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MONTESSORI FOR AGING & DEMENTIA

PRACTIONER’S CERTIFICATE COURSE WORKBOOK

1© 2020 BRUSH DEVELOPMENT WWW.BRUSHDEVELOPMENT.COM

TABLE OF CONTENTS

Welcome....................................................................................................................................4

ABOUT THE COURSE................................................................................................5Course Schedule & Syllabus.......................................................................................................6

Checklist of Requirements.........................................................................................................8

Microsoft Teams Instructions..................................................................................................10

Instructions for Submitting Required Documentation.............................................................12

Instructor’s Checklist for Course Completion..........................................................................13

GETTING STARTED.................................................................................................15Securing a Field Placement for your Case Studies...................................................................16

Case Study Call Script & Formal Proposal................................................................................17

Case Study Flyer.......................................................................................................................19

Obtaining Consent...................................................................................................................21

Consent Form.......................................................................................................................... 22

Principles of Good Practice during Field Work.........................................................................24

SAMPLES & GUIDANCE..........................................................................................25Sample Meaningful Engagement Plan.....................................................................................26

10 Tips for Creating Step-by-Step Tasks...................................................................................30

CASE STUDY 1........................................................................................................32Consent Form.......................................................................................................................... 33

Individualized Assessment.......................................................................................................35

Part 1: Personal Information................................................................................................35

Part 2: Cognition and Language...........................................................................................38

Part 3: Observation..............................................................................................................40

Reading Screening Form..........................................................................................................41

Meaningful Engagement Plan..................................................................................................43

Meaningful Engagement Log...................................................................................................45

CASE STUDY 2........................................................................................................46Consent Form.......................................................................................................................... 47


Individualized Assessment.......................................................................................................49

Part 1: Personal Information................................................................................................49

Part 2: Cognition and Language...........................................................................................52

Part 3: Observation..............................................................................................................54

Reading Screening Form..........................................................................................................55

Meaningful Engagement Plan..................................................................................................57

Meaningful Engagement Log...................................................................................................59

ADDITIONAL REQUIREMENTS...............................................................................60Essay........................................................................................................................................ 61

Practitioner’s Certification Quiz...............................................................................................62


Welcome

Congratulations! You are embarking on an exciting step in your professional journey. Montessori is transforming elder care communities to environments of joy and purpose where older adults can flourish!

We highly recommend that you keep a private journal of reflection during this process. It is helpful to have a place to record your feelings about working with individuals living with dementia. This can help you to deal with feelings of sadness, joy, frustration, hopefulness, helplessness, etc., that you may experience when working with a person who has memory loss. When we take time to consider and deal with our emotions, we are more effective as facilitators with other individuals. Allow yourself to acknowledge any feelings that may arise without judgement. Please feel free to talk about these issues during our class if you wish. We are here to support you.

Jennifer and Margaret


ABOUT THE COURSE


Course Schedule & Syllabus

REQUIRED BEFORE THE END OF THE COURSE (SELF-PACED)1. Read Montessori for Elder and Dementia Care by Jennifer Brush

MONTH ONE Read Montessori: A Modern Approach or Dr. Montessori’s Handbook (optional for those

already Montessori certified) Watch video Case Study Requirements Join the mandatory live coaching session July 28, 2020 from 7:30-9:00 PM EST.

MONTH TWO Watch 2 videos: Assessment and Engagement Plans & Implementation Ideas Join the mandatory live coaching session August 25, 2020 from 7:30 – 8:30 EST Homework: Create and submit an engagement plan for a real or hypothetical person

before the August class date. Use the template in your workbook as a guide. Be prepared to discuss this in class

Homework: Find case study participants

MONTH THREE Listen to Class 3: What is Montessori? Observe for at least ½ day at a Montessori School. We recommend visiting a class for 3-6

year-old children and a class for 6-9 year-old children. Complete the observation from, submit the assignment and be prepared to discuss at

September class. Join the mandatory live coaching session September 29, 2020 from 7:30 – 8:30 EST Homework: Start your case studies

MONTH FOUR Read Memory Aids by Michelle Bourgeois Watch to Dementia Friendly Environments Homework: Create a 10 page memory book for yourself or for an elder Homework: Find one barrier in a care environment and be prepared to discuss how to

transform it to support elders Join the mandatory live coaching session October 27, 2020 from 7:30 – 8:30 EST

MONTH FIVE


Read Spaced Retrieval Step by Step: An Evidence Based Memory Intervention by Benigas, Brush, and Elliot

Watch Spaced Retrieval Create a need, lead question and response for an elder with cognitive impairment Join the mandatory live coaching session November 24, 2020 from 7:30 – 8:30 EST

MONTH Six Online presentations of case studies December 14, 2020 from 7:30 – 8:30 EST

Turn in all paperwork December 1, 2020

NEXT STEPS Course requirements are assessed and you are either notified via email of passing the

course or asked to make corrections or resubmit new work. Brush Development emails you an AMI and a Brush Development certificate

o With this certificate, you will be qualified as Montessori for Aging and Dementia Certified Practitioner, and you will be able to develop and implement this innovative intervention for older adults and people with dementia and serve as a resource for others in your care setting.

o The 2-day Montessori for Aging and Dementia Workshop and Practitioner Certification do not qualify you to teach or train others in Montessori for Aging and Dementia. An AMI Trainer’s Certification is required to teach the AMI Montessori for Aging and Dementia curriculum.


Checklist of Requirements

Task and Paperwork Date Completed

Date Submitted

Observe for at least ½ day at a Montessori School. We recommend visiting a class for 3-6 year old children and a class for 7-9 year old children (optional for those already Montessori certified)

N/A

Read Montessori for Elder and Dementia Care by Brush N/A

Read Spaced Retrieval Step by Step: An Evidence Based Memory Intervention by Benigas, Brush, and Elliot

N/A

Read Dr. Montessori’s Own Handbook by Montessori or Montessori: A Modern Approach, The Classic Introduction to Montessori for Parents and Teachers by Polk Lillard (if you are not a Montessori Guide already).

N/A

Read Memory and Communication Aids for People with Dementia by Bourgeois.

N/A

Student Information Form (submit as part of completed case study file)

Identified and obtained consent (use form) for at least two people with dementia (submit as part of completed case study file).

