Memento Montessori

Teaching methods that work on kids help old people struggling with dementia.

The Man Who Cried
On bad days, the crusty old soldier was listless. He didn't even recognize his dearest friends. But ask him about the Spanish Civil War, and he'd instantly perk up, rattling off the names of bygone dictators like it was 1934.

"That Franco is such a Fascist," he'd rail. "You wouldn't believe!" Alzheimer's disease had ravaged his memory, but glimmers of his feisty former self remained.

Those glimmers are what Cameron Camp looks for. A researcher at Menorah Park nursing home in Beachwood, Camp helps old people with dementia stay as mentally spry as possible.

"Therapeutic nihilism -- that's what we're battling against," he's fond of saying. "The idea that nothing can be done with these people. That the best thing we can do is make them comfortable."

For the old soldier, Camp fashioned a flashcard game that involved sorting the names of Spanish war heroes into "Fascist" and "Communist" piles.

"It got him talking," Camp recalls. "It became a very different visit than 'How are you doing? How are you feeling?'"

People who have lost their memory don't lose their desire to learn, says Camp, a balding, affable man with a professorial mien. They crave human contact just like everybody else, and they get bored just like everybody else.

"We've got people here who play the piano," he says. "They might not know who they are, but they can still plunk out a good tune." They shouldn't spend their twilight years watching paint peel off the wall. If their memory is shot full of Swiss-cheese holes, their intellect can be stimulated in ways that don't require memory, Camp says.

One way is through Montessori teaching methods, which were designed for children. Camp, whose wife teaches at a Montessori preschool, has found that they work wonders with demential residents, too. That's because in Montessori, remembering a task isn't as important as dividing it into a series of steps and practicing it repeatedly.

Camp first considered using Montessori in geriatrics almost 20 years ago, while a psychologist at an adult day-care center in New Orleans. He'd just enrolled his son in a Montessori school there.

"I got to see the classroom and all the materials they had," he remembers. There was a child-sized stove and instructional placemats with outlines for spoon, fork, and knife. "They looked exactly like the kinds of materials I'd been looking for to provide support for people with dementia.

"The idea lingered in the back of my mind for about 10 years. Then I dusted it off and started dabbling in it."

Soon, he had elderly clients sorting golf balls by color to improve their dexterity. He had them matching pictures with words, so they could better recognize common objects.

Six years ago, he moved his studies to Cleveland because of what he calls Menorah Park's reputation for "audacious research." Since then, he's published two manuals on improving memory through Montessori, which have been translated into several languages.

"It's not uncommon for us to work with people on the day before they die," he remarks. "No matter what stage they're in, we should be asking, 'How can we improve their lives?' We do that with people who are blind or deaf or can't walk, so why not someone with dementia?"

Not one to miss a golden opportunity, Camp has made good use of Menorah Park's day-care center, where employees drop off their children. If their parents say it's OK, preschoolers can participate in "Intergenerational Montessori" activities several times a week. Each child is paired with a demential resident, who "teaches" them basic tasks like folding clothes and stringing beads. When teacher and student both get stuck, an aide untangles them.

In the activity room, Ethel, a dainty woman with orange lipstick and matching orange fingernails, examines a row of perfume vials filled with distinct scents like gingerbread and cinnamon. Her partner, a preschooler named Marissa, climbs on a nearby chair, her colorfully banded braids bouncing every which way.

"Who are you?" asks Ethel. She's met Marissa many times, but she has no place to store the memory, so every meeting is the first.

Ethel uncorks a vial and takes a whiff. She can't quite place the scent. Then Marissa gives it a try, correctly identifying it as banana.

"Good job," encourages Ethel. After about 10 minutes of this, they both start fidgeting. But their concentration skills are actually pretty good, says Camp.

"Both will surprise you -- 3-year-olds and 93-year-olds with dementia -- if you give them something they wanna do. I've found they have very long attention spans, if they're engaged."

Compared to most nursing homes, Menorah is luxurious. Its amenities include an Olympic-sized pool and a research institute.

"But our archetype is a woman in a 50-bed facility in Pocatello, Idaho," Camp relates. "Are there ways of taking our training methods and applying them to help her?" To branch out, he's teaching Montessori techniques to family members and home health aides.

Annette Lusher is one such recruit. Her 98-year-old mother, Rose, has dementia. Since Rose was once a homemaker, many of her Montessori games have involved pretend grocery shopping. Rose adds up prices of plastic fruits and vegetables for her daughter, then makes change. When she does it right, Rose "gets very gleeful," says Lusher.

Men with dementia are less thrilled by grocery shopping. "We had a plumber who would not do a darn thing with us," says Nicole Schneider, one of Camp's assistants. "So we told him something was broken -- 'Show me how to fix it' -- and he went right at it." They brought him sink pipes, which he identified and deftly assembled.

Camp is a bit short on guy-centered activities, so he's trying to come up with more. "We have a sorting game where they match baseball teams with cities," he says. "We have a wire-cutting exercise where a guy gets a wire cutter and has to cut off four or five one-foot lengths of wire." Hopefully, his wife is still around to marvel at how handy he can be.

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