Showing posts with label Montessori. Show all posts
Showing posts with label Montessori. Show all posts

Sunday, March 17, 2013

Book Review: You Say Goodbye and We Say Hello: The Montessori Method for Positive Dementia Care

I just finished Tom and Karen Brenner's book, You Say Goodbye and We Say Hello: The Montessori Method for Positive Dementia Care. You may know that I went to a Montessori school for Pre-K-8th grade, my son attends a Montessori school, I have taken classes with Dr. Cameron Camp who has created Montessori Based Dementia Care activities which he has been using for over 15 years, I have training in the Montessori based religions education program Spirit Play, and we use the Montessori method in the art care activities we use with people in the CLF Foundation programs. Basically, I love Montessori and the principles are part of my everyday life. So, I was very excited to see another book about caring for people with dementia with Montessori methods.

I have never had the pleasure of meeting Tom and Karen Brenner, but I know that Tom has a MA in Gerontology and Karen is a teacher who has opened Montessori schools in Chicago. They have been using the Montessori method for many years with people with dementia and you can see in the book how they have found this method helps bring meaning and purpose into people's lives. Here is a short summary of what I thought of the book.
Copyright: Jeff Norris

What I Liked:
  • Some people may take writing style for granted, but I appreciate that this book is written in a more conversational and understandable style rather than being full of jargon which is not accessible to people who are not in the medical field. This means the book can be used by family members as well as professional caregiver. 
  • The Brenners understand the intense emotions that go along with dementia. They are compassionate in talking about our assumptions of people with dementia and how us family members struggle with judgement, guilt, frustration, sadness, and fear. For instance, they talk about how lonely and heartbreaking it can be to have to introduce ourselves to our own mother. Basically, I felt cared for by this book, like someone understood the emotional struggle and yet did not judge people for their feelings but gave you new insights and ways to cope with them.
  • The book addresses deep spiritual questions of dementia such as: "...can a person still be who they are  and not remember who they were? ...Is remembering all we are? Is a person lost to us because they don't remember their wedding day, or the job they held for thirty years?" (p. 24-25.) Throughout their book they answer these questions, basically by saying our loved one is still here (just as Dr. John Zeisel talks about as well.) We need to work with their abilities and help engage their inner selves, which is never lost, just much harder to find through the fog of dementia.
  • There are examples of Montessori activities in the book but what is even better is they really talk about how to find activities which are meaningful to the person. The same activity will not reach every person the same and sometimes an activity you assume someone will not enjoy, they absolutely love. It is all about getting to know the person as best you can and also trying new things with them to see what will reach them.
  • They answer well the common question: "Montessori is for kids, why would we use it with adults? Isn't that demeaning?" No matter our age, we are all curious, we all want to be seen for who we are, and we all want to be creative and accomplish things we can be proud of. The Montessori method is simply a way to help reach people on the deepest level where we all reside. They also address the issue of activities that seem "too simple" like matching wooden cylinders into holes. If you have ever touched and used Montessori materials, you know they are made with natural materials. They are beautiful and colorful, you want to use them, no matter your age. I have seen non-Montessori parents go into a Montessori classroom and be drawn to the Bead Bars, Trinomial Cubes, and Metal Insets because they are just so beautiful and thus fun to use. 
  • On pages 123-124 they describe a flower arranging activity and have listed not only how to do it but the purpose of the activity such as range of motion, small motor activity, creativity, and cognitive stimulation. It is a great example to show people how "simple" activities are not really so simple. They really provide a myriad of benefits.
What I Would Have Liked More Of:
  • Basically, there is just one thing I would have liked more of, and this is really more of a personal preference. I would have liked more information about the Montessori method and why it works. There is so much about the method that reaches people with dementia and I feel like if you have a knowledge of Montessori you will see how they use the method in more ways than just finding meaningful activity and correct ways to prepare the materials. If you are not a Montessori person, you could use some more insight into why Montessori works and all the intricacies of it like the use of color, texture, how to put things away so they are useable, etc... I think the Brenner's communicate well and make things understandable so could have provided even more information about Montessori methods and principles in a way that people actually understand it and see the meaning behind it. (Then again, this would have made the book longer and it is a fast and easy read so you can implement techniques right away.)
  • What I have not seen in really any of the books on dementia are these activities and this care being provided in a home setting. Yes, all the books, including this one, say "you can do this with someone at home" but there are few stories about such care. I will write a post about this, but there are specific things about a home setting that make these activities hard to do, and part of that is often the person with dementia will do activities for an outside caregiver or friend but rarely for the family members who care for them on a daily basis. The socialization and environment is completely different at home versus an institution and unless you work with people at home on a long term basis and see the dynamic with the family members, you can not make the claim that these activities will work just as easily at home as in an institution. 
Blessings,

Rev. Katie

Tuesday, May 8, 2012

Our First Montessori Based Activities for Dementia

Over the past few weeks, we have tried a few Montessori based activities with Mom. We are learning what will work for her as we go along. It has been really interesting to try different things that you think will work and are accessible for your loved one and find out there may be more limitations for them than you realized. It all depends on what kind of dementia and other issues your loved one has as to what will work for them.