2 Reading Screenings (submit as part of complete case study file), one for each case study

2 Personal Information Forms (submit as part of completed case study file)

2 Planning Meaningful Engagement Forms (submit as part of completed case study file)

Templates and/or other materials made for the activities, including any examples or expansion programming, if developed (submit as part of completed case study file)


2 Activity Instruction Sheets: Create instructions to enable other staff or family members to implement the activity (submit as part of completed case study file) for each person.

Templates and/or other materials made for the role, including any examples or expansion programming, if developed (submit as part of completed case study file)

2 Role Instruction Sheets: Create instructions to enable other staff or family members to implement the role (submit as part of completed case study file) for each person.

Document 10 interactions (working on a role or activity) you have completed with each person living with dementia on the Montessori Record Keeping Log (submit as part of completed case study file).

Write at least a 1,000-word paper discussing lessons learned from participation in the training and your experience implementing some of the Montessori principles. It should include any successes and challenges you may have experienced (submit as part of completed case study file).

Complete a written examination based on the topics covered in the 2-day workshop and the suggested reading (submit as part of completed case study file).Present your case studies to your AMI Trainer and submit the competed files two weeks prior to your presentation. Label file with your last name first, then first name, initials of case study, then the date. Upload all information to the online course.


Microsoft Teams Instructions

We use Microsoft Teams to manage all of the live coaching sessions for this class. You will be emailed a link via email at the beginning of the semester.

Using Microsoft Teams

Here's how a guest becomes a member of a team:

Step 1 – Welcome EmailYou will receive a welcome email with a link to join a team called Practitioner Certificate Course. DO NOT LOOSE THIS LINK. It cannot easily be reissued.

Step 2 – Accept the Invitation or Create an AccountGuests who have an email address that belongs to an Azure Active Directory or Office 365 account can accept the invitation directly. If you don’t have a Microsoft account associated with your email address, you will be directed to create one for free.

Step 3 – Explore TeamsAfter accepting the invitation, you can participate in teams and channels, receive and respond to channel messages, access files in channels, participate in chats, join meetings, collaborate on documents, and more. For more details, see What the guest experience is like.

Step 4 – Click on the Files TabYou can access all of the files you need in the Team account set up for the course. Click on the Files tab to access and download class documents. You will upload all of your files into the folder with your name on it.

Please read the instructions on how to accept Teams meeting invitations on page 2.

Joining an Online Team Meeting10© 2020 BRUSH DEVELOPMENT WWW.BRUSHDEVELOPMENT.COM

https://docs.microsoft.com/en-us/microsoftteams/guest-experience

https://docs.microsoft.com/en-us/microsoftteams/guest-experience

https://support.office.com/article/access-files-in-channels-c593c78a-27c4-4661-a598-682baa30ca7e

https://support.office.com/article/teams-and-channels-df38ae23-8f85-46d3-b071-cb11b9de5499

All you need to join a Teams meeting is a link.

When you open the link or select Join Microsoft Teams Meeting in your meeting invite, you’ll be taken to a page where you can choose to either join on the web or download the desktop app and then join. If you already have the Teams app, the meeting will open there automatically.

If you don’t have a Teams account and the organizer has allowed it, you may have the option to enter your name to join the meeting as a guest. If you do have a Teams account, select Sign in to join with access to the meeting chat and more. Then, depending on the organizer’s settings, you may join the meeting right away or go to the “lobby” where people in the meeting can admit you.

Some users, for some strange reason we haven’t figured out, (often with MAC users) can’t open the link and need to go to Microsoft Teams and set up a free account. If you have having trouble using the link we sent, set up a free account, then try again. you may need to set up a free Teams account


Instructions for Submitting Required Documentation

We strongly suggest you keep a copy of submitted assessment tasks for your own records.

Use only initials or first names of individuals to ensure anonymity.

All assessment tasks, the multiple-choice quiz, and your presentation session will be graded to determine an outcome of “Competent” or “Not Yet Competent.” If necessary, you will be given the opportunity to revise what you submit within 60 days.

Submitting Your Case StudiesWhen each study is complete, please copy and paste the pages of your case study – starting with the Consent Form and ending with the Meaningful Engagement Plan – into a new Word document and “save as.” Name the document with the following naming convention:

[Your last name, Your first name] - Case Study [Elder’s Initials] – [Date submitted].For example: Doe, Jane - Case Study RF - 1.15.20

Copy and paste the Activity and Role pages in the Meaningful Engagement Plan as many times as you need to include all of the activities and roles you created for this elder. Paste in any illustrations, photos, or templates you created for each activity and role.

Upload this document as a pdf into the course assignment area provided.

Submitting the EssayWhen your essay is complete, please copy and paste the pages of your essay into a new Word document and “save as.” Name the document with the following naming convention:

[Your last name, Your first name] - Essay - [Date submitted].For example: Doe, Jane - Essay - 1.15.20

Upload this document as a pdf into the course assignment area provided.

Take your final test online


Instructor’s Checklist for Course Completion

Your instructor will use this form to evaluate your case studies, paper, and oral presentation. Written and oral feedback will be provided where improvement is needed.

Student thoroughly completed the personal information form for all case studies

Student developed an appropriate activity for case study 1 based on the information collected about the person

Student developed an appropriate role for case study 1 based on the information collected about the person

Student developed templates and materials for case study 1 that clearly reflect the Montessori philosophy of care for the activity and role

Student clearly and accurately explained how to expand or modify this activity and role for case study 1

Student created appropriate environmental supports for case study 1

Student created a step-by-step instruction sheet for each role and activity with enough detail that another care partner could use it as an implementation guide

Student developed an appropriate activity for case study 2 based on the information collected about the person

Student developed an appropriate role for case study 2 based on the information collected about the person

Student developed templates and materials for case study 2 that clearly reflect the Montessori philosophy of care for the activity and role

Student clearly and accurately explained how to expand or modify this activity and role for case study 2

Student created appropriate environmental supports for case study 2

Student created a step-by-step instruction sheet for each role and activity with enough detail that another care partner could use it as an implementation guide


Student scored at least 80% on the quiz

Student’s paper indicated an understanding of the importance of:o knowing the persono facilitating meaningful roles and activities that meet human tendencieso invitation to the activityo demonstrating the activityo observation and reflectiono praise of the persono collaborating as a teamo task breakdowno modification and/or extension of activities


GETTING STARTED


Securing a Field Placement for your Case Studies

You will need to get permission from a care community to conduct your two case studies. After researching the communities in your area, select a community with an Assisted Living and/or Memory Care program to contact.

