Speak Out OCTOBER 2021 DIGITAL EDITION

Association NEWS

on the quality of mealtime care and the dining experience for residents. Using a novel coding protocol, we found that the Montessori model was associated with more person- centred mealtime care practices that provided richer opportunities for choice, social interaction, independence, and involvement in mealtime care. When viewing the Montessori mealtime footage, it was often difficult to tell the residents from staff, a true sign of enhanced resident engagement and participation in daily routines. Montessori in action: In-depth conversations with staff across all levels of the organisations and observation of videos of Montessori in action allowed us to learn what Montessori care looked like on the ground and to operationalise the model from the perspectives of care staff. This has supported dissemination and possible replication of the model by other organisations with a similar vision. We have identified critical ingredients that support the model and the culture change process, including opportunities for collaborative teamwork that promote mentoring, shared problem solving and a culture of innovation and creativity. A role for speech pathology: For example, a key implementation challenge experienced by care staff was knowing how to adapt activities, tasks, and roles for people with more advanced dementia and how to scaffold and cue residents based on their cognitive and communication support needs (e.g., to promote a person’s independence when eating and drinking during mealtimes). Our profession has a vitally important role to play here in tailoring supports, providing communication training, and devising personalised care plans. Speech pathology student models: Implementation of Montessori activities on an individual basis was challenged by lack of time and resources. We see an opportunity to utilise student placement and/or volunteer models to help build capacity for individualised Montessori-based interventions and further extend the model. Inspiring culture change Our research has contributed to an important conversation about the future of dementia care in Australia and how the required transformation can be achieved. Our team is proud of what we have achieved, although humbled by "The findings reveal unique opportunities for the speech pathology profession to support and strengthen the model."

The Montessori Method in action.

methods to uncover and address evidence-practice gaps and help drive dementia care reforms in Australia. Research findings The outcomes and learnings across the two memory support units have been significant, highlights include: Evidence of culture change: Both organisations successfully implemented the model and achieved systemic culture change. There was evidence that staff embraced and embodied Montessori principles, with tangible shifts in the quality and nature of interactions between staff and residents that had mutual benefits for all. We saw a deepening of person-centred practice over time and staff unanimously endorsed the model as the way care should be, enriching lives, and providing the type of care people with dementia deserve. Success stories: Case studies in the data provide powerful examples of residents adopting roles, engaging with Montessori activities, and becoming part of the community. Prior to Montessori, we saw video footage of one resident, walking up and down the corridors actively seeking something to do and waiting passively for her lunch time meal to be served. After Montessori, we observed this same resident routinely helping set the table for meals, making her own bowl of hot noodle soup, and engaging in moments of celebration and fun with staff. Staff often spoke of this resident’s response to the Montessori model and success stories like these challenged stereotypes about dementia and allowed staff to see the benefits of the model firsthand, building momentum for culture change. Montessori mealtimes: Our research was the first to evaluate the impact of a Montessori mealtime intervention

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Speak Out | October 2021