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: 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: 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: 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: 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: Montessori-based activities for persons with dementia have been used to successfully provide opportunities for programming between older adults and preschool children in shared site intergenerational care programs. Such intergenerational programming allows older adults with dementia to fulfill roles of teacher or mentor to younger children or as collaborative workmates for persons with more advanced dementia while providing children with positive one-on-one interactions with older adults. We review several studies using this approach; describe characteristics of the programs, participants, and results obtained; and provide recommendations for those interested in extending this line of work.

Language: English

DOI: 10.1080/15350770.2011.618374

ISSN: 1535-0770

Abstract/Notes: Background: To evaluate the effect of Montessori method on cognitive and behavioral function in patients with senile dementia by meta-analysis. Methods: The randomized controlled trials of the effect of Montessori method on cognitive and behavioral functions of Alzheimer’s patients in PubMed, Cochrane Library, Web of Science, Excerpt Medica Database, The Cumulative Index to Nursing & Allied Health Literature, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, Weipu Information Chinese Periodical Service Platform database and Wanfang database were searched by computer, and the references of relevant literatures were traced. Two researchers independently conducted literature screening, data extraction, evaluation and inclusion in the literature, using RevMan 5.4.1 software for meta-analysis. Results: A total of 11 literatures were included and 936 patients were enrolled. Meta analysis shows that compared with routine nursing, Montessori method is helpful to improve the overall cognitive function (standardized mean difference = 1.53, 95% confidence interval (1.32, 1.73), P < 0.01), activities of daily living and reduce the incidence of adverse events (relative risk = 0.37, 95% confidence interval (0.21, 0.63), P < 0.01) in patients with Alzheimer’s disease. Conclusion: Montessori method is helpful to improve the overall cognitive function, activities of daily living and reduce the incidence of adverse events in patients with senile dementia. Affected by the included study, it still needs to be confirmed by multi center and large sample randomized controlled study.

Language: English

DOI: 10.53388/AGING202204007

ISSN: 2815-7168

Abstract/Notes: To explore the effectiveness of acupressure and Montessori-based activities in decreasing the agitated behaviors of residents with dementia. A double-blinded, randomized (two treatments and one control; three time periods) cross-over design was used. Six special care units for residents with dementia in long-term care facilities in Taiwan were the sites for the study. One hundred thirty-three institutionalized residents with dementia. Subjects were randomized into three treatment sequences: acupressure-presence-Montessori methods, Montessori methods-acupressure-presence and presence-Montessori methods-acupressure. All treatments were done once a day, 6 days per week, for a 4-week period. The Cohen-Mansfield Agitation Inventory, Ease-of-Care, and the Apparent Affect Rating Scale. After receiving the intervention, the acupressure and Montessori-based-activities groups saw a significant decrease in agitated behaviors, aggressive behaviors, and physically nonaggressive behaviors than the presence group. Additionally, the ease-of-care ratings for the acupressure and Montessori-based-activities groups were significantly better than for the presence group. In terms of apparent affect, positive affect in the Montessori-based-activities group was significantly better than in the presence group. This study confirms that a blending of traditional Chinese medicine and a Western activities program would be useful in elderly care and that in-service training for formal caregivers in the use of these interventions would be beneficial for patients.

Language: English

DOI: 10.1111/j.1532-5415.2009.02271.x

ISSN: 1532-5415

Abstract/Notes: Ten years ago Tom and Karen Brenner developed a new approach to caring for people with dementia – Montessori for Dementia Care. Here, they explain their programme and training for care staff

Language: English

ISSN: 1351-8372

Abstract/Notes: Montessori-based activities are becoming a popular approach for the care of older adults living with dementia. The aim of this study was to systematically assess the quality of the research examining the benefits of Montessori-based activities for persons with dementia. Six peer-reviewed databases were systematically searched for all relevant articles published until April 2015. Included articles were peer-reviewed studies published in English that employed Montessori-based activities with persons with dementia. Methodological quality was assessed by 2 independent raters using the Physiotherapy Evidence Database Scale or the Downs and Black evaluation tool. Levels of evidence were assigned to the study design using a modified Sackett scale. One hundred fifty articles were identified, and 14 were selected for inclusion. Level-2 evidence examining the impact of Montessori-based activities on eating behaviors suggested that difficulties with eating could be reduced with Montessori training. There was limited level-4 evidence for the benefits of Montessori-based activities on cognition, wherein benefits appeared to be specific to lower-level cognitive abilities including memory and attention. Finally, there is level-1 (n = 1), level-2 (n = 3), and level-4 (n = 6) evidence for the benefits of Montessori-based activities on engagement and affect, whereby constructive engagement and positive affect were heightened. Overall, there is a strong level of evidence for the benefits of Montessori-based activities on eating behaviors and weak evidence for the benefits on cognition. Evidence for the benefits of Montessori-based activities on engagement and affect are mixed. Future research is needed to examine the long-term benefits of Montessori-based activities.

Language: English

DOI: 10.1016/j.jamda.2015.10.006

ISSN: 1525-8610