When you call the community, ask to speak to the Volunteer Coordinator. We have provided a sample script for the initial contact and a formal proposal that you can offer to provide the community. We have also provided a flyer that you can provide the community.

You may be asked to attend a volunteer training before you begin your case study work. You will also need to obtain consent from the two elders (or their families) to participate before you begin the individualized assessment.


Case Study Call Script & Formal Proposal

Initial CallHello, my name is ___________ and I am working to become a Certified Practitioner of Montessori for Aging and Dementia. As part of this training, I am required to conduct two case studies with older adults diagnosed with dementia, and I’m wondering if I could speak to your Life Enrichment Coordinator to discuss the possibility of doing this work in your community.

When Speaking to the Volunteer Coordinator (or other Administrator)Hello, my name is ___________ and I am working to become a Certified Practitioner of Montessori for Aging and Dementia. As part of this training, I am required to conduct two case studies with older adults diagnosed with dementia over a three to six-month period. I am wondering if I would be able to do this work in your community as a volunteer. If you think it’s a possibility, I would be happy to send you more information or come in to meet with you at your convenience.

Formal Proposal My name is ___________ and I am working to become a Certified Practitioner of Montessori for Aging and Dementia through Brush Development Company and the Association Montessori Internationale. This certification will enable me to implement roles and activities and create a prepared environment for older adults using Montessori principles. As part of this training, I am required to conduct two case studies with older adults diagnosed with dementia over a three to six-month period.

Description of Case StudiesThe requirements of the case studies are as follows:

1. Obtain Consent

2. Conduct Individualized Assessment (via Personal Information Form)● Cognition and Language (including Reading Screening)● Personal Observation● Personal Interview

3. Create Meaningful Engagement Plan● Identify a role, invite the individual, and create a routine to support this role● Design and introduce a Montessori activity● Create role and activity instructions (so family or other staff can implement them)● Work with the individual on the role and activity over ten sessions. ● Perform an environmental scan and make recommendations


● Create personalized memory aids (as appropriate) to address the following:● Memory book● Orientation● Facilitate care activities● Needs, wants, and safety● Increase engagement and activity● Encourage social interactions● Modify challenging behaviors

● Use the spaced retrieval technique to reinforce one important concept

Who will participate in the study?Two older adults residing in an Assisted Living or Memory Care community with early to mid-stage signs (or a diagnosis) of dementia. These individuals will be selected by the care community.

Duration of the studyI have a six-month time frame to complete the case study (starting in ______). I propose meeting with each of the selected individuals once a week for twelve weeks.

Risks and BenefitsMy hope is that the participant in this case study will enjoy the process and benefit from the personalized activities. The individual will have the option to end participation at any point. I will not collect any medical information. I will only record the person’s initials in the forms that I use to document my case study experience.

How will consent be obtainedConsent will be obtained through a consent form.

Qualifications of person conducting the studyDescribe your background and education here.

Thank you for your consideration!

Signature


Case Study FlyerPractitioner’s Certificate in Montessori for Aging and Dementia

The AMI Practitioner Certification is an international certification open to care partners, health care professionals, and Montessori educators who want to complete an in-depth study in order to apply the principles of Montessori to working with elders. The program is taught by Jennifer Brush, an AMI Certified Montessori Educator. Jennifer is one of just two dementia care experts in the US on the International Advisory Board for Montessori for Aging and Dementia and the only person in the US who teaches this AMI program.

Jennifer Brush, MA, CCC/SLP is an award-winning Dementia Educator, consultant, and author of six books. She has 25 years of industry experience, including leading countless live national and international trainings and facilitating ground-breaking research. Jennifer serves as the Program Director for The National Center for Montessori and Aging at Crossway Community.

The Practitioner’s CertificateHolding the certificate enables the practitioner to implement roles, design activities, and create prepared environments for older adults using Montessori principles. Practitioners can serve asrole models and leaders in care communities and help to establish Montessoriprogramming. Practitioners are not be qualified to serve as trainers.

The Certification ProcessThe certification process includes readings, online classes, completion of two in-depth case studies with older adults, writing a 1,000-word paper, passing a written examination, and giving a final presentation. It takes a minimum of 60-80 hours to complete these requirements.

About Brush DevelopmentBrush Development provides education in person-directed dementia care and Montessori for Dementia that enables health care professionals to create supportive memory care environments and implement effective dementia programming. Brush Development is the approved AMI training center for Montessori for Aging and Dementia in the United States, offering classes in person anywhere in the world. Brush also offers private in-home and internet-based coaching to families and persons living with dementia in an effort to help individuals successfully age in place at home.


Practitioner’s Certificate in Montessori for Aging and Dementia

Case Study Requirements:

1. Obtain Consent from two older adult residing in an Assisted Living or Memory Care community with early to mid-stage signs (or a diagnosis) of dementia. The care community will select these individuals.

2. Conduct Individualized Assessment (via Personal Information Form)● Cognition and Language (including Reading Screening)● Personal Observation● Personal Interview

3. Create and Implement a Meaningful Engagement Plan● Identify a role, invite the individual, and create a routine to support this role● Design and introduce a Montessori activity● Create role and activity instructions (so family or other staff can implement them)● Perform an environmental scan and make recommendations● Create personalized memory aids (as appropriate) to address the following:

● Memory book● Orientation● Facilitate care activities● Needs, wants, and safety● Increase engagement and activity● Encourage social interactions● Modify challenging behaviors

● Use the spaced retrieval technique to reinforce one important concept

Duration:After the initial assessments are complete, the volunteer will work with each individual on the designed roles and activities over ten sessions. The student volunteer has six months to complete these two case studies.

SupervisionRemote supervision of the student volunteer will be provided by Jennifer Brush. To reach Jennifer with questions or concerns, you may email her at [email protected].


mailto:[email protected]

Obtaining Consent

Students completing the Montessori for Aging and Dementia Certification course complete two case studies with older adults who have memory concerns or a diagnosis of dementia. Individuals can be living in a care community or at home. Individuals living with memory impairment or dementia are able to make a number of decisions regarding their own life. Either the older adult, or their responsibility party for health care decision making, must consent to participating in the case study.

If the person has volunteered him/herself for the course project and is living at home, typically the person will be able to sign their own consent. If the person indicates that a spouse or adult child makes their healthcare decisions, the student will ask the designated person to sign the consent form in addition to the person with dementia.

