Language: Korean

ISSN: 1226-9417

Abstract/Notes: Seniors with dementia living in nursing homes are often faced with boredom and loneliness due to lack of meaningful engagement and personalized activities. We applied Montessori method to design an interactive table for elderly home residents and evaluated the design with four female residents and a nurse. This method offers a range of levelled interactions to meet the needs at different stages and cognitive decline levels of the residents with dementia. The table initiates interaction with an increasing level of complexity that magnifies the rewarding effects and social connectedness among the residents. The qualitative evaluation during a pilot study indicated that the interactions with the table reduced agitation of the elderly participants and increased the instances of positive social behaviours.

Language: English

Published: Dordrecht, The Netherlands: Springer, 2018

Pages: 49-58

DOI: 10.1007/978-3-319-73062-2_4

ISBN: 978-3-319-73061-5 978-3-319-73062-2

Abstract/Notes: According to the World Health Organization, there are currently more than 55 million people living with dementia worldwide, and this figure is expected to triple by 2050. Recent studies suggest that there may be a link between childhood trauma (which refers to exposure to overwhelmingly stressful experiences before the age of 18 years) and the onset of dementia in later life. Therefore, in communities caring for persons living with dementia, some residents may have been exposed to trauma in childhood. Currently, there is an increasing awareness of the negative impact of childhood trauma on later adult health and well-being, and a corresponding recognition of the need for services, including for dementia care, to be trauma-informed. In the last decade, the Montessori Method has become established as a legitimate approach to elder/dementia care. However, it has not yet been examined as a trauma-informed approach. The aim of this paper is to address that gap by (a) highlighting how Maria Montessori took steps to integrate interdisciplinary knowledge of trauma into her Method when she began to understand the potential of childhood trauma to adversely impact adult health and well-being, and (b) outlining how the Montessori Method, when applied to dementia care, incorporates many of the core principles of trauma-informed practice. This paper concludes that the Montessori Method for dementia care has the built-in capacity to be trauma-sensitive and trauma-responsive, but that its ongoing rollout should follow Montessori’s lead by specifically integrating knowledge about the neurobiology of trauma into its training programs.

Language: English

DOI: 10.17161/jomr.v9i2.19480

ISSN: 2378-3923

Language: Korean

ISSN: 1598-1649, 2671-812X

Abstract/Notes: There is a need to translate research findings to support the wider adoption of person-centered care into typical long-term care environments across the world. Montessori for Aging and Dementia is one mechanism to support person-centeredness, dignity and autonomy of older adults living in long-term care environments. In this presentation, strategies used to support the implementation of Montessori for Aging and Dementia in a long-term care community of 20 people living with severe dementia will be highlighted. Implementation support was provided through capturing and sharing local knowledge, ongoing training and consultation, and tailoring communication supports. Through the use of these iterative strategies, the program was successfully adapted to include people living with severe dementia. While key findings of the project included improvements on a variety of observational and staff administered measures, the focus of this presentation will be on the relationships between the Montessori program’s fidelity, local needs and implementation strategies.

Language: English

DOI: 10.1093/geroni/igab046.187

ISSN: 2399-5300

Abstract/Notes: There is a need to engage direct care providers such as certified nursing assistants (CNAs) explicitly in efforts to implement innovative programming in long-term care environments. This presentation will outline engagement strategies that supported the implementation of Montessori programming in a community of 20 individuals living with severe dementia. Examples about positioning the CNA at the center of decision making, negotiating and building trust, cultivating opportunities for mutual consultation, creating spaces for new ideas to emerge, and synthesizing diverse perspectives will be highlighted. Although the program achieved positive outcomes on a number of measures including decreased responsive behaviors from people living with dementia, decreased negative qualities of relationships between CNAs and persons with dementia, and increased positive qualities of relationships between CNAs and persons with dementia, this presentation will focus on the “how” of engagement between the project team and the CNAs by highlighting qualitative data.

