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: 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: Six persons in the early to middle stages of dementia (“leaders”) were trained in Resident-Assisted Montessori Programming (RAMP™) to lead a reading activity fo...

Language: English

DOI: 10.1177/1533317506297895

ISSN: 1082-5207, 2162-9986

Abstract/Notes: The purpose of this study was to determine the effects of an activity implemented by means of Resident-Assisted Montessori Programming (RAMP). Design and Methods: Four persons with early-stage dementia were trained to serve as leaders for a small-group activity played by nine persons with more advanced dementia. Assessments of leaders' ability to learn the procedures of leading a group, as well as their satisfaction with this role, were taken, as were measures of players' engagement and affect during standard activities programming and RAMP activities. Results: Leaders demonstrated the potential to fill the role of group activity leader effectively, and they expressed a high level of satisfaction with this role. Players' levels of positive engagement and pleasure during the RAMP activity were higher than during standard group activities. Implications: This study suggests that to the extent that procedural learning is available to persons with early-stage dementia, especially when they are assisted with external cueing, these individuals can successfully fill the role of volunteers when working with persons with more advanced dementia. This can provide a meaningful social role for leaders and increase access to high quality activities programming for large numbers of persons with dementia.

Language: English

DOI: 10.1093/geront/44.3.426

ISSN: 0016-9013

Abstract/Notes: Montessori-based Activity Programming (MAP) was adapted for Veterans Affairs (VA) Community Living Centers (CLCs) and aims to increase independence and meaningful engagement in residents with cognitive impairment. The Montessori model prioritizes offering choice, knowing and harnessing a resident’s abilities, and enabling them to carry out purposeful roles and activities. Any perceived deficit in cognitive functioning is “circumvented” by preparing the environment to support maximum independence. The implementation of MAP-VA in VA Western NY CLC involved 3 lodges, 52 staff, 16 champions, and 65 CLC residents. Standardized implementation measures demonstrated improvements over six months in five domains assessing development of a resident-directed community. Hypothesized outcomes included improved national percentile quality improvement (QI) rankings related to psychological symptoms and medications (e.g., depressive symptoms and use of antipsychotic/antianxiety medications) and physical functioning (e.g., less falls and ability to move independently). Scores six months prior to the implementation of MAP-VA (April, 2018 to September, 2018) were compared with scores during six months of implementation post training (November, 2018 to March, 2019). Compared to pre-intervention QI measures related to psychological symptoms, a clinically meaningful trajectory of symptom decrease was observed with rankings during implementation (e.g., depressive symptoms, amount of antipsychotic medications). Likewise, compared to pre-intervention QI rankings regarding physical functioning, post-training rankings showed a trajectory of improvement (e.g., help with ADLs, ability to move independently). Implementation of the MAP-VA intervention demonstrates preliminary evidence for improvement in QI measures related to psychological symptoms and physical functioning. Implications for QI efforts in VA CLCs will be presented.

Language: English

DOI: 10.1093/geroni/igz038.3448

ISSN: 2399-5300

Abstract/Notes: Effectively adapting evidence-based interventions for nursing home (NH) implementation is a critical, yet underexamined, component of improving care quality. Montessori-based activity programming (MAP) is an evidence-based intervention that promotes person-centered care, engages persons living with dementia, and mitigates distress behaviors. Currently, there is sparse evidence of MAP in Department of Veterans Affairs NHs (i.e., community living centers [CLCs]). CLCs differ significantly from community NHs and require adaptations to support MAP use and sustainability. This study uses the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to track changes made to MAP as an exemplar for clinicians and implementation scientists. This work fills a gap in adapting interventions through a detailed examination of the adaptation process in NHs.Qualitative and quantitative data were collected across 8 CLCs (e.g., advisory panel, staff interviews, training evaluations, field notes, and fidelity assessments). We used an iterative, rapid content analytic approach to triangulate findings and identify needed adaptations for the CLC setting.Thirty-six adaptations were made. Most adaptions occurred during the preimplementation phase, were reactive, focused on training/evaluation, and involved researchers, intervention developers, and practitioners. All were fidelity-consistent with MAP. The most common goal across adaptations was increased reach/engagement of the intervention.CLCs and community NHs can use findings to support intervention adaptation, and adapt and implement MAP to improve meaningful engagement for persons living with dementia and other residents. Future research should further evaluate and standardize FRAME for diverse users of complex interventions.