If the older adult lives in a care community, the student will ask the nurse or other medical processional in charge of the person’s care if the person is his/her own decision maker. The student will ask the care community to facilitate contact with the responsible party, if indicated, for consent to participate.

At no time will a student ask for medical history or access to any medical records.


Consent Form

I, [LEARNER NAME], am a student enrolled in Brush Development’s Practitioner’s Certification Program titled Montessori for Aging and Dementia. The course provides knowledge and skills in the creation and facilitation of Montessori environments for people living with dementia including the development of both activities and roles. The activities may include matching/sorting tasks, reading groups, and/or roles involving common household duties such as setting the table or making the bed. These are all designed to aid independence and promote each person’s sense of self-worth, so that each person is able to make a contribution to their community.

As part of this education and training course, I need to complete two case studies with older adults that include a number of tasks including:

Conducting a personalized assessment via interview of the older adult and the person’s family (if the older adult is not able to provide the needed information). This information includes a screening of reading and cognitive ability as well as a profile of past roles, likes and dislikes, and current abilities

Developing an engagement plan in collaboration with the older adult to promote independence and involvement in meaningful daily activities

Making the necessary related Montessori materials

Visiting at least 10 times to participate in activities with the older adult

All information will be kept confidential and only used for the purposes of the certification. All paperwork submitted for grading will only have the person’s initials and no identifying information.

Please tick the relevant circle in each case to indicate whether or not your consent with each request.

Consent Requested for:

Consent

Given

No Consent

Consent for collection of personal information (no access to medical records) for case studies for the above Montessori Certification ⃝M ⃝MConsent to participate in meaningful activities for the about Montessori Certification. ⃝M ⃝MPhotographs taken that will be used for the purposes of this Montessori Certification Assessment only. ⃝M ⃝M

Individual‘s Name: Date:

Name of Responsible Party: Signature:


Address:

Comments: (e.g., permission via phone conversation):


Principles of Good Practice during Field Work

The adult learner will: Endeavour to be physically, mentally, and emotionally prepared for field work Observe the norms and rules of the healthcare setting where s/he is completing her/his

field work Be sensitive to, and respect the culture of the healthcare setting where s/he is completing

her/his field work Understand the limits of his/her competence in a new situation but be willing to explore

new skills Accept constructive feedback Respect and adhere to the principle of confidentiality at all times Be aware of boundary issues, in particular the boundaries of personal and professional

engagements Be aware that any form of physical, verbal, or emotional abuse is deemed unethical and

unprofessional behavior Adhere to ethical guidelines while completing assignments during field work

Adult learners are expected to consistently demonstrate the professional attributes of: Knowledge and Understanding - Knowledge is a fundamental component of Montessori

education; knowledge of methodologies and pedagogy and also knowledge of the theories underpinning methodologies. In line with Montessori philosophy, learners will have the knowledge bases necessary to create the conditions, for adults to be active in their own learning.

Commitment - Learners are expected to prepare, be organized, be punctual, be responsible and generally act in a professional manner while on placement. They must show dedication, to their studies, and also to the social, cultural, emotional and cognitive development of the adults in their care.

Inclusion - Learners are required to develop and maintain a respectful, caring and sensitive attitude towards, peers, healthcare personnel, and people living with dementia. During field work they must be respectful of diversity and be prepared to recognize and respond to the differentiated needs of older adults.

Ethical Practice - During field work learners will respect the rights of all in a consistent, impartial and confidential manner

Collaboration - Learners are expected to demonstrate good interpersonal skills and to be willing to work as part of a team during field work. They should be aware that as guests in their host healthcare settings they need to make themselves aware of the norms and rules of the setting. They should seek assistance from their supervisor(s) and accept and act upon constructive feedback.


SAMPLES & GUIDANCE


Sample Meaningful Engagement Plan

Elder’s Name: Jane Doe

ACTIVITIES

Pouring Beans

Rationale (based on strengths, abilities, interests, and needs): The elder would like to pour her own coffee in the morning.

Purpose: Preliminary activity that may lead to the next activity of pouring coffee. Maintaining pincer grasp when cleaning up spilled beans.

Materials/Templates Needed: Tray Placemat that contrasts from the table and materials Two identical clear pitchers, lightweight with a large handle to hold One pitcher filled ¾ full of black beans

Control of Error: Add a large-print sign that says “Please pour beans into the empty pitcher.”

Modifications for Different Abilities: For those who have more manual dexterity and stable hands when holding the pitcher,

you can use black or colored rice instead. These will pour faster, and if they spill, they require more dexterity to clean up. The rice needs to be a dark color so the person can see the grains when pouring and if they spill.

If the pitcher is too heavy, help support pouring by holding the handle with the and/or supporting the bottom of the pitcher with your hand.

Step-By-Step Instructions:

Preparation:

Preparation can be done before the person starts the activity, or follow the steps with them to make this part of the activity.

1. Bring the tray to the table.27© 2020 BRUSH DEVELOPMENT WWW.BRUSHDEVELOPMENT.COM

2. Unroll the mat and place on the table.

3. Place both pitchers on the mat, the one with the beans on the dominant hand side of the elder.

4. Place the tray off to the side.

Instructions:

First demonstrate a step and then invite the person to participate in the step.

1. Pick up the pitcher with the beans in it, supporting the bottom of the pitcher with your other hand if needed.

2. Move the spout of the pitcher with beans over to the center of the empty pitcher and slowly pour the black beans from the first pitcher into the empty one.

3. Pick up any spilled beans, one at a time, and place them back into the pitcher with the beans.

4. Repeat steps 1-3 as often as desired between the two pitchers.

5. Bring the tray back to the table.

6. Pick up the pitcher with the beans and place on the tray.

7. Pick up the empty pitcher and place on the tray.

8. Roll up the mat.

9. Place the mat on the tray.


ROLES

Setting the Table

Rationale (based on strengths, abilities, interests, and needs): The resident enjoys helping staff prepare for mealtimes.

Purpose: Maintain role in the community of setting the table. Practice in sequencing of a task.

Materials/Environmental Supports Needed: Tray or rolling cart Laminated paper placemats with outlines of a dinner plate, napkin, fork, knife, spoon,

and cup Dinner plates, forks, knives, spoons, cups, napkins Separate, labeled baskets for that keep utensils sorted by kind

How will you create a routine to support this role? Invite resident to set the tables at 11:30am and 4:30pm each day.

