Abstract/Notes: PurposeThis study examined the impact of a Montessori mealtime intervention for people living with dementia to support the mealtime experience of residents and mealtime care practices of staff in a memory support unit. The mealtime intervention was part of a broader culture change project.MethodAn observational research design was used to evaluate changes in the mealtime experience and care practices across three time points (baseline, post-implementation, maintenance), spanning 30 months. Five video recordings of the lunch time service (range: 19?32 min) were analysed. The coding protocol comprised pre-determined indicators related to accepted dimensions of person-centred care. Resident and staff behaviours were quantified across four categories: providing choice and preferences, promoting the social side of eating, supporting independence and showing respect towards residents. Staff behaviours that reflected personal enhancing actions and personal detractors were also coded during each mealtime service.ResultsA significant increase in staff providing residents with the opportunity for choice and a subsequent significant increase in residents demonstrating choice behaviours was evident. Staff and residents both significantly increased their interactional behaviours, with greater social interaction between staff and residents. Staff further demonstrated greater support for mealtime independence that reached and maintained significance during the final two sampling points. Significant gains observed post implementation were largely maintained and, on specific measures, further increased over time. A significant increase in staff use of personal enhancing actions during mealtime care was also evident. Variability in individual staff and resident behaviour highlighted the complexity of mealtime care and culture change processes.ImplicationsThe study provides novel evidence to support the use of a Montessori mealtime intervention to achieve more person-centred mealtime care, and which resulted in a more respectful, enabling and social dining experience. Clinical implications and direction for future research are presented to build on these findings.

Language: English

DOI: 10.1177/14713012211057414

ISSN: 1741-2684, 1471-3012

Abstract/Notes: Some types of formulaic (routine and familiar) language seem to remain fairly intact in people with language and memory disturbances, making it a useful tool fo...

Language: English

DOI: 10.1177/1471301211413338

ISSN: 1741-2684, 1471-3012

Abstract/Notes: Montessori-based activities use a person-centred approach to benefit persons living with dementia by increasing their participation in, and enjoyment of, daily life. This study investigated recreation staff and multidisciplinary consultants’ perceptions of factors that affected implementing Montessori Methods for Dementia™ in long-term care homes in Ontario, Canada. Qualitative data were obtained during semi-structured telephone interviews with 17 participants who worked in these homes. A political economy of aging perspective guided thematic data analysis. Barriers such as insufficient funding and negative attitudes towards activities reinforced a task-oriented biomedical model of care. Various forms of support and understanding helped put Montessori Methods for Dementia™ into practice as a person-centred care program, thus reportedly improving the quality of life of residents living with dementia, staff and family members. These results demonstrate that when Montessori Methods for Dementia™ approaches are learned and understood by staff they can be used as practical interventions for long-term care residents living with dementia.

Language: English

DOI: 10.1177/1471301215625342

ISSN: 1741-2684, 1471-3012

Abstract/Notes: This study evaluated the validity and reliability of the Montessori Assessment System. The Montessori Assessment System assesses preserved abilities in persons ...

Language: English

DOI: 10.1177/1471301217729533

ISSN: 1741-2684, 1471-3012

Abstract/Notes: Literature regarding Montessori-based activities with older adults with dementia is fairly common with early stages of dementia. Conversely, research on said activities with individuals experiencing late-stage dementia is limited because of logistical difficulties in sampling and data collection. Given the need to understand risks and benefits of treatments for individuals with late-stage dementia, specifically regarding their mental and behavioral health, this study sought to evaluate the effects of a Montessori-based activity program implemented in a long-term care facility. Utilizing an interrupted time series design, trained staff completed observation-based measures for 43 residents with late-stage dementia at three intervals over six months. Empirical measures assessed mental health (anxiety, psychological well-being, quality of life) and behavioral health (problem behaviors, social engagement, capacity for activities of daily living). Group differences were observed via repeated measures ANOVA and paired-samples t-tests. The aggregate, longitudinal results—from baseline to final data interval—for the psychological and behavioral health measures were as follows: problem behaviors diminished though not significantly; social engagement decreased significantly; capacities for activities of daily living decreased significantly; quality of life increased slightly but not significantly; anxiety decreased slightly but not significantly; and psychological well-being significantly decreased. Improvements observed for quality of life and problem behaviors may yield promise for Montessori-based activities and related health care practices. The rapid physiological and cognitive deterioration from late-stage dementia should be considered when interpreting these results.

Language: English

DOI: 10.1177/1471301217703242

ISSN: 1741-2684, 1471-3012

Abstract/Notes: Altered behaviour associated with dementia can present a number of challenges in the provision of care within both community and residential aged care settings. This paper presents a qualitative case study investigation of the implementation of the Positive Interactive Engagement programme within a residential aged care setting. The Positive Interactive Engagement programme incorporates non-pharmacological sensory techniques that have been informed by a person-centred, Montessori approach. Face-to-face semi-structured interviews with workers at a residential aged care facility in South Australia yielded seven case studies. Data were thematically analysed both within and between cases. Our data indicate the programme demonstrates underlying Montessori principles and supports participant behaviour change, with a noted reduction in ‘disruptive’ behaviours and increased social connection amongst participants. Programme staff report increased job satisfaction. The Positive Interactive Engagement programme offers a model that demonstrates encouraging outcomes, and further research would be useful in ascertaining whether these outcomes translate to quantifiable improvements in the quality of life for people with dementia in a residential aged care setting.

