9 x 11 tabbed spiral-bound papercover
Best Friends Book of Alzheimer's Activities, Volume One
Excerpted from the Introduction for Montessori-Based Activities for Persons with Dementia, edited by Cameron J. Camp, Ph.D.
Copyright © 1999 by
This manual has been prepared for use with persons suffering from Alzheimer’s disease (AD) and related disorders. Participants with dementia need cognitive stimulation, along with opportunities to successfully and meaningfully interact with their physical and social environments on a regular basis.
It is extremely important to remember that persons with dementia are, first and foremost, people. Human beings, even those with the memory and cognitive deficits seen in dementia, have basic needs. Among these are: the need to feel a sense of self-worth, the need to express one’s thoughts and feelings, the need to have a sense of belonging, the need to have a sense of accomplishment, and the need to have a sense of order. Many of the problem behaviors associated with dementia can be traced to the inability to meet one or more of these basic human needs. This manual provides stimulating, interesting, and challenging activities that can be performed successfully as a means of helping persons with dementia meet such needs.
What’s Wrong with Activity Programs Today?
Activity programs developed for persons with dementia are often criticized in two ways:
Family members of residents in long-term care often complain that persons with dementia spend large amounts of time disengaged from their environment sleeping, staring into space, making repetitive movements or vocalizations, etc. There is a clear need for more effective activity programming in long-term care settings, where a majority of residents have dementia.
Two major problems are encountered when creating and implementing programming for persons with dementia:
Often when people with dementia show the capacity to engage in an activity, they are continually presented with that same activity. In nursing homes, for example, this is seen when residents sit at a table folding washcloths for extended periods of time. When all the washcloths have been folded, staff may unfold them and ask the residents to start the process over again. Under the best of circumstances, this represents meaningless busy work. Still, if a person with dementia cannot do the activity, what should be provided instead of the washcloth folding? And if the person with dementia can fold washcloths successfully, how can this be made into a more meaningful activity? Also, are there other activities that could be performed by persons with dementia once they demonstrate the ability to fold washcloths? The purpose of this manual is to provide some guidance in answering these questions and solving these two major problems.
Primary Goals for the Manual
This manual used Montessori-based activities as a rehabilitation approach to the treatment of dementia. It is imperative to provide people with AD and related dementias with tasks that enable them to maintain or improve skills needed in their daily lives. These activities enhance the skills required to perform basic tasks such as self-feeding, preparing simple meals, dressing, and participating in recreational activities.
In addition, it is important to provide intellectual stimulation and some amount of challenge, while enabling the successful completion of activities. Engaging memory and reasoning is a worthwhile goal. Finally, Montessori activities are designed to be open-ended; hence there is no final end point. It is hoped that by becoming familiar with the materials, procedures, and underlying principles involved in these activities, readers will be able to create additional activities that are meaningful for the specific participants in their care. Such activities are not childish, nor do they represent busy work. Rather they provide meaningful stimulation as well as guidance in completing tasks successfully. Persons successfully performing activities they perceive as challenging and meaningful are at the “top of their game,” and relish the experience, no matter what their stage of dementia.
Need for an Underlying Theory and Philosophy
The existing problems of activity problems of activity programming for people with dementia are likely to arise when no underlying theory guides the development of activities. This manual and its activities are guided by the work of Maria Montessori. Montessori wanted to create opportunities for children to become self-sufficient, contributing members of society who had respect for themselves and for their physical and social environment. Her theoretical work and philosophy match our own goals.
The mission statement of a good Montessori school closely resembles the mission statements of good long-term care and adult day care facilities. In addition, literally hundreds of activities designed to facilitate cognitive, physical, and social skills have already been field tested for over 80 years in Montessori classrooms.
Montessori activities are planned in sequences, giving guidance and a programmatic perspective to their use. In addition, general principles of Montessori education guide the development of activities. Some of these include the following:
For example, if participants are to match a picture (e.g., Butterfly), with a category label (e.g., INSECT), you could put a colored dot, e.g., a red dot, on the back of the category label and a dot of the same color on the back of the picture of the butterfly. A different colored dot, e.g., green, would go on the back of the pictures for an alternate category label, e.g., MAMMAL, and its corresponding pictures. Thus, participants could look at the red dot on the back of the INSECT label and see if the back of the picture of a butterfly had a red dot (indicating it was an INSECT). Similarly, they could look at a green dot on the back of the MAMMAL label as a means of ensuring that they made the correct selection of category for the picture of a dog.
Folding paper can lead to creating figures such as those made in origami classes. Using a melon scoop can lead to making melon balls eaten for snacks.
For examples, put activities on over-bed tables that adjust in height so that materials can be accessible to persons in wheelchairs. If participants cannot comfortably reach objects, they cannot demonstrate their true competencies.
In a Montessori classroom, activities are contained on shelves that line the room and children go to the shelves to select materials. In long-term care settings, where mobility is often a problem, we have created shelves on wheels that can be brought to participants. Older adults can help select activities, and if they cannot easily pick up a tray and its accompanying materials, the participants can verbally instruct a staff member to bring them materials.
Use large type (48- or 100 point, for example) and a sans serif font such as Helvetica or Arial. Also, avoid long sentences by using single words and short phrases.