Person-Centered, Skilled Services Using a Montessori Approach for Persons with Dementia

Douglas, Natalie; Brush, Jennifer; Bourgeois, Michelle S.

doi:10.1055/s-0038-1660781

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…For example, SLPs can facilitate decision-making in PWD through caregiver training in supported communication strategies about valued daily activities, food, and clothing choices 2 . SLPs can also make changes to the environment to maximize engagement in valued activities by providing visual aids or compensatory strategies to ensure that the individual is able to participate 8 . Specifically, the Montessori approach, which aligns with PCC principles, provides evidence-based guidelines on how to select and adapt activities and structure the living environment to maximize participation 8 .…”

Section: The Role Of Slps In Person-centered Dementia Carementioning

confidence: 99%

“…2 SLPs can also make changes to the environment to maximize engagement in valued activities by providing visual aids or compensatory strategies to ensure that the individual is able to participate. 8 Specifically, the Montessori approach, which aligns with PCC principles, provides evidence-based guidelines on how to select and adapt activities and structure the living environment to maximize participation. 8 Bourgeois et al 9 reported positive outcomes of the Montessori approach in dementia care, including individuals showing increased independence, identifying with meaningful roles, and contributing to the community, which resulted in higher levels of self-esteem.…”

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confidence: 99%

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A Visual Analog Scale for Self-Reported Quality of Life

Redford,

Heuer

2023

Alzheimer Disease &Amp; Associated Disorders

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Purpose: People with dementia (PWD) are one of the fastest-growing clinical populations for speech-language pathologists. Self-reported quality of life (QoL) assessments are critical patient-reported outcome measures that align with person-centered care principles. However, proxy-reporting is most often used due to assumptions that PWD cannot provide reliable self-report. Visual analog scales (VASs) have been successfully used with people with expressive and cognitive deficits to measure subjective constructs such as QoL, mood, and pain. The purpose of this project is to evaluate the feasibility and reliability of a VAS QoL assessment tool. Methods: Twenty older adults free of cognitive impairment were assessed using the quality of life in Alzheimer’s disease (QoL-AD) and the QoL-AD in combination with a VAS (VAS QoL-AD). The construct validity, internal consistency, and test-retest reliability of the VAS QoL-AD were assessed by performing both assessments twice, 4 weeks apart. Results: Significant correlations between the overall VAS QoL-AD and the QoL-AD scale ratings, between most of the QoL-AD and VAS QoL-AD subtests, and between the first and second assessment scores were observed. Conclusions: Results indicated strong construct validity, internal consistency, and test-retest reliability of the VAS QoL-AD in people without dementia. These results warrant further research into the development of a dementia-specific, self-reported VAS QoL scale for PWD.

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Section: The Role Of Slps In Person-centered Dementia Carementioning

confidence: 99%

mentioning

confidence: 99%

A Visual Analog Scale for Self-Reported Quality of Life

Redford,

Heuer

2023

Alzheimer Disease &Amp; Associated Disorders

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“…To support care team members in developing a meaningful and safe environment for the PWD, we suggest incorporating principles of Montessori for Dementia and Aging, such as freedom, structure and choice, nature, atmosphere, and specialized materials (Douglas et al, 2018;Montessori for Dementia and Ageing, n.d.). This environment should incorporate multimodal cues (e.g., auditory, visual, olfactory, and tactile) and include items that are meaningful to the PWD, such as personal photographs, old furniture, or personal awards.…”

Section: Counseling+ Activities For Pwd During Residential Long-term Carementioning

confidence: 99%

The “Counseling+” Roles of the Speech-Language Pathologist Serving Older Adults With Mild Cognitive Impairment and Dementia From Alzheimer's Disease

2021

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Purpose Persons with dementia and mild cognitive impairment (MCI) are major consumers of services provided by speech-language pathologists (SLPs). These services include not only direct assessment and treatment of communication and swallowing but also counseling, collaboration, prevention, and wellness. These “counseling+” activities can be especially challenging for SLPs to deliver because of the lack of evidence, as well as the complex nature of Alzheimer's disease (AD) and other conditions that cause MCI and dementia. Method This tutorial is written by a speech-language pathologist, a neuropsychologist, and a geriatric psychiatrist to provide education, resources, and recommendations for SLPs delivering counseling+ activities to patients with MCI and dementia from AD and related disorders. Results and Conclusions We describe counseling+ activities across the continuum of care ranging from educating and conducting cognitive screenings with adults experiencing age-related cognitive decline to supporting end-of-life wishes. Because of their expertise in communication, SLPs can provide an array of important leading and supporting services to patients, their family, and other health care professionals on the care team, such as providing patients with appropriate feedback following a cognitive screening and helping caregivers identify the communicative intent of a responsive behavior. The demand for SLP services for patients with MCI and dementia will grow significantly over the next few decades, necessitating more systematic research and clinical evidence in this area.

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“…The type of activity and level of facilitation is based on the interests, abilities and needs of the individual and should be failure free. In a care home setting this may be, for example, a laundry sorting activity (Douglas et al., 2018).…”

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confidence: 99%

Communication support in care homes for older adults: Views and reported practices of speech and language therapists and care home activities staff in the UK

Davis,

Botting,

Cruice

et al. 2024

Intl J Lang & Comm Disor

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BackgroundSpeech and language therapists (SLTs) and care home activities staff play key roles in managing and supporting the communication needs of older residents in care homes. However, the current practice and perspectives of these two professions in the United Kingdom has not been examined.AimsTo investigate the practice patterns and views of SLTs and activities staff working in UK care homes for older adults in relation to residents’ communication needs.Methods and ProceduresTwo online surveys, with 63 questions (SLT survey) and 46 questions (activities staff survey) in total, were created using the online platform Qualtrics. Participants were asked to consider their routine practice before COVID‐19. Results were analysed using descriptive statistics and qualitative content analysis.Outcomes and ResultsA total of 116 valid responses were received from SLTs and 29 valid responses from activities staff. A high level of communication needs in care homes was reported by both participant groups, as was insufficient time and resources and lack of managerial encouragement in this area. SLTs reported that the majority of referrals to their service from care homes was for swallowing needs (70%). Cognitive communication difficulty was the most commonly reported communication need by SLTs (65%). Most SLTs (73%–87%) provided some level of communication intervention and considered management of residents’ communication needs to be both part of the SLT role and a good investment of their time. Lack of confidence setting goals and providing direct intervention for communication needs was reported, with 25% feeling stressed at the thought of this. The main themes from free text responses about SLT service improvement were increased staff training, funding (of resources and specialist posts) and changes to service provision (referral criteria and accessibility/awareness of SLT service). Hearing impairment was the communication need most commonly reported by activities staff (43%). Participants demonstrated relatively high awareness of communication difficulty in residents and reported high levels of knowledge and confidence identifying and supporting residents’ communication. Most (79%–89%) considered identifying and supporting the communication needs of residents to be part of their role and expressed interest in receiving further training in communication support. The reported activities staff data set may be positively biased.Conclusions and ImplicationsSLTs and activities staff were highly motivated to support the communication needs of care home residents. Increased training, time and resources dedicated to managing the communication needs of residents emerged as opportunities for service improvement across both data sets.WHAT THIS PAPER ADDSWhat is already known on the subject There is a high level of communication need amongst older care home residents. Social interaction and relationships are important factors contributing to quality of life in this population and rely on successful communication. Speech and language therapists (SLTs) and activities staff play key roles in managing and supporting the communication needs of this client group, but the current practice and perspectives of these professions in the United Kingdom has not been examined.What this study adds A high level of communication need in care home residents was identified by both SLT and activities staff and both participant groups were motivated to address, identify and manage this need. However, insufficient time and resources, as well as a perceived lack of encouragement from managers to provide communication support/intervention, were reported by both groups. SLT practice was constrained by referral criteria and care pathways, which differed between services. Suggestions for SLT service improvement are reported.Clinical implications of this study Targeted, ongoing staff training is required in care homes to improve the communication environment and develop care home staff capacity to support residents’ communication needs. There is also a call for service level improvements to increase the range of SLT practice in care homes, including a greater focus on communication needs and more specialist (e.g., dementia) SLT roles.

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Person-Centered, Skilled Services Using a Montessori Approach for Persons with Dementia

Cited by 8 publications

References 19 publications

A Visual Analog Scale for Self-Reported Quality of Life

A Visual Analog Scale for Self-Reported Quality of Life

The “Counseling+” Roles of the Speech-Language Pathologist Serving Older Adults With Mild Cognitive Impairment and Dementia From Alzheimer's Disease

Communication support in care homes for older adults: Views and reported practices of speech and language therapists and care home activities staff in the UK

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