When Varnadore “Willie” Williamson first came to JABA’s Adult Day Healthcare Center he was still independent. Later, however, his Alzheimer’s had progressed to the point where he could no longer go to the bathroom by himself. He couldn’t unbuckle his belt.
Ellen Phipps, director of the healthcare center, went next door to the Montessori School and borrowed a buckle frame that three and four-year-olds use to learn to manage buckles.
She gave it to Willie. “He became totally absorbed,” she recalled. “Soon he had relearned a skill that had escaped him.”
That is just one way the Montessori method of teaching skills to preschoolers is finding a use in rehabilitation of Alzheimer’s patients.
In the early 1900s, Maria Montessori developed her method of teaching cognitive, social and functional skills to children. Using materials from everyday life, Montessori taught simple skills, making the tasks more complex as the child advanced.
On this level, Montessori’s method is used for the young who are just learning about their environment. On the other end of the spectrum are adults who are losing their knowledge of the environment. And as Phipps and others who work for the elderly have discovered, the Montessori method works here, too.
As adults advance in their dementia, this loss is a source of frustration and anger. The use of the Montessori tools can resharpen abilities that have been dulled by the disease.
“I used to have a dream that I could use the method to help the clients with the Montessori method,” Phipps said. Before working with adults, she had learned the Montessori method and had been an aide in a Montessori school, so she was well-versed in its concepts. “But could it work?”
From Cleveland, Ohio, came the answer and it was a resounding yes. Psychologist Cameron Camp is a research scientist with the Myers Research Institute of the Menorah Park Center for the Aging in Beachwood, a suburb of Cleveland. For three years he has been testing the method on clients at its adult day care center and he has discovered some amazing things.
* Patients with dementia can prolong the period in which they retain skills.
* Not only do they prolong their retention, they can teach skills to children.
* Agitation, aimless wandering and loss of attention, so prevalent in Alzheimer’s patients, decrease not only during the Montessori lesson period, but for an extended period of time.
No one professes that Montessori will prevent or stop the progression of Alzheimer’s. But Camp and Phipps both believe it delays it – and does something even more important.
It changes the way patients feel about themselves.
Self-worth! Self-esteem! Dignity! These are the words Camp used over and over again and Phipps echoed.
“We look for activities that can enhance their independence,” Camp explained. “If the activity doesn’t do that we change the activity.”
For instance, one activity used at Menorah Park has the client using a scoop to pick up white, yellow and red golf balls and place them in a muffin tin cups painted white, yellow and red.
“If the client can’t put the golf ball in its corresponding colored cup, then we change to balls and cups that are only one color,” Camp explained. “If they can’t use a scoop, they can use their hands.”
For those who have mastered scooping golf balls, they progress to scooping lima beans, then corn, then water – and pretty soon they can feed themselves soup.
Another activity involves a series of photographs. “Is that person happy or unhappy?” the patient would be asked, and the picture would be put into the “happy” or “unhappy” pile.
Music is especially useful, he said, and Phipps agreed that the musical events held at her day care center are very popular. Sing the first bar of music, she said, and the senior will respond with the second line.
The ability to read lasts for a long time, even in severe dementia cases, Camp said, “but the letters have to be a clear font, very large and very thick. If they are done the right way, people who didn’t recognize their own nametags can now read them.”
Word games are often used, such as word bingo or beginning a phrase and having the senior finish it.
“We had a woman who was reluctant to do anything,” Camp said. “We showed cards and she said she couldn’t read anymore. I held up the card ‘Chicago.’ She looked at it and said, ‘I’m from a small town.'”
Besides independence, the activities also enhance the patients’ awareness. Some Alzheimer’s patients doze all day long, remaining awake and aware only a few minutes at a time.
“After two months, one of our clients was awake 30 to 45 minutes at a time – even when we were not doing Montessori activities,” Camp said. “Another patient who had stopped talking, began again after two months of participation in Montessori activities.”
Perhaps the most remarkable feat is when people who were totally disengaged become involved in intergenerational activities. The children at the Montessori School which is located in the JABA building are frequent visitors to the Adult Day Healthcare Center, where they join in dancing and often perform for the seniors.
At Menorah Park, the children from the employees’ day care center, which is not Montessori-oriented, learn from the seniors. In one activity, a senior was paired with a child to whom the senior taught phonics using a block with a letter cut out of sandpaper.
The senior rubs the letter with her finger until she knows what it is, Camp explained. Then she is shown objects that have the letter; for instance for W she might be given a wagon or water. Once she is comfortable with the letter, she teaches it to the child.
“We had rehearsed a woman to be videoed for a scientific presentation,” Camp recounted. “The plan called for her to hand the child the block and have him trace the “T” all the while pronouncing it until he got it. Then she’d give him a toy. ‘Toy,’ she said. Then she took a teabag. ‘Teabag,’ she said, giving it to him.
“Then she asked, ‘What is the word on the teabag?’ We wondered what she was doing; she was going off script. ‘See,’ she said. ‘It says Lip-ton.'”
The Montessori method is working so well that Camp hopes to teach volunteers and family members to use it at home. He has developed a manual that offers guidelines for using the principles and directions for specific activities that Phipps is using to train her aides. It is Phipps’ hope to bring Camp to JABA for a training program.
Phipps has been borrowing Montessori equipment from the school, but she would like to have her own.
“If there is a handyman out there who loves creating, we would love to talk to him about making the Montessori toys. It could be very meaningful to someone’s life.”
Providing a purpose to a life is the point of the program. No one expects Maria Montessori’s methods for teaching children to reverse the progress of a degenerating disease.
“The purpose is to make their lives meaningful. To give them dignity. To foster their self-esteem,” she said. “What better way is there to do that than to make them feel useful and help them regain some independence.”
This article was republished with the author’s permission in Tomorrow’s Child magazine.
