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The population of individuals who reside in assisted living memory care (ALMC) is increasing. This population presents with responsive behaviors that reflect unmet physical, emotional, and environmental needs, which are characterized by physical or verbal expressions that are labeled by staff as “challenging behaviors.” Although recognized that engaging the individual in meaningful activities can decrease these responsive behaviors, finding meaningful social activities that are reflective of the individual's interests and abilities can be difficult. In a scoping review, Hitzig and Sheppard (2017) noted that Montessori-based programing is an emerging approach for promoting engagement of individuals with dementia.
The Goodman Group initiated the implementation of the Montessori-Inspired Lifestyle® (MIL) in 2015 as a foundation of care for residents in ALMC neighborhoods. The outcomes of the implementation of the MIL were investigated through a quality improvement process.
The MIL is a resident-driven approach in providing care for adults living with dementia or Alzheimer's disease (Camp, 2010). The program, based on the methods of Maria Montessori as adapted for adults by Dr. Cameron Camp (2006), uses Montessori principles that encompass task breakdown, guided repetition, and progression from simple to complex and concrete to abstract. These Montessori principles are integrated with principles used in dementia interventions, including extensive use of external cues and reliance on procedural or implicit memory rather than declarative or explicit memory. Activities and everyday interactions are used as a means to reconnect persons with dementia and create opportunities for engagement within their community (Camp, 2010). As a foundation of care, the MIL was integrated into every interaction with the resident on a 24-hour basis, not just for activities. The implementation of the MIL allowed the team to build on the current program and intensify the focus on discovery of residents' strengths and abilities to determine meaningful activity for each individual.
Implementation of the MIL was sequenced over several years, based on budget and readiness, at various ALMC neighborhoods throughout the United States. All staff who work in an ALMC neighborhood (e.g., nursing, life enrichment, dietary, facilities) were required to participate in training. In addition to this training, changes in the environment were made to support the implementation of the MIL as a model of care. In addition, education on the MIL was provided to...