Although there is plenty of information for care partners of those living with dementia, this interview with the man who adapted Dr. Maria Montessori’s method of teaching will surely provide new insight and inspiration to many. So much can be done to help care partners help their loved ones who are the same people they’ve always been…but happen to have dementia.
Engaging in meaningful activities throughout the day helps to bring a more peaceful sleep at night. It also helps those afflicted to practice and re-learn daily activities like feeding themselves, and more.
This interview provides information for care partners who accompany persons with dementia. Dr. Cameron J. Camp, the originator of the scientifically proven adapted Montessori method for the elderly with dementia, visited Slovenia recently and gave a lecture on the adapted method at the St.Jožef’s Home in Celje, where the method was first used in Slovenia two years ago.
The following is a translated transcript of the interview. Attribution to interviewer to follow.
What is your method?
It is a way of life based on four basic values: respect, dignity, equality and trust. Whatever we do, we have to ask ourselves whether it will be respectful to others, dignified, whether people will be treated equally and whether it will build trust between us. If the answer is yes, then we are doing the right thing. We are treating others as we would like to be treated. We need to create the environment in which we ourselves would like to live. We need to show people what we want them to do. We invite them to do something, we do not show them. This way puts people in control of the situation. In everything we do, we offer choice. Choice determines the quality of life. A place where you have no choice is a prison. If you have no choice, it is not your life. We give a resident in a nursing home a choice if, say, we ask him which shirt he would like to wear.
Why did you develop this method?
I started working with people with dementia when my children started attending a Montessori school, my wife is a Montessori teacher. I was working on memory in aging, but none of the techniques were effective with people with dementia. When I saw a Montessori school, I thought that this could be the way to go. Maria Montessori was a visionary, a fighter for human rights. And this is a fight for human rights. To give independence to people who are in long-term care, to give them choice, to give them freedom and to treat them the way you want to be treated. I was once called by a gentleman who was building a nursing home and asked what it would be like if everyone had their own room and shared a bathroom. It would be cheaper that way. And I asked him if he wanted to share a bathroom. In France, they have been doing this for a few years and we are seeing wonderful results – residents putting on musicals, and people learning to play the piano.
Information for Care Partners: Yes! A person with dementia can do many things.
With dementia?
Yes. They also write stories. In the US they make their own cheese, others make jams, brew beer, and some make homemade, natural dishwasher detergent. With the money they earn, they buy pets, dogs and cats.
Can a person with dementia be happy?
When a lady from the south of France moved into a home, the animator told her that she had to do exercises to strengthen herself. But she asked why, saying she had nothing to live for. The animator replied that she would like to take her to a concert for her birthday and what would she like to hear. She said she would listen to something she had never listened to before. So she took her to a reggae concert. During the concert, the band and the whole audience sang Happy Birthday to her. She went backstage and was also in the newspaper. Last week, I asked her in a lecture if she was happy. And she said, ‘Of course.’
(She shows us a smiling photo of her from the concert, op. p.)
Which country has been particularly successful in using the method?
France, Switzerland. In the French part of Switzerland, if an inspector comes to a retirement home, the first thing he asks is whether they use the Montessori method.
Is it the norm?
It is becoming the norm. In France, the state pays for staff training in non-drug methods for dementia. Montessori is at the top of the list.
Information for Care Partners: Those with dementia can learn!
You seem to be challenging neuroscience.
Yes. Neuroscience often says that people with dementia cannot learn. That is the lie of dementia. People with dementia learn all the time. We are not trained to measure it, to look for it, to see it, even though it is right in front of our noses. Residents learn which chair to sit in at lunch. They learn when they already have a diagnosis of dementia.
Why?
Because there are learning systems in the brain that have developed early in a person’s life and are not damaged by dementia. But we are not looking for that. We are looking for deficits, we are testing whether the person will fail. Failure gives us a diagnosis, but it does not help, it does not tell us what to do, and so we are left only to give the person medication that is consistent with the diagnosis. It is necessary to know a person’s abilities and to know who he is.