Mom has Lewy Body Dementia which means she has Parkinson's-like symptoms so her hands shake and movement is hard for her. In the two activities we tried, it was hard for Mom to do the motor skills to complete the projects, but our son was good at helping her out. We did both of these projects with me and our eight year old son assisting Mom.

Our first project was to make templates for setting the table. Montessori uses templates in many different ways in the classroom. For instance, the world map puzzles have templates (control maps) in varying degrees of detail (labeled and unlabeled) in order to help the children learn where the states and countries are and start to memorize the maps. We made place setting templates with Mom because Mom likes to set the table but does not remember where the items go.
Placemat Template. Photo by Jeff Norris

Part of Dr. Cameron Camp's suggestions for Montessori Based Dementia Care is to have your loved one help you make materials for activities as much as possible. So with the place setting templates, making the templates was an activity and now she has the activity of setting the table each day if she wants. Mom had a hard time following directions with this one as she needed to trace things, like a plate, with a marker. Those directions were a bit to complicated for her but working together we got the project done and she said she liked it. Mom is able to use the templates to set the table although she does sometimes question if she should be using them because she does not always remember we made them with her for her; she thinks they belong to us instead.

Our second activity was pouring sand. I always loved to do this when I was little, and now there are many more jars and things to pour colored sand into which can actually make pretty decorations in your home. We put each color of sand into a cup and used a funnel for Mom to pour the sand into the glass block display. We did find that Mom can not lift the cup high enough on her own, her arms are too weak, so we needed to help her a lot with that. While she enjoyed the project, I am not sure it is really that accessible for her.
Sand pouring. Photo by Jeff Norris

The Montessori method of simplifying and finding activities that match the skills of the person is working, it just takes a while to find out what is realistic for your loved one to do. Also, to make enough projects to have something to do multiples times a day would take a long time in a home setting and some of the activities are not reusable. I am working on a scrapbooking activity, which would be ongoing and anyone who comes over can do with Mom. I am really excited about it so as soon as I get that done I will post it.

Blessings,

Rev. Katie

Wednesday, April 18, 2012

Montessori: Changing the Way We Think of Dementia

How many times have you heard these comments about people with dementia?:

"People with dementia can't learn new things."
"All you can expect him/her to do is sit and watch TV."
"Dementia patients can't contribute to society anymore."
"You can have a person with dementia do the same task over and over again because they never remember it anyway."

My family and I have been told all of these things about dementia. We have been told to put Mom in an adult daycare where they fold towels over and over again. In our hearts Dad and I just felt that this was not right. We knew there had to be something better out there. We knew Mom, and each person with dementia, is still a person who deserves dignity and respect and who has the ability to contribute to the world in a purposeful way. From the medical field though we were hearing the exact opposite.

Instinctively I knew that what the medical field was saying could not be what laid in store for Mom. In fact, my whole theology revolves around showing people dignity and respect and helping people find purpose and meaning in their lives. With those two things, people feel happy, whole, and find their connection to that which is greater than themselves (God, the Universe, etc...). What people were saying about Mom went against my theology and my understanding of the world. I knew it couldn't be true, but had no proof until this week.
Dr. Maria Montessori 1870-1952

For two days Dad, Mom's caregiver, and I attended a Montessori-based dementia training with the Center for Applied Research in Dementia with Dr. Cameron Camp. This training showed me that we can help Mom have a wonderful and meaningful life even with her Lewy Body Dementia. What annoys me is that I did not see it before.

I went to a Montessori school until eighth grade and I know that is where the core of my belief system came from. I have preached about Dr. Maria Montessori and how her values are in line with Unitarian Universalism. My son goes to a Montessori school. Montessori has been a part of my life forever, yet I also live in a world which drills it into our heads the belief that people can't learn for themselves and they have no value if they are not fast, brilliant, and controllable. After eighth grade, I learned to live in this system because I had to, but I lost some of myself along the way. That's why I didn't notice that if I just applied Montessori principles to life, we could take care of Mom much better.

Dr. Camp taught us:
"People with dementia can learn new things."
"You can expect him/her to participate in activities they enjoy every day."
"Dementia patients contribute amazing things to society when we give them the chance."
"Never have a person with dementia do busywork, like folding towels all day, that does not honor their worth and dignity."

You will see many blog posts in the future about the Montessori method and how we will use it in our care with Mom and with the participants in our weekly dementia program. Right now I am just so excited to be reminded of how Montessori changes lives. As a person with mental illness, I know the Montessori teachings were what enabled me to believe in myself and figure out how to use my strengths to contribute to the world. Without it I would have only focused on what I can't do. Forgetting about the core Montessori teachings meant that we were only focusing on what Mom can't do. Well, no more. Mom has lots of great things ahead of her thanks to Dr. Camp and his colleagues who have brought Montessori to people of all ages. I am glad now I can return to my parents the gift of Montessori that my Mom and Dad gave me.

Blessings,

Rev. Katie