Language: English

DOI: 10.1093/geront/gnac133

ISSN: 1758-5341

Abstract/Notes: Objective To investigate the effect of the DementiAbility Methods: The Montessori Way (DMMW) on agitation in long-term care home residents with dementia. The activities using the DMMW are hypothesized to reduce agitation in terms of its frequency and disruptiveness to greater extent than structured social activities as control. Methods Forty-six long-term care home residents with dementia were randomly allocated to receive the DMMW (n = 23) or structured social activities as control (n = 23). Each participant received six intervention sessions of 45 minutes each within 2 weeks, at long-term care home. Agitation in terms of frequency and disruptiveness before and after the intervention were compared. Results The results showed that the DMMW resulted in significant reduction in overall frequency and disruptiveness of agitation. The DMMW group had significant reduction in frequency and disruptiveness of verbal aggressive, physical nonaggressive, and physical aggressive behaviors after the intervention. Conclusions The present findings support the potential of the DMMW as a safe and efficacious therapeutic intervention for addressing agitation in long-term care home residents with dementia, relevant to Hong Kong culture.

Language: English

DOI: 10.1002/gps.5063

ISSN: 1099-1166

Abstract/Notes: Creative activities can support people with dementia, leading to moments of reconnection and joy. This book shows how the Montessori method - with its arts-based, person-centred and positive focus - can help caregivers connect to people with dementia. Drawing on 20 years of experience, Tom and Karen Brenner explain the philosophy of the Montessori method, provide clearly-written steps to follow when applying it, and share a wealth of case studies and stories from their personal work using this method with people with dementia. This includes reading circles, art programmes, drum circles, poetry, and video diaries. Supported by research of the importance of creativity and the arts in dementia care, it is made clear throughout how every aspect of the Montessori method can help those with dementia to rediscover the world around them, maximising the opportunities they have to reconnect with their peers, family, friends, and support staff.

Language: English

Published: Philadelphia, Pennsylvania: Jessica Kingsley Publishers, 2020

ISBN: 978-1-78592-813-0 978-1-78450-873-9 1-78450-873-X

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: Objective: To compare ADL scores of elderly with early stage dementia who had attended Activities of Daily Living (ADL) skill training using Montessori-based activities with those who had not. Method: A quasi experimental study was conducted with Solomon Four Groups design experiment. The subjects consisted of 32 elderly living in Bang-Lamung senior home aged from 63-94 who met the inclusion criteria. They were diviecl into 2 qroups with 16 participants in each group then subgroup of 8 participants were selected to receive intervention and the controls were not. The screening instruments include mini mental status exam (MMSE-T2002) and Thai Geriatric Depression Scale (TGDS). Activities of Daily Living (ADL) scores of each subject were measured against Chula ADL index. The post test score was measured at the end of the 4th week, then the intervention was decreased and the follow-ups were measured at the end of the 8th and the 12th week. The data obtained was analyzed for descriptive statistics and the average ADL scores were compared by means of t-test and ANOVA. Results: The results showed that the average ADL pre-test scores of both groups were indifferent. The experimental groups average ADL scores of the post-test increased by 0.62 and the first follow up increased by 0.25 which are statistically significant at the level of p<0.05. Conclusion: Activities of Daily Living training using Montessori-based activities is effective in increasing ADL scores. It is recommended to be used as the activities for elderly with early stage dementia.

Language: Thai

ISSN: 2697-4126