Louisiana State University, Baton Rouge, LA, USA.
Seaside Behavioral Center, Metairie, LA, USA.
Dementia (London). 2019 May;18(4):1373-1392. doi: 10.1177/1471301217703242. Epub 2017 Apr 27.
Literature regarding Montessori-based activities with older adults with dementia is fairly common with early stages of dementia. Conversely, research on said activities with individuals experiencing late-stage dementia is limited because of logistical difficulties in sampling and data collection. Given the need to understand risks and benefits of treatments for individuals with late-stage dementia, specifically regarding their mental and behavioral health, this study sought to evaluate the effects of a Montessori-based activity program implemented in a long-term care facility.
Utilizing an interrupted time series design, trained staff completed observation-based measures for 43 residents with late-stage dementia at three intervals over six months. Empirical measures assessed mental health (anxiety, psychological well-being, quality of life) and behavioral health (problem behaviors, social engagement, capacity for activities of daily living).
Group differences were observed via repeated measures ANOVA and paired-samples t-tests. The aggregate, longitudinal results-from baseline to final data interval-for the psychological and behavioral health measures were as follows: problem behaviors diminished though not significantly; social engagement decreased significantly; capacities for activities of daily living decreased significantly; quality of life increased slightly but not significantly; anxiety decreased slightly but not significantly; and psychological well-being significantly decreased.
Improvements observed for quality of life and problem behaviors may yield promise for Montessori-based activities and related health care practices. The rapid physiological and cognitive deterioration from late-stage dementia should be considered when interpreting these results.
关于蒙台梭利活动对痴呆老年人的研究在痴呆早期阶段相当常见。相反，由于在抽样和数据收集方面存在实际困难，针对晚期痴呆患者的此类活动的研究有限。鉴于需要了解晚期痴呆症患者（特别是与他们的心理健康和行为健康相关的）治疗的风险和益处，本研究旨在评估在长期护理机构中实施的基于蒙台梭利的活动计划的效果。
利用中断时间序列设计，训练有素的工作人员在六个月的三个时间间隔内对 43 名晚期痴呆症患者进行基于观察的测量。实证措施评估了心理健康（焦虑、心理幸福感、生活质量）和行为健康（行为问题、社会参与、日常生活活动能力）。
通过重复测量方差分析和配对样本 t 检验观察到组间差异。从基线到最后数据间隔，心理和行为健康措施的综合纵向结果如下：行为问题虽有减少但不显著；社会参与显著减少；日常生活活动能力显著下降；生活质量略有增加但不显著；焦虑略有减少但不显著；心理幸福感显著下降。
生活质量和行为问题的改善可能为基于蒙台梭利的活动和相关医疗保健实践带来希望。在解释这些结果时，应考虑晚期痴呆症的快速生理和认知恶化。
