Anna Fisher

I have always been fond of the Montessori philosophy. Even when my children were young, I searched for alternative schools where they could explore this type of learning. People ask me, “What is Montessori?”

The Montessori method of teaching provides an environment of student-centered learning and discovery backed by a rigorous curriculum. The idea is to allow students the freedom to make their own choices about what and how they learn, thus encouraging their desire and potential to learn.

I apply this same philosophy in the graduate classes I teach in health care administration. I want to incite critical thinking in my students and to encourage them to be individualized in their thoughts. Learning is a reciprocal experience. We are always learning from each other.

The Opportunity
Over the years, my career path led me to working with aging adults diagnosed with cognitive disorders for Hillcrest Health Services’ assisted living and memory support communities. After a personal experience of watching a loved one with Alzheimer’s slowly change to a person I could no longer reach, I was fascinated with how to reignite that connection and improve quality of life for individuals with memory disorders.

What can we do as health care professionals to better navigate the dementia care map and to provide a better life for those who are still living, even though they may not engage?

My research led me to Cameron Camp’s book, “Hiding the Stranger in the Mirror.” Dr. Camp is an internationally-known research scientist in the field of aging. His research in using the Montessori method in dementia care has been proven effective. I was compelled to learn more.

At a chance meeting with fellow dementia professionals, a local entrepreneur and Montessori supporter, John Adair, learned of my interest in this topic, and coincidentally, he personally knew Dr. Camp. After a swift introduction and a productive conference call among the three of us, a connection was forged and our plan to merge dementia care and Montessori was hatched. That was four years ago.

Making a Connection
With the support of Mr. Adair and Dr. Camp, Hillcrest embarked on something innovative and pioneering in the world of dementia care. Hillcrest’s leadership was no stranger to the Montessori concept, as its Chief Operating Officer, Brendan Bishop, was a Montessori student himself, and our organization embraces forward-thinking and new concepts to advance the care of aging adults.

Hillcrest Mable Rose, an assisted living community, partnered with the only secondary Montessori school in Nebraska, the Montessori International School of the Plains (MISP), to offer the first all-day eldercare Montessori learning program of its kind.

For four years, we conducted “class” at the Hillcrest community every Friday, integrating students in grades 7 through 12 with cognitively-impaired residents under the guidance of dedicated and wonderful Montessori instructors.

Together, we developed a schedule that incorporated student learning and intergenerational activity with the residents. The students introduced the residents to a variety of sensorial activities, enabling them to connect socially and engage in purposeful activity. Who knew the residents would come to learn—and teach us a thing or two? And the students walked away with life lessons learned.

As one student stated, they “learned how to learn.”

It was a natural fit — the young and old trading stories, singing songs, sharing learning experiences. Friendships were formed. Respect was earned.

A Proven Method
We decided to take it a step further and conduct a study on effectiveness of using the Montessori method with our assisted living and memory support residents. The purpose of the study was as follows:

  • Use Montessori materials to increase engagement and enjoyment of the residents;
  • Determine which activities were used the most;
  • Allow residents and team members to have more exposure to the Montessori method; and
  • Encourage student engagement in research.

The students were coached and instructed on how to conduct a study, collect data, and interpret their findings. Students kindly reminded me that they were now “young researchers” and wanted to contribute to research in care for residents with dementia. The young researchers created a list of 94 possible sensorial and auditory activities ranging from Montessori method activities to music and art projects. They observed residents participating in the various projects and recorded mood changes, engagement, behavior, and more.

The growth of the students was extraordinary. They took pride not only in conducting the research but also in making sure each activity brought value to the residents.

The results were remarkable. We were surprised to find that some of the residents we never expected to engage in the activities chose to participate and came alive! It was like watching a flower blossom.

A student anecdotally shared the following:

“Beatrice” became interested in the table bells that another resident was working with. She began by ringing the bell when I rang a bell. Then she started arranging the bells. Then Beatrice played the scale. She commented that there was a note missing. She was correct. Another resident had the bell!

A Dose of Intergenerational Activity
The students and Montessori instructors were so proud of their efforts. You can imagine how I felt—proud to be associated with such passionate learners who want to make a difference.

Highlights of the results indicated that:

  • Residents showed constructive and positive engagement while involved in Montessori activities.
  • Residents also exhibited positive behavior and mood while engaged in these activities.

These findings are good news for those with dementia who do not respond well to medication. Non-pharmacological interventions, such as Montessori method activities, can result in positive behavior. I say, let’s start giving doses of intergenerational activity to our dementia residents.

I encourage everyone working with dementia residents to learn more about this method and to introduce it in your model, even if it is just a few activities at a time. Watching someone with dementia find a spark that unlocks their interest and curiosity is an amazing experience, and I hope you can experience it, too.

To view a presentation about the study, you can visit

Anna Fisher, Ph.D., is the Hillcrest Health Services‘ Director of Quality and Education. She is also on the American Health Care Association (AHCA) Clinical Practice Committee and a certified dementia practitioner.