A Montessori Project at Lakeview - Alzheimer’s Australia Model of Care for People Living with Dementia

Lakeview is currently involved in a project called Montessori which has shown a reduction in resident aggressive behaviours and in the use of antipsychotic medications which was identified during the QPS Benchmarking reporting cycle. The achievement of zero resident aggressive behaviours is a key strength for the organisation in providing a safer and more enjoyable environment for residents and staff.

How did we become involved in the Project?

Mount View Aged Care Facility was asked by Western District Health Service who worked in partnership with Alzheimers Australia Vic (AAV) to develop and implement a Montessori model of dementia care across Western Victoria. A number of Residential Aged Care Facilities across the Western District participated in-depth training sessions, 3 days at 6 hours per day so the model of care can be successfully embedded into our workplace culture.  The training included mentoring sessions on site, with staff and residents and their families, so that staff can see the benefits for the residents they care for daily. We were asked to provide a small working party to send to the in depth study sessions. These people were responsible in coming back to the facility to educate all the staff and were the leaders in the implementation phase at Mount View Aged Care Facility.

What is Montessori

Montessori for Dementia is a model of care, a new way to deliver care which requires us to change what we all thought we knew about dementia and providing care for people living with dementia. Montessori for dementia focuses on supporting both the person and the environment which is adapted to support memory loss and maintaining independence.

Changing the way we think about dementia

Goals

The goal is to create the kind of place we would want to live.

Montessori for Dementia enables individuals to be as independent as possible, to have a meaningful place in their community, to have high self-esteem, and to have the chance to make choices and meaningful contributions to their community.

What are the 12 Principles?

Montessori is a model of care developed and promoted by Alzheimer’s Australia Evidence based with 12 principles These principles are designed to focus on the person’s capabilities, capturing their interest and showing respect. It is important that the focus builds on the person’s strengths. The principles are structured in order that you will use them when interacting with a person with dementia.

1. The activity should have a sense of purpose and capture interest
2. Invite the person to participate
3. Offer choices whenever possible
4. Talk less. Demonstrate more
5. Physical Skills. Focus on what the person can do
6. Match your speed. Slow down!
7. Use visual hints, cues and templates
8. Give the person something to hold
9. Go from simple to complex
10. Break the task down into steps
11. To end, ask: “Did you enjoy doing this?” and “Would you like to do this again?”
12. There is no right and wrong.

Goals

By Implementing Montessori Model of Care we hoped to reduce behaviours, reduce falls reduce medications and provide our resident’s with a more fulfilled life and being able to promote their independence. This was done by us sitting down and discussing a few of our residents who had challenging behaviours. We tried to work out who the person was behind the dementia. This involved unwrapping the past and who they were and being able to match their strengths with their personal history. We aimed to repeat the activities each day to develop routines, by doing this we hoped to build confidence and self-esteem of our residents. We hoped to educate all our staff so they can provide a supportive environment for our residents.

Residents are encouraged to voice their opinions

Small Steps Improvement

At our study sessions we have been encourage to start with small projects to implement across our facility so other staff can see the positive effects that the projects can have on the residents

We started with three projects on the go throughout the time the project has occurred. We have a resident who attends to our daily board each day. This includes changing the day, date, weather, and activity of the day. The resident has taken ownership of this position and enjoys doing this when he comes down to the dining room after breakfast.

We have developed a make shift letter box (whilst we are having one built by our residents at men’s shed). We have a resident who checks the mail each day and sorts the mail out and delivers the mail to other residents. This satisfies the residents need to go outside each day. The resident takes great pride in being able to deliver the mail and feels extremely important and has contributed to the other residents.

We have also set up a “beauty room”. The beauty is designed for the ladies and they all have an appointment and can have any beauty treatment they wish. Most of the ladies enjoy being able to have their hair blow dried, styled nicely, pedicure or a manicure. This is thoroughly enjoyed by all that attend the beauty room.

Outcomes

With the implementation of the three projects we have been able to increase our resident’s independence by enabling them to have better choices for themselves, they are offered freedom of choice and are encourage to voice their opinions, especially when it comes to their care. This is demonstrated by encouraging residents to complete as much of their care as possible and enables them to have simple pleasures in being able to choose what clothes they wear. At Mount View we aim to support our residents with their memory loss by placing familiar signs as memory prompts around the facility. We have individualized our activities program which provides more meaningful activities for our residents. This provides our residents with a feeling of sense of importance and satisfaction when they are able to participate and complete the activity. Families have reported improved visits with their relative. As a result of the implementation of the Montessori model of care we have had a reduction in behaviours such as wandering often associated with dementia and also a decrease in the use of antipsychotics. As a result this has decreased the work load of staff as there are less behaviours exhibited. Our residents appear to be sleeping better due to the changes implemented. Overall, we have better care outcomes for the residents with dementia as a result of the Montessori model of care.

Tracey Harris, NUM