Language: English

DOI: 10.1177/1471301218792144

ISSN: 1741-2684, 1471-3012

Abstract/Notes: Montessori-Based Programming (MBP) in dementia care refers to a growing body of research and practice that has developed Montessori methods to facilitate self-paced learning, independence and engagement for people living with dementia. A number of research gaps have been identified in the existing literature such as a lack of cross-cultural studies and well-powered, robustly designed outcome studies. The current study investigated the use of MBP with a focus on provision in the United Kingdom. It aimed to identify MBP implementation approaches, challenges and barriers, and research gaps.Design and MethodsA qualitative design was implemented to analyse data from in-depth, semi-structured interviews with key stakeholders (N = 8) with experience of MBP in the UK. Participants included care home management and staff, MBP trainers and independent dementia experts with a background in Montessori methods. Thematic analysis identified 4 main themes and 12 sub-themes. The study took place between April 2019 and October 2019.FindingsA framework describing knowledge and understanding of MBP in the UK, implementation considerations, challenges and barriers, evidence of outcomes and research gaps was developed to provide guidance for researchers and practitioners. Implementation considerations included using a whole-home approach and changing the culture of care through management support. Barriers to implementation included conservative attitudes to care, perceived lack of time and resources, health and safety issues, and issues of sustainability.ConclusionThe benefits of MBP in dementia care are promising but require further empirical investigation. There is a need to design, execute and publish evidence to secure the support of key stakeholders in dementia care research, policy and commissioning in the UK.

Language: English

DOI: 10.1177/14713012211020143

ISSN: 1741-2684, 1471-3012

Abstract/Notes: Background: Increasingly more attention has been paid to non-pharmacological interventions as treatment of agitated behaviors that accompany dementia. The aim of the current study is to test if personalized one-to-one interaction activities based on Montessori principles will improve agitation, affect, and engagement more than a relevant control condition.Methods: We conducted a randomized crossover trial in nine residential facilities in metropolitan Melbourne, Australia (n = 44). Personalized one-to-one activities that were delivered using Montessori principles were compared with a non-personalized activity to control for the non-specific benefits of one-to-one interaction. Participants were observed 30 minutes before, during, and after the sessions. The presence or absence of a selected physically non-aggressive behavior was noted in every minute, together with the predominant type of affect and engagement.Results: Behavior counts fell considerably during both the Montessori and control sessions relative to beforehand. During Montessori activities, the amount of time spend actively engaged was double compared to during the control condition and participants displayed more positive affect and interest as well. Participants with no fluency in English (all from non-English speaking backgrounds) showed a significantly larger reduction in agitation during the Montessori than control sessions.Conclusion: Our results show that even non-personalized social contact can assist in settling agitated residents. Tailoring activities to residents’ needs and capabilities elicit more positive interactions and are especially suitable for people who have lost fluency in the language spoken predominantly in their residential facility. Future studies could explore implementation by family members and volunteers to avoid demands on facilities’ resources.Trial Registration: Australian New Zealand Clinical Trials Registry – ACTRN12609000564257.

Language: English

DOI: 10.1017/S1041610212002128

ISSN: 1041-6102, 1741-203X

Abstract/Notes: LEAD IT! is an app that enables persons with early and middle stage dementia to lead activities for their peers—i.e., other persons with dementia (PWD). An alpha version of the app was tested in a Phase 1 SBIR project. The alpha version included three Montessori-inspired activities. While PWD ostensibly view LEAD IT! as a set of enjoyable activities, it is actually an evidenced-based intervention aimed at reducing responsive behaviors and enabling PWD to fill meaningful social roles. A total of 24 PWD participated in the Phase 1 study: five leaders and 19 players. LEAD IT! Programming was implemented for six weeks, twice per week. LEAD IT! produced higher levels of positive engagement and affect, and lower levels of negative engagement, as compared to standard, baseline activities—i.e., non-digital activities led by staff. More specifically, when compared to baseline programming, players exhibited an 82% increase in Constructive Engagement (P=0.000), 80% increase in Passive Engagement (P=0.000), 60% reduction in Other Engagement (P=0.035), and 171% increase in Pleasure (P=0.000). One limitation of the Phase 1 study is that, at least insofar as the intervention is only implemented twice per week for six weeks, the positive outcomes seem to be limited to the period of time during which PWD are participating in the activity—i.e., changes on global measures, such as quality of life and depression were not detected. Still, the promising results of this study suggest that LEAD IT! is worthy of further development and evaluation in a planned Phase 2 study.

Language: English

DOI: 10.1093/geroni/igaa057.878

ISSN: 2399-5300

Abstract/Notes: This study was designed to analyze the effects of intervention guided by Montessori Method on patients with dementia. Methods: 85 patients diagnosed with Alzheimer’s disease (AD) in our hospital were included for retrospective analysis and were divided into 2 groups by double-blind randomized method. The control group (n=42) received routine guides on dieting, and the observation group (n=43) was intervened under the guides of Montessori Method. The 2 groups were compared for cognitive function, feeding capacity score, feeding difficulty, voluntary feeding time, and nutriture. Results: (1) After intervention, the observation group yielded a higher MMSE score for cognitive function than the control group (P<0.001); (2) The scores of feeding capacity in both groups achieved increase, which in the observation group was higher than that in the control group 1 month after intervention (P<0.001); (3) The scores of feeding difficulty in both groups achieved decrease, which in the observation group was lower than that in the control group after intervention (P<0.001); (4) For voluntary feeding time as intervention completed, 1 month and 3 months after intervention, the observation group reported prominent extension (P<0.001) while the control group achieved shortening gradually (P<0.001), and the voluntary feeding time in the observation group was longer than that in the control group (P<0.001). Conclusion: Intervention guided by Montessori Method helps patients with dementia by reducing their feeding difficulty and improving their cognitive function, feeding capacity, and nutriture. It is a method deserving popularization.

Language: English

ISSN: 1940-5901