A speech therapist recently returned to her home country of Singapore after spending eight weeks studying the dementia program at Clark Retirement Communities in Grand Rapids.
An An Chia is one of six professionals creating an outpatient group therapy program for eight to 10 dementia patients at the new Sengkang General Hospital in Singapore.
The Singaporean government awarded Chia a grant that completely financed a trip to an organization of her choosing.
About a year ago, Chia simply Googled dementia Montessori programs in the U.S., and Clark Retirement’s Facebook page was in the top results. Clark Retirement has several practitioners — the most of any organization in the U.S. — certified by Amsterdam-based Association Montessori Internationale, trained through Brush Development Company. There are about 50 practitioners in the U.S.
Montessori dementia care is a philosophy of care with a goal of increasing residents’ independence, resulting in an increased sense of purpose and well-being, according to Renee Parham, a life enrichment specialist at Clark Retirement.
“I wanted to see somewhere that actually has done it and to be in that environment, not just go for some training program and then not see it in action,” Chia said.
After looking through information on the program, Chia reached out to Clark Retirement and explained what she was doing, and the organization agreed to host her.
Chia spent much of the time observing group activities and assessing residents, as well as observing training sessions for caregivers and families.
Through her observations, Chia particularly was interested in the activities Clark Retirement introduces to help dementia patients use their thinking abilities and feel a sense of purpose.
At Clark, there is a focus on giving dementia residents roles in the community based on what they enjoy or used to do, such as sorting lost and found, delivering mail, placing menus for each meal, playing piano for a group song or whatever other tasks would be useful for individual residents, Parham said.
Since it’s often easier and quicker to have staff complete simple tasks, she said that’s often what happens in health care and long-term care facilities.
“So, residents become accustomed to this learned helplessness,” Parham said.
Clark Retirement staff complete intake assessments to help determine individual roles and care.
Another major piece of the program involves therapy through group games and activities, which staff has found has created a stronger sense of community among residents.
Communication pathways in the brains of dementia patients can become jumbled and create difficulties for some. Games like charades and Scattergories require a higher level of cognitive effort to recall vocabulary used to express themselves, Parham said.
Chia said she believes the social aspect of these games is beneficial, as well.
“They might not interact on a normal basis … but within the context of the game, they might help each other. They might give clues. I think that is useful,” Chia said.
Each resident also has a memory book, which is like an organized, simplified version of a scrapbook, meant to help patients reminisce about their lives. It also can contain information to help residents remember daily routines.
“To help them self-initiate and remember that information for themselves, instead of having to constantly ask staff and feel not self-sufficient,” Parham said.
Chia said speech therapy in Singapore focuses solely on the impairment and typically does not include fun games or activities.
“I think what I've observed here is that therapy can be fun, and it can be incorporated into a group activity,” Chia said.
Chia said she plans to appropriately adjust some of these activities and implement them in the new program in Singapore, likely starting with some of the individual assessment techniques she learned.
Parham said Clark Retirement regularly has interns, so allowing someone in for training wasn’t unusual. But hosting another professional from a different country allowed both parties to learn from each other and understand how different techniques work with different cultures.
The biggest cultural difference Chia said she noticed in Grand Rapids was people seemed friendlier, greeting each other daily. Chia stayed in a room at Clark Retirement, which allowed her to interact with residents daily.
Following the eight-week session in the U.S., Chia was required to write a training report on what she learned and give a presentation to her department at the hospital in Singapore.
“I think we initially started a group not knowing the direction of the group, so it was good that I had this opportunity to learn about how to do group activities so that I could take it back and share everything,” she said.
Chia and Parham plan to keep in touch as Chia works to implement new ideas in Singapore.
“I think it's been a great partnership, and I think it will continue to be a great partnership for Clark and for An An in the future, just so we can keep bouncing back ideas off each other and continue to grow,” Parham said.