Control of Error: Place the napkins and utensils each in their own bins that are different colors. Color the

outlined areas on the placemat the same color as the item. (This gives another cue, allowing the person to match by color and shape, rather than just by shape.)

Hand the person each item they are to place instead of having them choose the items off the tray themselves. (Only do this if you have tried color coding the items or creating other ways they could do it independently.)

Modifications for Different Abilities: Some people may not need the placemat with the outlines on it. For them, just provide

solid colored placemats and a picture of the finished place setting for them to refer to if needed.

Make an activity out of creating the placemats with the outlined items on them.



Preparation:


1. Bring tray or rolling cart with supplies over to the table to be set, in easy reach of the elder.

Instructions:

Demonstrate one full place setting and then let the elder follow what they saw with the rest of the place settings for the table. You can offer guidance cues by pointing or handing them items as they go along.

1. Place the placemat down on the table in front of the seat.

2. Pick up the napkin from the tray and place it over the outline of the napkin.

3. Repeat step 2 with all the other items for the place setting.

4. Invite the elder, or with the elder, place down all of the other place setting placemats you need for that meal.

5. Invite the elder to complete step 2 for each item on the place setting.


10 Tips for Creating Step-by-Step Tasks

1. Know the person! While you can create a general framework for a task, you will almost always need to modify the breakdown and setup of the task for the specific person. The person may also have movement, hearing or sight limitations.

2. Brainstorm all the possible steps. You could say that there are three steps to brushing your teeth:

Put toothpaste on the toothbrush. Wet the toothbrush. Brush your teeth.

However, brushing your teeth actually has many, many more steps: Pick up the toothpaste tube. Unscrew the cap from the toothpaste and place the cap on the sink. Hold the toothpaste in your right hand (if the person is right handed). Pick up your toothbrush in your left hand. Place the toothbrush head under the opening of the toothpaste tube and squeeze

toothpaste out with your right hand. Place the toothpaste tube on the sink. With your right hand, turn the water on. Put your toothbrush in your right hand. Place the toothbrush under the water to get it wet. Bring the toothbrush to your mouth and smile. Place the toothbrush on your front teeth and move the brush right and left. Push the toothbrush to the right side of your mouth and move the brush right and left. Push the toothbrush to the right side of your mouth and move the brush right and left. Now open your mouth and flip the toothbrush so the brush is facing the roof of your

mouth and move the brush onto the bottom of your teeth on the right side and move the brush forward and back.

Etc...If you know all of the potential steps, you can help a person figure out what step they need as a cue for them. Some people may need detailed steps on getting the toothpaste on the toothbrush, but as soon as they put the brush in their mouth, procedural memory kicks in and they can brush their teeth. Others may need step-by-step instructions on how to move the brush when it is in their mouth.

3. Use items and words that make sense to the person. One person may call the bathroom a “powder room” and another may call it a “restroom.” Some people may recognize an electric toothbrush, others may not.

4. Who are the instructions for? Are you making a sign of photos and word instructions for a person with dementia to follow to wash their hands on their own? Or, are you writing out instructions for their guide to demonstrate how to set the table to a person with dementia


so the person with dementia can follow the guide? Make sure all words are big enough to read and all photos are big enough to see.

5. Are they reading the steps, hearing the steps, watching the steps, or some combination? Some people may be able to follow photos of handwashing on their own. Others may need words with the photos. Others may not be able to use the photos at all and the guide will need to show each step to the person and invite them to follow. For example, at two sinks, the guide turns on the water and then asks or indicates to the person to turn on their own water. The guide then pumps soap out of the soap dispenser on their own hands and indicates or asks the person to do the same with their soap dispenser, etc...

6. What modifications might be needed? If you are writing out general instructions to be used by family members or staff, always put in some suggestions for modifications so that the task can be modified for a person with a different ability level, or if the person’s own abilities change over time. For example, if a person is making notecards and you give them a sticker to place on the card, some people may be able to just follow the step of “Place the sticker on the card.” For others, that is too confusing and you would modify it by placing a black dot on the card and saying or showing “Place the sticker on the black dot.”

7. What templates are needed? The black dot in the notecard example above is an example of the template. Do the glasses need to have a line drawn around them so the person is cued to stop pouring juice when it reaches the line?

8. What special supplies and signs are needed? Clear glass cups so they can see the juice and they do not overfill the glass? Large handled paint brushes due to issues with manual dexterity? Sign that says: “Please put the napkins in the ring.”

9. What greater environment considerations are needed? In order to help a person eat on their own, do you need to note that the tablecloth needs to be a contrasting color to the plates used? Can this task be done in a loud common room, or in a smaller room with no music and not a lot of people?

10. Observe then modify. Always try out your step-by-step instructions with the people you will be working with and see if they work! If they do not work, it is probably not set up in a way that works for them. This is not your fault or their fault, it just is. Observe what parts of the process work for the person and what does not and observe why that might be happening. For example, we may have talked them through the steps when what they really need is for us to demonstrate the steps and have them follow us. Or, the process may be correct, but you are doing a task in a crowded and loud room or a room with low light, so the larger environment is making the task inaccessible. Reminder: Never correct a person with dementia.

© Brush & Norris, 2018


CASE STUDY 1Each case study should include the following:

Consent Form Individualized Assessment Reading Screening Form Meaningful Engagement Plan (including at least 1 activity and 1 role) Meaningful Engagement Log


Consent Form

I, [LEARNER NAME], am a student enrolled in Brush Development’s Practitioner’s Certification Program titled Montessori for Aging and Dementia. The course provides knowledge and skills in the creation and facilitation of Montessori environments for people living with dementia including the development of both activities and roles. The activities may include matching/sorting tasks, reading groups, and/or roles involving common household duties such as setting the table or making the bed. These are all designed to aid independence and promote each person’s sense of self-worth, so that each person is able to make a contribution to their community.









Consent

Given

No Consent



Name of Responsible Party: Signature:


Address:



Individualized Assessment

Name (Initials): Date:

Date of Birth: Age: Gender:

Part 1: Personal Information (Use initials for all people listed to maintain confidentiality)

Likes & Dislikes

How do you like to be addressed? (e.g. nickname, Mr., Mrs., Miss, first name)

What hobbies and activities do you enjoy?

What is your favorite way to spend the day?

Do you like to listen to music? Yes No If yes, what kind(s)?

Do you play an instrument? Yes No If yes, what instrument(s) do you play?

