None listed
Conditions
Brief summary
Background Following admission to a nursing home, the feelings of depression and burden that family carers may experience do not necessarily diminish. Additionally, they may experience feelings of guilt and grief for the loss of a previously close relationship. At the same time, individuals with dementia may develop symptoms of depression and agitation (BPSD) that may be related to changes in family relationships, social interaction and stimulation. Until now, interventions to alleviate carer stress and BPSD have treated carers and relatives separately rather than focusing on maintaining or enhancing their relationships. One-to-one structured activities have been shown to reduce BPSD and also improve the caring experience, but barriers exist to the implementation of activities in aged care facilities, for example lack of resources. The current study will investigate the effect of individualised activities based on the Montessori methodology administered by family carers in residential care. Methods/ Design We will conduct a cluster-randomised trial to train family carers in conducting personalised one-to-one activities based on the Montessori methodology with their relatives. Montessori activities derive from the principles espoused by Maria Montessori and subsequent educational theorists to promote engagement in learning, namely task breakdown, guided repetition, progression in difficulty from simple to complex, and the careful matching of demands to levels of competence. Persons with dementia living in aged care facilities and frequently visiting family carers will be included in the study. Consented, willing participants will on facility level be randomly assigned to a treatment condition using the Montessori approach or a control waiting list condition. We hypothesise that family carers conducting Montessori-based activities will experience improvements in quality of visits and overall relationship with the resident as well as higher self-rated mastery, fewer depressive symptoms, and a better quality of life than carers in the waiting list condition. Discussion Training family carers to deliver personalised activities to their relatives in a residential setting may make visits more satisfying and improve the quality of life for carers and their relatives. These beneficial effects might also reduce nursing staff burden and thus impact positively on residential facilities.
Interventions
We will train family members of nursing home residents to apply personalised one-to-one activities based on the Montessori approach with their relative.
Montessori-based activities follow the principles espoused by Maria Montessori and subsequent educational theorists who promoted engagement in learning by sequencing tasks from simple to complex; providing cues to successful completion; encouraging repetition, and carefully matching demands to individuals’ interests and levels of competence (Ca
We will train family members of nursing home residents to apply personalised one-to-one activities based on the Montessori approach with their relative. Montessori-based activities follow the principles espoused by Maria Montessori and subsequent educational theorists who promoted engagement in learning by sequencing tasks from simple to complex; providing cues to successful completion; encouraging repetition, and carefully matching demands to individuals’ interests and levels of competence (Camp, 1999; Camp et al., 2006). For people with dementia, Montessori-type programs entail detailed interviews with family carers about their former interests and skills coupled with assessments of cognitive, language and motor skills. A range of activities are then presented, tested and refined. When dementia is advanced, the activities themselves are simple (e.g. completing a jigsaw made from a family photograph). Facilitators present tasks deliberately, modelling them first and using little language if preferred. The main objective is to engage participants’ interest and involvement. Family carers will be trained in the principles underpinning Montessori activities in three-hour group sessions in their relative’s facility. A pair of researchers will conduct these workshops. They will spend half an hour helping carers to fill out the baseline questionnaires; an hour explaining the theoretical basis of Montessori activities in dementia, and an hour and a half in smaller groups brainstorming possible about activities and then practising them.
Sponsors
Monash University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
0 to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion criteria for residents: (i) A chart diagnosis of dementia or probable dementia; and (ii) residency in the facility for over 3 months to allow for adjustment to the new setting. Inclusion criteria for family carers: (i) Visit regularly 2 or more times per week for 30 minutes or more to match study requirements, (ii) willing to follow study protocol, and (iii) sufficient fluency in English to understand the workshop and fill out questionnaires.
Exclusion criteria
Exclusion criterion for residents: Acute life-threatening illness as reported by nursing staff.
Outcome results
None listed