I'm Still Here

“I’m Still Here”

How Montessori helps adults living with dementia

By Sarah Burke

The need for innovative solutions to memory care has never been greater. An estimated 5.4 million Americans are currently living with Alzheimer’s disease, and that number is expected to nearly triple to 13 million by 2050.

Through a partnership with the Hearthstone Institute in Boston, the Jewish Association on Aging (JAA) is learning how to apply Montessori principles to help adults with dementia live more meaningful, dignified lives. While most people associate Montessori methods with preschools rather than memory care facilities, this interpretation of the philosophy also represents a return to its roots.

Italian physician and educator Maria Montessori opened her first school in 1906 and began developing teaching techniques to rehabilitate people with cognitive disabilities. Her approach – in which students choose their own tasks, materials, and projects in a lovingly prepared environment – is grounded in the human rights principles of respect, dignity, independence, and choice.

"I'm Still Here" by Dr. John Zeisel.

“I’m Still Here” by Dr. John Zeisel.

By training its entire staff in the Montessori-based “I’m Still Here” approach outlined in Dr. John Zeisel’s book of the same name, the JAA aims to engage seniors with memory impairments in meaningful activities, focus on the strengths and abilities of each individual, create purposeful social roles, and emphasize connections to the larger community.

“The basic premise is that, even when living with memory impairments, the foundation of the person is still there,” said Martha Martel, the JAA’s executive director of the Residence at Weinberg Village and director of memory care programming.

The “I’m Still Here” approach encourages connecting with that person by taking their interests, abilities, and history into account. Care providers find out what their residents did for a living, what hobbies they enjoyed, and what mattered most to them in life. Then they create personalized opportunities for residents to engage in rewarding work, whether it’s painting, gardening, going for a hike, or repairing appliances.

“I’m Still Here” treats people living with dementia as highly creative, capable, and emotionally intelligent. At the Hearthstone Institute’s own memory care facilities in Massachusetts, residents are participating in book clubs and other activities once considered out of reach for people with dementia.

Hearthstone Institute trainer Sue Blackler demonstrates to JAA staff the challenges someone with dementia faces when following instructions, such as how to make a peanut butter and jelly sandwich.

Hearthstone Institute trainer Sue Blackler demonstrates to JAA staff the challenges someone with dementia faces when following instructions, such as how to make a peanut butter and jelly sandwich.

A primary goal of “I’m Still Here” is to reduce the four A’s of Alzheimer’s – anxiety, agitation, aggression, and apathy – without the use of medication. If residents are happy and busy during the day, they are less likely to exhibit these behaviors and more likely to sleep through the night.

While the JAA is still completing its training and it is too early to report final outcomes, Martel says residents are already sleeping better and experiencing fewer falls. In addition, employee and family member satisfaction has increased since the “I’m Still Here” program began.

The JAA is on track to become the first “I’m Still Here” Center of Excellence in Pennsylvania this fall.