Language: English

DOI: 10.1093/geroni/igab046.578

ISSN: 2399-5300

Abstract/Notes: Pragmatic clinical trials test the effectiveness of interventions in “real-world” settings. One challenge with conducting such research in non-controlled environments is exposure to unpredictable events: in the case of the studies here, the COVID-19 pandemic. This session shares the implementation experiences and findings from four pragmatic clinical trials designed to improve dementia care and describes how the studies were impacted by and adapted to respond to the pandemic. The first speaker discusses a successful, team-based approach for adapting and implementing an intervention to improve sleep for nursing home residents with dementia. The second speaker presents the modifications made to implementation strategies between two trials of a personalized music intervention delivered to nursing home residents with dementia. The third speaker discusses findings from a mixed-methods evaluation with frontline staff at VA Community Living Centers enrolled in a stepped-wedge cluster randomized trial of Montessori-based approaches to improve dementia care. The fourth speaker shares findings from a pilot trial comparing two modes of meal delivery to homebound older adults with dementia. The discussant situates these adaptations and findings in the context of lessons learned by other trialists working to improve care provided to people living with dementia.

Language: English

DOI: 10.1093/geroni/igad104.1636

ISSN: 2399-5300

Abstract/Notes: HOME 4 CARE® (H4C) is an NIA-funded SBIR study in which a mobile app is being developed and tested with clients and staff in the Home Health environment. With the increased prevalence of dementia, demand has increased for education and interventions that can be used to treat and/or circumvent the responsive behaviors associated with the condition. While much emphasis has been placed on improving dementia care in LTC over the last decade, the thrust to improve dementia care in home health has lagged behind. This is unfortunate, because 58% of PWD live in the community. The app consists of three main components: (1) Montessori-based digital activities for persons with dementia, (2) interactive, video-based dementia training modules for care partners, and (3) a “Get to Know You” module that enables staff to better understand their clients’ activity, care, and social preferences. The study explores the effects of the activities on engagement/affect, satisfaction with activities, the training modules’ effects on knowledge transfer, and satisfaction with the Get to Know You module. Preliminary outcomes are promising. H4C activities have produced a 34% increase in constructive engagement (p<.01) and a 100% decrease in non-engagement, as compared to other interventions for PWD. Client satisfaction with activities was 90%. The H4C Training modules increased staff dementia knowledge by 21% (p<.01). Staff have reported high satisfaction with the Get to Know You Module. The presentation will discuss outcomes to-date, lessons learned about developing mobile apps for PWD, and future plans and extensions of HOME 4 CARE®.

Language: English

DOI: 10.1093/geroni/igy023.2075

ISSN: 2399-5300

Abstract/Notes: Reading is a skill that remains for a long time in persons with dementia (PWD), with oral reading and grammatical knowledge often being preserved through the latest stages of the condition. However, without access to dementia-appropriate reading materials, many senior living communities are compelled to provide children’s books to PWD. While the large font and simple sentences in such books make them easy to read, they fail to respect PWD’s status as adults who have significant life histories. Hearthside Book Club® (HBC) is a Montessori-based and adult-appropriate reading and discussion activity that capitalizes on the remaining abilities of PWD. This paper will discuss the key features of HBC, outcomes of a research study that examined HBC, processes used to disseminate HBC, and lessons learned while disseminating the intervention. Regarding the research study, persons from all stages of dementia participated (N=108), with 33% in the Early Stages, 28% in the Middle Stages, and 39% in the Late Stages. When compared to baseline activities, HBC produced an 85% increase in Constructive Engagement (p<.01), a 91% increase in Pleasure (p<.01), a 76% decrease in Distracted Engagement (p<.01), and a 59% decrease in Non-Engagement (p<.01). In addition, Quality of Life (measured with the DEMQOL) increased (p<.05), while Apathy (measured by the NPI-NH) decreased (p<.05). Regarding dissemination of HBC, a competitive analysis, surveys, and interviews with end users were used to determine optimal ways of delivering and pricing the intervention. Ultimately, we decided to disseminate HBC digitally as a Book of the Week Club.

Language: English

DOI: 10.1093/geroni/igy023.025

ISSN: 2399-5300

Language: English