Do you enjoy singing? Yes No

Do you like to read? Yes No What do you like to read (e.g. science fiction, romance, adventure)?

Do you like watching TV? Yes No What are your favorite shows or movies?

Do you like to play games? Yes No What type of games do you like?

Do you like to play sports? Yes No What kind of sports do you like?

What household chores were your responsibility? Which ones do you enjoy?


Personal History

Place of birth:

Name of mother: Name of father:

Name(s) of brothers: Name(s) of sisters:

Place of childhood home:

High school and/or College:

What kind of jobs did you have? (e.g. homemaker, nurse, electrician, teacher)

Military service:

Special honors/Awards:

Places lived as an adult:

What are some of the major milestones in your life? (e.g. important life events)

Clubs or social organizations:

Religious affiliation and related activities or involvements (e.g., deacon, choir, etc.):

Name of spouse:

Date and location of marriage:

Date of spouse’s death (if applicable):

Names of children:

Current occupations of the children:

Names of grandchildren:

Place of residence of children and grandchildren:


Favorite pets (past and/or present):

Memorable vacations:

Best friends:

Any other memorable events or details:

Daily Routines

Daily events: Monday:Tuesday:Wednesday: Thursday:Friday:Saturday:Sunday:

Other activities that are not part of the weekly schedule?

Family who visit:

What makes you physically more comfortable? (e.g. always have glasses on, have a hearing aid in, daily lotion or special soap, favorite robe or sweater)

What makes you happy? (e.g. conversation topics, activities, sports, music performances, being around children/animals)

What do you dislike? (e.g. foods, activities, topics of conversation, sounds, smells, places)What comforts you when you’re upset?

Approximate morning wake up time and bed-time:

What are your wake up and bedtime routines like?

Care partners (name and activity):

Roommate:


Part 2: Cognition and Language

Wears Hearing Aid ❑ Yes ❑ No

Wears glasses ❑ Yes ❑ No

Language(s) spoken:

Conversational Sample:

“Tell me about…” (possible topics: your family, your favorite holiday, or your typical day)

Notes:

Conversational Features:

Present Absent No Opportunity

Single words only

Short phrases only

Few sentences

Many sentences

Initiates new topic

Requests clarification

Takes turns

Asks questions


Orientation to Environment:

Independent Requires Assistance Unable

Locates the dining room

Locates the bathroom

Locates the bedroom

Locates the activity room

Other:

Reading:

Could the individual read before the onset of memory loss? ❑ Yes ❑ No

What language(s) does the individual read? ❑ English ❑ French ❑ Spanish ❑ Other

Does the individual require glasses? ❑ Yes ❑ No ❑ For distance ❑ For

reading

What does the person enjoy reading? ❑ Signs ❑ Magazines ❑ Books

What book is the person currently reading?

Administer the attached Reading Screening.

What font size does this person require? ____

Ask the elder to read a short passage from a book at the required font size.

Does the person read aloud? ❑ Yes ❑ No

Does the person make reading errors? ❑ Yes ❑ No

Does the person transition from page to page? ❑ Yes ❑ No

Does the person engage in conversation about book? ❑ Yes ❑ No


Part 3: Observation

Social Communication:


Communicates wants and needs

Makes likes/dislikes known

Initiates conversations

Asks questions

Answers questions

Presence of Responsive Behaviors:

Behavior According To Description (including time of day)

Activities of Daily Living:

Assistance Needed

Mobility Independent Cane Walker Wheelchair

Eating Independent Some Assistance Much Assistance Totally dependent

Grooming Independent Some Assistance Much Assistance Totally dependent

Dressing Independent Some Assistance Much Assistance Totally dependent

Toileting Independent Some Assistance Much Assistance Totally dependent

Bathing Independent Some Assistance Much Assistance Totally dependent


Reading Screening Form


Directions:

1. Ask the individual to help you determine the size of type that he/she can comfortably read.

2. Print each sentence on the following page on its own page. Ask the individual to hold one page at a time in his or her non-dominant hand.

3. Starting with the first page, point to the sentence. Say, “Read the sentence aloud and then do what it says.” Repeat for each page/sentence. Record the person’s responses below.

Type size

Read the sentence aloud and do what it

says.

Was the response read aloud?

(NR=No Response)

For an incomplete response, circle

which words were not read.

Was the task completed?

(NR=No Response)

Yes No NR Yes No NR

72 pt Pat your head. Pat your head.

48 pt Close your eyes. Close your eyes.

36 pt Point to the ceiling. Point to the ceiling.

24 pt Stick out your tongue. Stick out your tongue.

16 pt Touch your nose. Touch your nose.

12 pt Tap the table. Tap the table.

4. Using the necessary font size, create a sign with the person’s name and room number. Place it on a wall 48–60 inches off the ground. (Use the lower height if the person is in a wheelchair).

5. Position the individual 10 feet away from the sign.

6. Ask the individual to read the sign aloud and then record the person’s response.

Did the individual correctly read their name? ❑ Yes ❑ No ❑ No ResponseDid the individual correctly read their room number? ❑ Yes ❑ No ❑ No Response

From Spaced Retrieval Step by Step: An Evidence-Based Memory Intervention, by Jeanette E. Benigas, Jennifer A. Brush, and Gail M. Elliot. Copyright © 2016 by Health Professions Press, Inc. All rights reserved. www.healthpropress.com.


http://www.healthpropress.com/

Pat your head.Close your eyes.

Point to the ceiling.

Stick out your tongue.

Touch your nose.

Tap the table.



Meaningful Engagement Plan

Elder’s Initials:

NAME OF ACTIVITY:

Rationale (based on strengths, abilities, interests, and needs):

Purpose:

Materials/Templates Needed:

Control of Error:

Modifications for Different Abilities:


Preparation:


1.

Instructions:


1.

Please attached photos, illustrations, or templates here.


Elder’s Initials:

NAME OF ROLE:


Purpose:

Materials/Environmental Supports Needed:

How will you create a routine to support this role?

Control of Error:



Preparation:


1.

Instructions:


1.

Please attached photos, illustrations, or templates here.


Meaningful Engagement Log

Initials of Participant:Student Log Sheet (to be completed by the student after every interaction)


Date & Lengthof Activity(in minutes)

Activity/Role

Supports Provided(i.e., visual,

cognitive, physical)

Level of Engagement

(i.e., interest,joyful, distracted,struggling, etc.)