In Switzerland, there was a resident who refused to change into his pajamas in the evening. He walked around at night, and at 3 am, others woke up to see him at the door, fully dressed. We found out that he was a fireman. They sleep with their clothes on because minutes can make the difference between survival and death. To show a man like that nice pajamas is crazy. But we said he should sleep in fresh clothes every night.
The next question was what would be meaningful for him to do during the day. Because if you work during the day, you will be able to sleep at night.
People need to be given autonomy and choice, explains Cameron J. Camp.
What do you think about locking up people with dementia?
It is important to ask why this is happening. The answer must never be that dementia is the cause. How do we know that a person has dementia? Just because it is happening? It is necessary to ask him why he wants to leave. One woman said she had to get her car and she had not driven for 15 years. She needs to go home. Home is a place where you have control over your life, and responsibilities, you know the people you live with. To prevent people from being forced to go home, they need to feel at home. To have their things in their rooms, to know who their neighbors are, to call them by name, so we have name tags on our T-shirts. We need to give them a sense of purpose, to make them feel part of a community. If that happens, they will not be forced to go home because they will already be home.
But until then?
They need to find activities that mean something to them, because refugee-hood is when they have nothing to do. Either they are helpless or they are completely absent. The cure for both conditions is activity. If they are, say, in a cooking committee and they are all together cutting and peeling vegetables, throwing them in the pot and talking, they don’t bother to go home. And when the staff are saying goodbye, they tell themselves to close and lock the door. Just like we lock our own home.
Information for Care Partners: See their abilities, not what they cannot do.
So you just have to look at it from a different angle.
Yes, it is a different way of thinking. To see the abilities that a person has, not what they cannot do. Let’s say there is a woman on the cooking committee who, on the one hand, is lame. She was given a board with big nails pointing upwards, she put vegetables on it, took a peeler and peeled them herself. Did she have a board like that when she was a child, a young wife? No. That is to say, she only learned to use it after her diagnosis of dementia and after her stroke. When people say that people with dementia cannot learn, I think of her. Maria Montessori said they would learn through their hands. Learning by doing – this system of learning in the brain is still available for people with dementia if we want to use it. When you look at a paralyzed woman, do you see the paralyzed part or do you see the good arm? Do you see potential or do you see what she cannot do? That is our decision. We have to learn to see with new eyes. And not to believe the lie. If they can learn, what do you want them to learn and what do they want to learn?
Reggae?
Why not? Remember the face of the woman at the concert. Is she suffering? We often hear that people suffer from dementia, Alzheimer’s disease. We treat dementia by giving the person a good life. That is the best treatment.
Montessori taught children. Is it a sign of disrespect for the elderly if you use this method for them?
Montessori did not treat children as “children”, but as people. That is a big difference. People are treated with respect, dignity, equality. We give everyone choice, meaning, and purpose, we give everyone the opportunity to be part of a community, and to do meaningful work. Montessori said that when the environment supports the individual’s capacities, gives them meaningful activities, activities with meaning, and enables them to become part of the community, a process she called normalization begins. It is our duty to create environments that bring normalization for older people with memory impairment. To enable them to be ‘normal’. And this is possible in the right environment.
Until the end?
Why not? If we have the option, why not take it? What we create for the elderly is what we ourselves will live in. Why not live well until you die?
The world would be a better place if we measured what we can do, not what we can’t do.
Of course. We can apply this approach to employees too. What they can do, not what they cannot do, are not able to do. Are we respectful to our employees, do we maintain their dignity, are they equals, do we trust them? Do we coach or supervise? Do we show them what to do or do we tell them what to do? It is not about treating people like children. It is about giving people choices. They should not be hard-wired, controlled, and thereby ‘normalized’. That is why dictators, whether they run a state, a retirement home or a family, hate the Montessori method.
What is the perspective, the future?
This method should be the norm. I would like it to be my future. We have to create this environment ourselves.
Dr. Cameron Camp is the Director of Research & Development for the:
