9 Principles of the Montessori Approach for Dementia Care

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People living with dementia deserve to live to their full potential, with meaningful activities and the right support to achieve maximum engagement in social and leisure pursuits.

Engagement and participation are good indicators of quality of life for nursing homes and other senior care organisations.

There are many types of psychosocial interventions available and the Montessori approach is just one of them. Acknowledged for successfully improving the lives of the elderly living with dementia, the Montessori method offers flexible activities focusing on people’s strengths, abilities and interests.

9 Principles of The Montessori Approach

With Montessori activities, Activity staff should encourage people to be as independent as possible and to do what they can for themselves. Here are some of the ground rules for the Montessori approach.

1. Match Interests
The activity will have a sense of purpose and match the person’s interest. Whether physical, creative or a daily living activity, it must capture the person’s interest.

2. Invite
An invitation is important. If the person refuses, try another time.

3. Ask them to choose
Offer two or three activities to choose from - let the person determine what is meaningful to them. Setup activities on a table and ask: ‘Which one would you like to do?’ - If the person cannot choose, you may ask: ‘How about this one?’ Point and observe the person’s response for signs of interest.

4. Demonstrate
Demonstrate the activity and match their talking pace, voice volume, and how much they speak.

5. Support
Observe what the person is doing or is trying to do e.g. alphabet blocks, drying dishes, sorting colours. Support without interfering (don’t do it for them unless demonstrating).

6. Provide cues and visual hints
Some people will have difficulties to understand what you are saying. In this case, you can start the activity demonstrating. If the activity is sorting, sort the first items and then encourage them to repeat the process.

7. Start with simple tasks
The activity should be successful, so it is best to start with simple tasks. Be aware however that if it is too easy, the person may lose interest. Offer alternative activities in this case. They should feel competent and appreciated.

8. Break the activity into steps
If needed, break the task into small steps. For example, if a male participant is completing a 12-piece vintage car puzzle, slowly pick up the car’s bonnet and wait for a response; if he is unsure, set the bonnet in place. Then, show him the car bumper bar and let him hold it, encourage him: ‘Where does this piece goes?’. And so on with each piece.

9. Strive for engagement
Think about engagement rather than the outcome. Remember, the right way is their way. You are only providing a framework to help them organise their thoughts. Praise the participant at the end of an activity and invite them along for more sessions.

12 Examples of Suitable Montessori-style Activities

Think of activities that alert the mind by stimulating the five senses: sight, taste, hearing, smell and touch. For example:

Tasting foreign fruit
Listening to music of their choice
Dancing
Differentiating textures
Simple puzzles
Recognizing famous people
Identifying objects: vegetables, utensils etc
Rolling dough or pastry
Peeling vegetables
Beating eggs
Making sandwiches
Sanding a table

You may also offer activities that involve pouring, scooping, matching, sorting, counting, cooking, threading, bouncing, passing, and others.

Be Prepared to Switch to a Different Activity

Some activities may bring negative behavioral changes caused by frustration at not being able to do what was once routine. If this is the case, change the activity and try something else.

It is also important to establish that participants are not fatigued or sedated before engaging in activities as this often leads to apathy.