Modifications Made to

Presentationof Activity

Notes for Planning

Next Session

CASE STUDY 2Each case study should include the following:

Consent Form Individualized Assessment Reading Screening Form Meaningful Engagement Log Meaningful Engagement Plan (including at least 1 activity and 1 role)


Consent Form

I, [LEARNER NAME], am a student enrolled in Brush Development’s Practitioner’s Certification Program titled Montessori for Aging and Dementia.

The course provides knowledge and skills in the creation and facilitation of Montessori environments for people living with dementia including the development of both activities and roles. The activities may include matching/sorting tasks, reading groups, and/or roles involving common household duties such as setting the table or making the bed. These are all designed to aid independence and promote each person’s sense of self-worth, so that each person is able to make a contribution to their community.









Consent

Given

No Consent




Name of Responsible Party: Signature:Address:



Individualized Assessment


Date of Birth: Age: Gender:

Part 1: Personal Information (Use initials for all people listed to maintain confidentiality)

Likes & Dislikes

How do you like to be addressed? (e.g. nickname, Mr., Mrs., Miss, first name)

What hobbies and activities do you enjoy?

What is your favorite way to spend the day?

Do you like to listen to music? Yes No If yes, what kind(s)?

Do you play an instrument? Yes No If yes, what instrument(s) do you play?

Do you enjoy singing? Yes No

Do you like to read? Yes No What do you like to read (e.g. science fiction, romance, adventure)?

Do you like watching TV? Yes No What are your favorite shows or movies?

Do you like to play games? Yes No What type of games do you like?

Do you like to play sports? Yes No What kind of sports do you like?

What household chores were your responsibility? Which ones do you enjoy?


Personal History

Place of birth:

Name of mother: Name of father:

Name(s) of brothers: Name(s) of sisters:

Place of childhood home:

High school and/or College:

What kind of jobs did you have? (e.g. homemaker, nurse, electrician, teacher)

Military service:

Special honors/Awards:

Places lived as an adult:

What are some of the major milestones in your life? (e.g. important life events)

Clubs or social organizations:

Religious affiliation and related activities or involvements (e.g., deacon, choir, etc.):

Name of spouse:

Date and location of marriage:

Date of spouse’s death (if applicable):

Names of children:

Current occupations of the children:

Names of grandchildren:

Place of residence of children and grandchildren:


Favorite pets (past and/or present):

Memorable vacations:

Best friends:

Any other memorable events or details:

Daily Routines

Daily events: Monday:Tuesday:Wednesday: Thursday:Friday:Saturday:Sunday:

Other activities that are not part of the weekly schedule?

Family who visit:

What makes you physically more comfortable? (e.g. always have glasses on, have a hearing aid in, daily lotion or special soap, favorite robe or sweater)

What makes you happy? (e.g. conversation topics, activities, sports, music performances, being around children/animals)

What do you dislike? (e.g. foods, activities, topics of conversation, sounds, smells, places)What comforts you when you’re upset?

Approximate morning wake up time and bed-time:

What are your wake up and bedtime routines like?

Care partners (name and activity):

Roommate:


Part 2: Cognition and Language

Wears Hearing Aid ❑ Yes ❑ No

Wears glasses ❑ Yes ❑ No

Language(s) spoken:

Conversational Sample:

“Tell me about…” (possible topics: your family, your favorite holiday, or your typical day)

Notes:

Conversational Features:

Present Absent No Opportunity

Single words only

Short phrases only

Few sentences

Many sentences

Initiates new topic

Requests clarification

Takes turns

Asks questions


Orientation to Environment:


Locates the dining room

Locates the bathroom

Locates the bedroom

Locates the activity room

Other:

Reading:

Could the individual read before the onset of memory loss? ❑ Yes ❑ No

What language(s) does the individual read? ❑ English ❑ French ❑ Spanish ❑ Other

Does the individual require glasses? ❑ Yes ❑ No ❑ For distance ❑ For

reading

What does the person enjoy reading? ❑ Signs ❑ Magazines ❑ Books

What book is the person currently reading?

Administer the attached Reading Screening.

What font size does this person require? ____

Ask the elder to read a short passage from a book at the required font size.

Does the person read aloud? ❑ Yes ❑ No

Does the person make reading errors? ❑ Yes ❑ No

Does the person transition from page to page? ❑ Yes ❑ No

Does the person engage in conversation about book? ❑ Yes ❑ No


Part 3: Observation

Social Communication:


Communicates wants and needs

Makes likes/dislikes known

Initiates conversations

Asks questions

Answers questions

Presence of Responsive Behaviors:

Behavior According To Description (including time of day)

Activities of Daily Living:

Assistance Needed

Mobility Independent Cane Walker Wheelchair

Eating Independent Some Assistance Much Assistance Totally dependent

Grooming Independent Some Assistance Much Assistance Totally dependent

Dressing Independent Some Assistance Much Assistance Totally dependent

Toileting Independent Some Assistance Much Assistance Totally dependent

Bathing Independent Some Assistance Much Assistance Totally dependent


Reading Screening Form


Directions:

1. Ask the individual to help you determine the size of type that he/she can comfortably read.

2. Print each sentence on the following page on its own page. Ask the individual to hold one page at a time in his or her non-dominant hand.

3. Starting with the first page, point to the sentence. Say, “Read the sentence aloud and then do what it says.” Repeat for each page/sentence. Record the person’s responses below.

Type size

Read the sentence aloud and do what it

says.

Was the response read aloud?

(NR=No Response)

For an incomplete response, circle

which words were not read.

Was the task completed?

(NR=No Response)

Yes No NR Yes No NR

72 pt Pat your head. Pat your head.

48 pt Close your eyes. Close your eyes.

36 pt Point to the ceiling. Point to the ceiling.

24 pt Stick out your tongue. Stick out your tongue.

16 pt Touch your nose. Touch your nose.

12 pt Tap the table. Tap the table.

4. Using the necessary font size, create a sign with the person’s name and room number. Place it on a wall 48–60 inches off the ground. (Use the lower height if the person is in a wheelchair).

5. Position the individual 10 feet away from the sign.

6. Ask the individual to read the sign aloud and then record the person’s response.

Did the individual correctly read their name? ❑ Yes ❑ No ❑ No ResponseDid the individual correctly read their room number? ❑ Yes ❑ No ❑ No Response



http://www.healthpropress.com/

Pat your head.Close your eyes.

