting to change and social skills—all areas that are difficult for adults with dementia.

Key Montessori tenets and how they can help dementia patients…

  • Emphasis on environment. The surroundings of the dementia patient should be familiar and comforting and designed to foster as much independence as possible. For example, the layout of a facility, or your home if a loved one is living with you, should be uncomplicated so there is less potential for confusion. Visual cues, such as large-print labeling indicating what can be found in drawers, are also very helpful. Clutter should be minimized, but the use of natural elements—such as plants, pictures of nature, natural lighting, etc.—can induce a feeling of calm.
  • Muscle memory stimulation. While the mind of a dementia patient might be faltering, the muscles often “remember” how to do an activity that was done repetitively and enjoyably in the past. The key is to discover a patient’s unique strengths, passions and interests—not only tapping muscle memory but strong emotions as well. Focusing on a physical task and having success helps dementia patients feel more secure and confident and less angry and agitated.A caregiver might take a former golfer to the driving range to jump-start his/her muscle memory. Or a long-retired handyman might be given a toolbox with a tape measure, paintbrushes and a level so that he can tinker.These activities also build muscle coordination and can simply make life more pleasant and enriching for a dementia patient.
  • Sharing stories. This is one of the most effective tools for helping dementia sufferers stay connected. Moments when patients share their stories, even if the time is fleeting, can enable the patient and caregiver to feel a deep connection, boosting the patient’s sense of security.To encourage a patient to share a story: A caregiver might give him a meaningful object to hold—something important from the patient’s life or an object from nature. This simple act can help spark a memory and get the patient talking.
  • Art therapy. Painting, singing and playing an instrument can provide patients new avenues of self-expression and strengthen their spirits. These activities also can give patients the opportunity to engage their senses.Good activity: Flower arranging. Patients are encouraged to feel and smell the flowers, cut stems and pour water. This exercise calls on small motor skills, essential for independence and range of motion. Key areas of the brain are also exercised when deciding how to arrange the flowers.
  • The Knobbed Cylinder. This classic Montessori tool—a long wooden block with 10 different-sized holes in which the user places matching cylinders—builds focus and small-muscle coordination. Dementia patients might be asked to fill only two holes—the point is for the patient to feel success and build confidence through this activity.
  • Finish a phrase. Old sayings may never leave our minds. With this technique, the caregiver holds up the first half of a statement on a piece of paper (“The whole nine…”) and asks the patient to finish the saying (“…yards”). It’s astonishing to see dementia sufferers suddenly become very vocal and involved.

Benefits for the caregivers: The Montessori method gives the caregiver more tools to care for a dementia patient. It encourages the caregiver to use his imagination and allows him to act more like a guide than a director. Plus, patients are less agitated and aggressive, so they are easier to be with. All this helps minimize caregiver burnout and frustration.

Try out a few of these exercises with your loved one. To find a facility that offers this specific approach, you’ll need to ask the director of the center you are considering.

*Sometimes called procedural memory, this involves physical movements fixed into memory through repetition (think of riding a bike or playing a musical instrument).

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Source: Gerontologist Tom Brenner, MA, cofounder, with his wife, Karen Brenner, MA, of Brenner Pathways, a consulting and educational company in Chicago that specializes in the Montessori Method for Positive Dementia Care. He and his wife are also coauthors of You Say Goodbye and We Say Hello: The Montessori Method for Positive Dementia Care (Brenner Pathways). A researcher for the State of Illinois Department on Aging, Brenner trains caregivers and case managers through the Illinois Community Care Program. www.BrennerPathways.org

Date: July 1, 2013 Publication: Bottom Line Health
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