Effectiveness of Montessori Programs for Increasing Occupational Participation & Independence Among Older Adults With Dementia: A Systematic Review

The purpose of this systematic review was to synthesize evidence from quantitative studies to answer the question: Do Montessori programs increase occupational participation and independence in older adults with dementia? There has been an increase in dementia-related diagnoses indicating the need for an effective and client-centered treatment approach to address the impact on daily occupations (Hitzig & Sheppard, 2017). Associated behavioral and psychological impacts of dementia can effect engagement with daily occupations, quality of life and care needs. Non-pharmacological interventions, like Montessori programs, are strategies for decreasing some symptoms associated with dementia (Wilks et al., 2019). Client centered, holistic approaches utilized with Montessori programming align with core principles of occupational therapy.

METHOD: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized. Six databases were searched: PubMed, CINAHL Complete, OT Seeker, ProQuest Nursing and Allied Health Source, Physiotherapy Evidence Database (PEDro), and Academic Search Complete (EBSCOhost). Inclusion and exclusion criteria were established and quality of the studies assessed for risk of bias. Reference management software was utilized by the researchers to store, organize, and screen articles. Strength of evidence was assessed using a critical appraisal instrument for systematic reviews.

RESULTS: Nine research studies were included. All studies included more females than males except one (Wu et al. 2014). Severity of dementia ranged from mild to moderate to severe/late-stage. The studies showed the benefits of Montessori interventions on social interactions, engagement, quality of life, mood and behavior.

CONCLUSION: Evidence summarized demonstrates that Montessori approaches may increase independence and occupational participation in individuals living with dementia by increasing ADL function, quality of life, mood and behavior.

References

Hitzig, S. L., & Sheppard, C. L. (2017). Implementing Montessori methods for dementia: A Scoping review. The Gerontologist, 57(5), 94–114. https://doi.org/10.1093/geront/gnw147

Kwon, M. H., & Kim, S. K. (2022). Effects of client-centered occupational therapy on behavioral psychological symptoms, social interaction, occupational performance, quality of life, and caregiver burden among the individuals with dementia. Occupational Therapy in Health Care, 1–16. https://doi.org/10.1080/07380577.2022.2028330

Wilks, S. E., Boyd, P. E., Bates, S. M., Cain, D. S., & Geiger, J. R. (2019). Montessori-based activities among persons with late-stage dementia: Evaluation of mental and behavioral health outcomes. Dementia, 18(4), 1373–1392. https://doi.org/10.1177/1471301217703242

Wu, H. S., Lin, L. C., Wu, S. C., Lin, K. N., & Liu, H. C. (2014). The effectiveness of spaced retrieval combined with Montessori-based activities in improving the eating ability of residents with dementia. Journal of Advanced Nursing, 70(8), 1891–1901. https://doi.org/10.1111/jan.12352