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Stock #12674
(ISBN 978-1-878812-67-4)
76 pages
9” x 11” tabbed spiral-bound papercover
© 1999

Related Titles:

Montessori-Based Activities for Persons with Dementia, Volume 2

Memory and Communication Aids for People with Dementia

The Best Friends Book of Alzheimer's Activities, Volume One

Movement with Meaning

The Positive Interactions Program of Activities for People with Alzheimer's Disease

The Sunshine on My Face

Engaging and Communicating with People Who Have Dementia: Finding and Using Their Strengths

Montessori-Based Activities for Persons with Dementia, Volume 1

Edited by Cameron J. Camp, Ph.D.

Excerpted from the Introduction for Montessori-Based Activities for Persons with Dementia, edited by Cameron J. Camp, Ph.D.

Copyright © 1999 by Menorah Park Center for Senior Living. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.


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: 

  • Activities given to persons with dementia are often viewed as childish or busy work.
  • Not enough activities are provided.

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:

  • What should be done if an activity is presented and they cannot successfully complete the task? 
  • What should be done if an activity is presented and they can successfully complete the task?

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 Principles

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:

  • Use real life materials that are aesthetically pleasing.
  • Progress from the simple to the complex.
  • Structure materials and procedures so participants will work from left to right, and from top to bottom. 
  • These patterns parallel eye and head movements associated with reading (in Western cultures). 
  • Arrange materials in order from largest to smallest, and from most to least. 
  • Allow learning to progress in a sequence.
  • Ideally, this occurs through observation, followed by recognition, and then through recall or demonstration. 
  • Break down activities into component parts, and practice one component at a time. 
  • Ensure that participants have the physical and cognitive capability to manipulate materials and understand what is required to accomplish a task. 
  • It is important to minimize the risk of failure and maximize the chance of success. 
  • Use as little vocalization as possible when demonstrating activities. 
  • Match your speed of movement to the speed of the participants when presenting activities. 
  • Almost always use slow and deliberate movements, especially when demonstrating an activity. 
  • Make the materials and activities self-correcting. 

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.  

  • Have the participants create something that can be used whenever possible. 

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. 

  • Adapt the environment to the needs of the participants. 

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. 

  • Whenever possible, let participants select the activities they will work with. 

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.

  • Accommodate for vision problems associated with aging and dementia when using labels. 

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. 

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