Jewish Care and the Challenge on Dementia 2020

Wednesday 9 May 2018

The DAA are aiming to shine a spotlight on the Challenge on Dementia 2020 as we want to help the Department of Health and Social Care implement this important piece of work. Padraic Garrett writes about what Jewish Care have been doing.

Shortly after joining Jewish Care, Jewish Care’s Occupational Therapist; Romy Pikoos, was asked to work in one of their care homes to support and adapt the environment for individuals with dementia; and improve general wellbeing and engagement.

Having heard about the Montessori Inspired Lifestyle (MIL) in Australia, Pikoos introduced this concept to Jewish Care who agreed this would be a good place to try this dynamic and innovative approach to care.

It is based on the philosophy and methods of Dr. Maria Montessori, the first female M.D. in Italy and world-renowned educator, which have been adapted for persons with dementia by American neuro-psychologist - Cameron Camp, Ph.D.

There are now hundreds of Montessori care homes in USA, Australia, Canada, France, Switzerland, Singapore and various other countries around the world. With the help of Dr. Camp, we are now trying to introduce MIL into the UK – starting at Jewish Care.

This ground-breaking approach combines rehabilitation principles and educational techniques using the physical and cognitive abilities available to individuals. The key values of MIL are respect, dignity, and equality. 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. This way the person not only engages in life, but has the opportunity to maintain, and even restore function.

The approach is flexible, dynamic and grounded in research. Since memory is impaired, remembering information for any length of time is a challenge, so MIL focusses on putting information into the environment (e.g. labels, name tags, cue cards, or in memory books) and working with preserved abilities (eg. reading, which is generally spared in dementia). When the environment is set up in such a way, residents are able to explore and achieve success with minimal if any support from others.

Since introducing this method, subtle changes have been made around the home – e.g. Posters inviting residents to take a drink/snack – thereby encouraging independence and less reliance on staff, placing posters by the book shelf asking residents to read, or next to the activities inviting families to use them.

Activities are now placed out on tables and near where residents sit so that they don't need to ask for something to do – this too has made the environment more engaging and interactive.

We purchased open shelves for the lounges - this way the lounges look homelier and the activities can now be organised and on display for all to use and engage with, as opposed to behind closed doors where only staff know they are there.

Residents are given roles and responsibilities around the home – assisting to set the tables, fold laundry, run groups and much more. Using their procedural memory; persons with dementia can learn how to find their way around the home, how to remember facts that have been forgotten and indeed regain skills such as feeding oneself.

MIL is a good business model – if residents are more independent – staff will have more time. If residents are eating their food as and when they want to – there will be less food wastage and therefore less money spent. If residents are walking with purpose – there will be less falls. If residents are happier and have meaningful lives – there will be less deaths. The research and evidence has been completed; 30 years of MIL successfully changing lives in USA, Australia, Ireland, France, Switzerland, Asia! There is a reason Alzheimer’s Australia provides and encourages Montessori training to services. There is a reason that when French care homes are being assessed by the equivalent of CQC, they are often asked if they are using Montessori Methods. Jewish Care is spearheading the introduction of MIL, with their care homes to be the first in the UK to run according to these principles, hoping to spread the word to care homes throughout London and the UK.

For more information contact Romy Pikoos (Occupational Therapist) on romy.pikoos@jcare.org or 020 8922 2000.

“We are not helpless in the face of dementia. We can best care for ourselves and our loved ones with dementia by embracing the humanity that exists, and has always existed, within each other.” – Cameron Camp, from the preface of “Hiding the Stranger in the Mirror”.