have a memory impairment?’ and ‘How can we help them do that?’”
Leading with Reading
That kind of thinking led Cameron and his team at the Center for Applied Research in Dementia to develop the Reading Roundtable®. Franklin facilitates a group discussion, attended by people with all levels of dementia, including the later stages. Topics range from the invention of basketball, to the life of Leonardo da Vinci, to the history of the chocolate chip cookie. Each participant receives an eight-inch by ten-inch booklet with a colorful cover and large, bold print on each page. Franklin begins by reading the first page, which describes the wonderful aroma of fresh-baked chocolate chip cookies.
“According to our research, when persons with early to moderate dementia lead reading and discussion groups, attendees are happier and more constructively engaged than they are when staff leads the group.”
Franklin asks the group, “Who baked cookies in your growing up household?”
One woman says, “My mother.”
Another says, “I did.”
Then he goes around the table, asking the next person to read a page, assisting anyone who needs help. Along the way, he continues to ask questions, and they get into interesting conversations.
“According to our research, when persons with early to moderate dementia lead reading and discussion groups, attendees are happier and more constructively engaged than they are when staff leads the group,” Cameron says.
Treat People as We Wish to be Treated
“We simply try to treat people living with dementia as we wish to be treated,” he says. “We follow Montessori’s guidelines, trying to help people regain control of their lives.”
Instead of focusing on, ‘Look what they can’t do,’ we celebrate, ‘Look what they can do with assistance.’
Montessori said, “Everything you do for me, you take away from me.” To keep this from happening, Cameron and his team work with families and facilities to create an environment where everyone enjoys responsibilities, purpose, and meaningful social roles. Examples include empowering people living in care settings (or at home) to greet new people, memorializing those who pass away, visiting friends who are in the hospital, and deciding what kinds of outings they want to experience.
“We are attempting to revolutionize the way we treat and think about dementia.”
Cameron encourages intergenerational work. He creates workstations, where people living with dementia can mentor young children, showing them how to use work tools, bake a cake, hang up clothes, make model boats, knit, and more.
He supports families in creating cognitive ramps. “Similar to physical ramps for people who are in wheelchairs, cognitive ramps help people overcome challenges so they more fully participate. Instead of focusing on, ‘Look what they can’t do,’ we celebrate, ‘Look what they can do with assistance.’”
What they can do is legion. Take the open mic comedy club created and staffed by people living with dementia. They send invitations to family and friends. They select and print the jokes, and they find a singer to entertain between acts. The singer types the lyrics to all the songs he knows and prints them. When guests arrive, two gentlemen who are wearing tuxedos guide them to their tables. A waitress asks, “Tea, lemonade, red wine, or white wine?”
“Tea,” a guest might answer.
The waitress places a brown square beside him. “Please don’t move that or I won’t know what kind of drink to pour,” she explains. She knows the brown square equals ice tea; the red square equals red wine. This Montessori matching exercise allows her to fill the social role of the server and outshine the memory issues. To set the tables, she consults a template—a drawing on a placemat that outlines fork, spoon, knife, glass, napkin, and plate.
“We are attempting to revolutionize the way we treat and think about dementia,” Cameron says. “People want to live well with dementia, just as they want to live well with diabetes and cancer.”
Creative Sparks
Notice your partner’s interests and abilities.
Build on strengths by developing “cognitive ramps,” which can help your partner stay active and engaged and living his best life.
Incorporate Montessori principles into your activities. These include using materials you can hold and manipulate, offering choices, and demonstrating the activity first.
Use matching principles and templates to expand and enhance activities.
“Let the things you love be your escape.” —Anonymous
“My mom loves gardening, but with her memory loss she just can’t work outside anymore.”
During her career as an executive in the senior living industry, Mara Botonis often heard this kind of lament from family members. When her own beloved grandfather was diagnosed with dementia, she was determined that he would continue to enjoy his lifelong passions, which included golf, playing cards, and fishing.
“I wanted Grandfather to have the best possible experience every day, so I learned to put laughing ahead of laundry and dishes.”
Mara, author of When Caring Takes Courage: A Compassionate, Interactive Guide for Alzheimer’s and Dementia Caregivers, understood the care partner’s tendency to let creative time slide in favor of vital practical matters, such as assisting with dressing, feeding, and bathing.
“I wanted Grandfather to have the best possible experience every day, so I learned to put laughing ahead of laundry and dishes,” she says. “So what if we use throw-away paper plates?”
Here are some ways Mara successfully kept her grandfather involved in his passions. For a time, he walked the golf course and played with empathetic friends. When he could no longer play, he liked being driven around the course, enjoying the scent of freshly mown grass, the vistas of rolling green lawns, and the thwack of a well-hit ball. At home, the family set up an indoor putting green and watched golf tournaments on television with him.
Family gin rummy sessions were another of her grandfather’s favorites. When he could no longer track the game, Mara asked herself, “What is important about these family competitions?” She realized the game was a catalyst for reminiscing, laughing, and eating their ritual potato chips and dip. Even when Grandfather couldn’t play, he still liked sorting the cards by suits and sitting around the card table with his family.
Mara helped Grandfather stay involved in fishing by taking him out on a boat when he could no longer navigate on his own. On other days, they’d walk by the shore, stopping to chat with fishermen, smelling the salty breeze, and watching the sea birds. Back home, Mara encouraged him to organize a tackle box, by sorting and arranging the hook-less lures.
To adapt your own projects, ask yourself: What is most important about the activity? For example, for gardeners, is it the feel of their hands in the soil? Is it producing flowers or harvesting vegetables? Having something
