Montessori Method Helps Those Living With Dementia

7WaysMontessoriDementiaPatients

American Montessori expert Dr. Cameron Camp has developed a new approach to caring for persons living with dementia. This new approach is known as The Montessori Inspired Lifestyle ® (MIL). It is based on the philosophy and methods of Dr. Maria Montessori, the first female M.D. in Italy and world-renowned educator.

“Within this new paradigm, abilities, interests, and preferences will be respected, encouraged and maximized. Providing choice throughout the day is central to all interactions.” Said Dr. Camp “Central to MIL is the creation of meaningful activities and social roles within the context of a community. This helps to ensure that residents are engaged in life, have a feeling of belonging, have a sense of purpose, have access to meaningful activity, and can have a sense of control and independence.”

Having done a 3 week course with Omnicare Alliance to learn about Montessori and apply the principles and methods in her own home where she resides with her husband who lives with dementia, Susan was blown away by his progress.

“We have a bunch of signs around the house with cartoon pictures for Jim now that ask him questions. ‘Have you taken the bin out?’ or ‘Do you have your house keys?’ she explains “This actually gets him to think and engage with himself which is a big part of learning.” She has realised that if she communicates in a simple way with her husband he will understand and be able to help with chores. Rather than tell him to cut carrots into cubes, for example, she now models instructions, showing him how she wants them cut. He is then perfectly capable of carrying out her request.

The Montessori Method utilises simple, modifiable and practical tasks that utilise everyday items to re-engage individuals and help to retrain skills that may have diminished due to dementia. A person’s abilities are closely tied to their life experiences and passions, and identifying these passions and harnessing them to rekindle and engage a person is the essence of what makes Montessori training and learning effective. For instance, if a woman grew up playing the piano, music may be the key to her learning and engaging, but if she enjoyed gardening instead, then heading outdoors and incorporating seeds and plants into her activities, may be the key in helping her rediscover some old skills.

As an Aged Care Placement Consultant I would love to see this method used in more aged care facilities. With the current strong focus on the quality of care I hope providers are taking note of Dr. Camp’s new approach.

 

 

Recommendations Have Been Made To Address Elder Abuse

In my work as an Aged Care Placement Consultant I sometimes come across abuse of my elderly clients and I take this very seriously. I attended the the 4th National Elder Abuse Conference 2016 in Melbourne last year following where they announced that a national enquiry into elder abuse was to be conducted by the Australian Law Reform Commission. The Commission has come up with a range of recommendations and have accepted responses to those recommendations. They will announce the final recommendations in August 2017.  I have been interested to see what these recommendations are and note that some refer to guardianship, enduring documents, aged care as well as Centrelink payments and family agreements.

In life each adult has personal and lifestyle decisions that need to be made and they also need to be able to manage their own financial affairs. However, if the tribunal is satisfied that a person no longer has the capacity to manage those aspects of their life, due to a loss of legal capacity, it will appoint a Guardian and Financial Administrator. Typically, the person’s family member would be appointed if there is one available to perform the role. Only where there is not a family member would an external party like the State Trustees be appointed. I have on occasion been asked to find suitable aged care accommodation for a client by a State appointed Guardian.

Unfortunately, because the Guardian and Financial Administrator has complete control over the elderly person of both financial and lifestyle matters it does make the elderly person vulnerable and there is a risk these arrangements can be abused. This could be deliberate where the Guardian and Financial Administrator uses the powers to take money away from the person under the financial administration order, but the enquiry found that the most common type of elder abuse is really mismanagement of the funds through misunderstanding or confusion.

So the Commission’s recommendations are that more information about the nature of the role is made available in tribunals and that people accepting this appointment sign an undertaking that they understand the nature of their obligation. They believe this would minimise the risk of someone taking on the role without understanding their responsibilities and the scope of the role.

The best way to protect a person when they lose capacity is to be prepared before it happens and put in place enduring documents where the person appoints someone in their family they consider is best suited to make decisions on their behalf. The enquiry found that one of the risks with enduring documents is that they can be used after they are revoked. They made several recommendations, firstly to establish a national online register of enduring documents so documents can be verified to ensure that they only operate when they are genuinely authorised by the person. Secondly, to develop a suite of national safeguards that include enhanced witnessing requirements so a person isn’t under duress when signing, certification to ensure the person understands what they are signing, protections from attorneys’ conflict of interest; so they don’t make decisions to benefit themselves rather than the principal.
Also the language used for these roles was assessed and the Commission proposes that they be renamed representative’s agreements, reflecting that when you’re acting on behalf of someone else under these document you’re essentially representing the person.  Another recommendation was for a mechanism for low cost compensation be available in cases where a person has been financially abused.
These recommendations seem like sensible and simple solutions that would help to offset the risk of elder abuse that can occur when a person loses capacity. Next week’s news blog will explore the problems of elder abuse in aged care and the Commission’s recommendations.

Placing Clients in Aged Care Facilities Under Guardianship Orders

Visiting Regis Aged Care Facility in Malvern.

Visiting Regis Aged Care Facility in Malvern.

Currently I am working to place two clients in suitable aged care facilities who are under a Guardianship Order. Generally, the clients who are referred from the Office of The Public Advocate (OPA), are under guardianship because they do not have the capacity to make decisions regarding their accommodation and lifestyle. Often a person appoints a trusted family member as their guardian at the time they appoint a Power of Attorney, knowing they will see their wishes are carried out. However, if they haven’t appointed a guardian and they don’t have family or the family do not want to be involved or family members cannot agree a guardian is appointed from the OPA. Usually an administrator is also appointed to take care of the financial interests of the person if there’s no power of attorney.

For example, in my role as a Placement Specialist I was asked by an appointed guardian to find suitable accommodation for a 67 year old man who has a history of alcohol abuse and has become estranged from his children and brother. Finding a client a new home is not difficult, but trying to align the various decision makers can be.

When facilitating a placement in these circumstances, I am required to liaise with the guardian, the administrator and sometimes various factions within a family who have differing opinions. Firstly, I need information on the client’s financial status before I even approach a facility and this can take quite some time, involving waiting in queues at call centres and numerous emails. The accepting facility wants paperwork completed and residential agreements signed and this can take days or even weeks and a lot of liaising on my part. There is often a tight time frame involved too as the client is usually transferring from a hospital or transitional care.