Relate, Motivate, Appreciate

‘Promoting positive interaction with people with dementia.’

Based on research conducted in Australia and in other parts of the world, this is a new way of thinking about dementia and persons who have dementia. People with dementia are people – normal people just like you and me. They happen to have cognitive disabilities. All of us have disabilities of one kind or another. When we put on glasses, who we are is not defined by the fact that we need glasses to help us to see well. We are living with a chronic condition, and trying to compensate and live well in spite of our disabilities. We are not defined by them. When we start to see dementia as a disability rather than a ‘medical condition’ or ‘disease’, we will begin to think differently. We will begin to ask questions like ‘Where are the “cognitive ramps” for persons with dementia? and ‘How can we modify our homes and communities to better accommodate persons with dementia?’

Cameron J. Camp, PhD

Cameron J. Camp, PhD

We must find ways to connect or reconnect with the humanity in people with dementia. This is done by providing opportunities for engaging in personally meaningful activity and allowing individuals who have dementia to contribute to the lives of their families and communities.

Dr Cameron Camp is running workshops and seminars throughout Australia from July-September, 2013. His schedule and registration details here.

One of the main Montessori principles emphasises using less verbal language, while simultaneously promoting non-verbal communication by demonstrating everything that you would like the person to engage with.

In other words, talk less and demonstrate more!

When using less language in your interactions, you are likely to avoid frustration or disappointment on the person’s part about not being able to respond to questions verbally. You will also allow them to focus all their attention on what you are demonstrating. This may make it easier for them to engage with you.

To enhance the interaction with the person, it is important to apply all the Montessori principles.

The principles can be summarised in the Relate, Motivate, Appreciate model.

Relate

The person you know has lived a rich and full life. They may have been a parent, spouse, brother, sister, professional, housewife, friend and/or lover. All these roles make up the person they are and how they feel. The first and most important step is to be able to relate to and focus on what were their past experiences. This should also be informed by an understanding of the current abilities and interests the person still has.

Consider whether they are able to:

  • read
  • talk
  • point
  • hold things
  • walk independently
  • answer questions.

Find out:

  • what they did for a living
  • whether they have siblings
  • what they enjoyed doing the most
  • whether they travelled
  • whether they are in pain or feeling unwell.

Language skills and vocabulary can diminish as dementia progresses, but the desire to communicate does not. It can often help the interaction if you reduce how much you speak and how fast you speak and move. Tasks can also become easier for the person when you break them down into a number of smaller steps, and then demonstrate every step separately as an explanation of what you are asking them to do. Be flexible and willing to adapt to what the person is able to do on a particular day, recognising that each day may be different.
Principles 4 to 10 are associated with Relate.

Click to close

Motivate

What motivates you?
Most of us are motivated by things we enjoy.
When considering activities that the person might enjoy, we need to reflect on their past life experience. What activities did they do in the past?
For example, did they enjoy:

  • cooking? – if so, consider pouring or mixing activites
  • accounting? – counting, writing
  • gardening? – growing vegetables or flowers
  • music? – listening, dancing, playing an instrument.

The aim should be to engage the person in a meaningful activity which is clear to follow and almost error-free. Then we may see their self-esteem rise and their sense of pride increase.
The aim should always be for them to have a positive and pleasant experience.
Principles 1, 4, 9, 10 and 12 are associated with Motivate.

Click to close

Appreciate

You may experience feelings of loss and grief for the relationship you once had with the person living with dementia. However, the person living with dementia may have experienced losing much more; for example, friends, social activities, various roles, the ability to drive, their job, their career, their partner, and the ability to dress and attend to activities of daily living.

With these in mind it is important that we try to give the person some confidence and roles back and, in that sense, return some meaning to their lives.
The aim should be to enable the person living with dementia to regain control of aspects of their life, through meaningful activities that have a purpose.

This can be achieved by firstly inviting them to participate in an activity. They may not always feel like participating and it is important to respect this choice. There always needs to be at least two choices of activity, as what was of interest yesterday may not be today.

Principles 2 and 3 particularly are associated with Appreciate.

Click to close

Development of the Relate, Motivate, Appreciate resources was led by the Aged Mental Health Research Unit at Monash University, in collaboration with Alzheimer’s Australia Vic

Next page: Stories about Dementia