How Montessori Practices Can Support Dementia Caregivers

By
Donna Marentay
Oct 12, 2022 • 4 min read

We blame Dementia for functional loss in people living with Dementia. It doesn’t have to be this way.

Maria Montessori is famous for revolutionizing child development and education, but people of all ages can benefit from the Montessori approach, especially when learning new things. Applying Montessori principles to Dementia Care doesn’t infantilize people living with Dementia. Similarly to children, it empowers them to be independent and creative. For people living with Dementia, each day is an opportunity to rebuild, discover, and learn, and it’s on us to support them. If we embrace this growth mindset, imagine the possibilities.

For too long, we’ve allowed Therapeutic Nihilism to stifle Dementia care and innovations. As Dr. Cameron Camp explains, Therapeutic Nihilism is a belief that those with Dementia cannot learn new things. All failures are attributed to Dementia, and there isn’t anything we can do “because they have Dementia.” There’s no question that living with Dementia is challenging, but it doesn’t need to be a living death sentence that we surrender to. Our loved ones deserve more than that.

Word finding, cognitive recognition, and memory degenerate over time, especially during later stages, and we accept this as inevitable with Dementia. This is a self-fulfilling prophecy. There’s no question that Dementia is a massive, life-altering challenge, but we need to rise to the occasion by offering the best Dementia care possible. This means re-examining past truths and finding opportunities to innovate. Care should be as unique and spirited as our loved ones are. We need to embrace and adopt a habilitative model of Dementia care, which focuses on the strengths and abilities they still have, not throw our hands up “because they have Dementia.” What does this look like? Empowering them to perform tasks themselves and supporting them IF they screw something up, instead of assuming they will.

In the words of Maria Montessori, “What you do for me, you take from me.” Dementia takes so much away from our loved ones; we shouldn’t join in.

This doesn’t mean compromising their safety – we aren’t throwing them to the wolves – rather, we are rebuilding independence in a supportive environment so we can be partners in their care, not providers. A Dementia diagnosis is not a no-knock warrant into their lives. Not sure what they need today? Ask them. Give them the dignity of choice. Their logic may seem a bit convoluted compared to our linear way of thinking, but it makes sense to them. We need to respect their wishes and meet them where they are in order to promote a sense of self-worth.

What if we reframed “Person-Centered Care” to “Person-Centered Assistance”?

Instead of doing everything for them, we help them achieve their goals and tasks. “Care” implies invalid status, but “assistance” assumes functionality with a little help where it may be needed. If we listen to them without prejudice, we could discover alternate methods of teaching new skills. Methods that encompass tactile and demonstrative instruction rather than verbal instructions. Methods that allow a person living with Dementia to carry on with skills that they’ve spent a lifetime honing. For example, allow a person who has always enjoyed cooking personally or professionally to assist in preparing a meal instead of assuming that Dementia would possess them to harm themselves or others. Under our current model of Dementia care, these concerns overshadow patient development. In our zeal to provide safety, we’ve put them in a functional straight-jacket that feeds the disease.

Adopting an assistive, habilitative approach to Dementia care doesn’t mean tearing down everything we’ve built over the years; it means building upon it. We can view behaviors through a different lens and identify which ones are a response to unmet needs. Human needs go deeper than food, clothing, and shelter. They include socialization, self-esteem, emotional safety, and self-satisfaction. We have to ask ourselves a tough question – are we meeting all of these needs and empowering the growth of the individual? Or have we given in “because they have Dementia”?

We know that every person's story is unique and deserves to be heard.

1. Create a List

List the names of all the doctors, hospitals, and other facilities your loved one visits regularly, along with those they have visited in the past. Try to go back as far as you can, striving for at least the last 5-10 years, but do your best. Even if you can’t remember them all, having a strong baseline can help you quickly identify gaps in records.

2. Ensure You Have the Appropriate Legal Status

It is important to make sure that you are fully empowered to make decisions on behalf of your loved one with Alzheimer’s. Your relationship status with the patient may not be enough to legally give you access to your loved one's medical information. It is a good idea to talk to an expert about securing special legal status, such as Power of Attorney (POA), a legal document that allows an individual to name someone as their decision maker should they no longer be able to make decisions on their own.

3. Gather and Organize the Medical Records in One Place

It’s important to have all of your loved one’s medical records together in one spot. This makes it much easier for you and your loved one’s physicians to accurately map the patient’s medical journey and more easily share information between doctors. Fortunately, tools exist to make record management and access simple.

4. Review the Medical Records to be an Informed Advocate

The better you understand your loved one's medical history, the better you can advocate on their behalf. Access and understanding of this information will help you to ask informed questions with physicians. Through regular communication backed by the data in the medical records, you can help your loved one’s care team develop a more successful care plan.

Together, we can make a difference.

1. Build a support network.

When you’re juggling appointment times and insurance claims, putting a robust support system together might not strike you as the most urgent task. Investing the time to cultivate relationships with people can turn to in times of need will pay dividends. The next time you need a last-minute ride or just someone to listen, you won’t be on your own.

2. Stay organized.

The backbone of effective caregiving is organization. Keep medical information, appointment schedules, and medication lists in order. Use a planner or a digital service to stay on top of your responsibilities. This attention to detail can prevent future complications and reduce day-to-day stress.

3. Explore treatments and clinical trials.

We’ve seen incredible breakthroughs in treatment over the past couple of years, powered by patients and their caregivers participating in research. Stay in the loop about the latest in medical advancements and available resources that could benefit your loved one. Whether it’s a new therapy option or a community service that aids independence, being informed can make a world of difference in the quality of care you provide.

4. Make time for self-care.

It may seem self-centered to focus on self-care—but when you feel good, you can be a better caregiver. Whether it’s exercise, a mindfulness practice, a soak in the bath, or just time to rest when you need it, carve out those moments in the day when you can unwind, reset, and stay healthy mentally and physically. Think of it as building up your reserves of kindness, patience, and understanding—which can only benefit your loved one. No one can pour from an empty cup.