Point to the ceiling.

Stick out your tongue.

Touch your nose.

Tap the table.



Meaningful Engagement Plan

Elder’s Initials:

NAME OF ACTIVITY:


Purpose:

Materials/Templates Needed:

Control of Error:



Preparation:


2.

Instructions:


2.


Elder’s Initials:

NAME OF ROLE:


Purpose:

Materials/Environmental Supports Needed:

How will you create a routine to support this role?

Control of Error:



Preparation:


2.

Instructions:



Meaningful Engagement Log

Initials of Participant:Student Log Sheet (to be completed by the student after every interaction)


Date & Lengthof Activity(in minutes)

Activity/Role

Supports Provided(i.e., visual,

cognitive, physical)

Level of Engagement

(i.e., interest,joyful, distracted,struggling, etc.)

Modifications Made to

Presentationof Activity

Notes for Planning

Next Session

ADDITIONAL REQUIREMENTS


EssayWrite at least a 1,000-word paper discussing lessons learned from participation in the training and your experience of implementing Montessori for Aging and Dementia. It should include any successes and challenges you may have experienced and demonstrate your knowledge of the philosophy of care.


Practitioner’s Certification Quiz

Please highlight the correct answer(s).

1. An important part of the Montessori philosophy isa. To enable individuals to be as independent as possibleb. To have all daily activities completed for the personc. To possess high self-esteemd. a & ce. a & b

2. Mark all of the components of a Montessori programa. The care community is a prepared environment for older adultsb. Activities and roles are introduced that are below the person’s cognitive deficitsc. Activities and roles have meaning and purposed. Materials use pastel colorse. Older adults choose materials freely and are able to respond to their own

internal needsf. Older adults are encouraged to repeat activities and develop routinesg. Older adults allow others to do things for themh. Older adults are encouraged to do as much for themselves as possiblei. Dignity is maintained at all times

3. Mark all of the human tendencies as identified by Maria Montessoria. Explorationb. Facilitationc. Successiond. Manipulatione. Workf. Repetitiong. Strictnessh. Abstractioni. Perfection

4. Order bringsa. Chaos and confusionb. Anxietyc. Predictability and securityd. Internal instability

5. The prepared Montessori environmenta. Facilitates movement and activityb. Uses sound and light at a minimum


c. Reduces all stimulationd. Restricts access to the outdoors

6. Long-term care communities that embrace culture change area. Places where elders stay in their homes until they die without assistanceb. Places where elders can continue to live, make their own choices, and have

control over their daily livesc. Places where elders can do whatever they want, whenever they wantd. Places where elders come from the same ethnic and cultural background

7. Dementia isa. A serious muscular disease affecting over 4.5 million people in the U.S.b. A diagnosis that means a life sentence of despairc. A blood disorder that impacts problem solving abilitiesd. A term that describes a wide range of symptoms associated with a decline in

memory or other thinking skills8. Immediate memory refers to

a. Information you learned yesterdayb. Information learned immediately after birthc. Information learned an hour agod. Information actively held in your mind

9. People with dementia can benefit from treatment plans that include environmental modifications that

a. Change the environment regardless of the person’s needs or functional limitations

b. Have been identified based on objective assessment of the environment and the needs of the client

c. Are developed as part of an annual inspection process of the long-term care setting

d. Result from standardized clinical assessments of communication dysfunction10. The typical 60-year old only receives about ____ the retinal illuminance of a 20-year-old.

a. One halfb. Twice as muchc. One thirdd. One eighth

11. People with dementia have a. Problems with depth perceptionb. Difficulty judging colorsc. Difficulty judging contrastd. All of the above


12. Environmental interventionsa. Put people in a situation that triggers immediate memoryb. Put people in a situation that triggers the right behaviorsc. Put people in a situation that triggers episodic memoryd. Put people in a situation that triggers disoriented behaviors

13. One example of an environmental barrier isa. Loud, overhead pagingb. Bright, non-glare lightc. High contrast printd. Frequent wayfinding cues

14. One example of an environmental facilitator isa. Loud, overhead pagingb. Bright, non-glare lightc. Low contrast printd. 60” high wayfinding cues

15. Optimizing visual aspects of the environment includesa. Enhancing lightingb. Enhancing motor organizationc. Reducing sightlinesd. Maximizing glare

16. Spaced Retrieval is thought to use _________, a preserved ability in Alzheimer’s disease.a. Episodic memoryb. Semantic memoryc. Autobiographic memoryd. Procedural memory

17. Spaced Retrieval uses _________ learning techniques. a. Errorlessb. Trial and errorc. Spaced task analysis d. Interval error model

18. Non-declarative memory is considered an area ofa. Preserved cognitive capability in Alzheimer’s diseaseb. Severely impaired cognitive capacity in Alzheimer’s diseasec. Fluctuating cognitive capacity in Alzheimer’s diseased. Absent cognitive capacity in Alzheimer’s disease

19. When someone is actively engaged in a creative activity,a. It is very difficult for he or she to functionb. Stress is reduced, and memories can be accessedc. Anxiety sets in, and attention span decreases


d. He or she will not pay attention to anything going on in the environment20. Tables for communication and activities should be arranged

a. Right next to the windowb. Away from direct light sourcesc. Under exposed bulbsd. In areas of bright, but non-glaring light

21. “Demonstrate and follow” means you should a. Show the finished art piece and ask the person with dementia to make itb. Show the person with dementia how to do the project and then tell them to do itc. Do one step of the project and ask the person with dementia to follow that step

with youd. Show a video of the art project and ask the person with dementia to follow along

22. Challenging behavior isa. A cause of dementiab. A form of communicationc. A cause of memory deficitsd. An act of defiance

23. Task breakdown is the process ofa. Helping a person successfully participate in or complete an activity by making it a

step-by-step process b. Removing things to do from a person’s environmentc. Helping a person successfully participate in or complete an activity by showing

them the finished productd. Completing a task for the person with dementia

24. Error-free activitiesa. Are activities that always look the same every timeb. Do not allow for mistakesc. Are activities that the guide completes for the artist with dementiad. Contain built-in control of mistakes that permits the person to self-correct

25. Choose the sentence that offers choice in an accessible mannera. What do you want to wear today?b. It is time to take a shower.c. Would you like to wear this blue shirt or this red shirt?d. We can have chicken, steak, pasta, or pork chops for dinner - which do you

want?


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