It was more than a hundred years ago that an Italian physician first noticed how children seem to absorb knowledge from their everyday environments. Her observations, and the theory Maria Montessori later developed, helped revolutionize the way young children are educated.

Montessori is a philosophy that views learning as a natural process in which a child's mind uses common things from the surroundings in creative ways.

Montessori is designed to enhance and guide this natural process by providing an environment that is rich in opportunities for learning using all the available senses.

Now those same theories are helping to revolutionize the care of people in a very different stage of life — those affected with Alzheimer's disease and other cognitive impairments.

The Montessori method has been incorporated into the programs of local facilities over the past several months, and caregivers on the front lines are giving the technique high marks.

Local experts all agreed Alzheimer's presents unique challenges in the health care arena. Patients are often in good physical health. As they begin to struggle with tasks that used to come easily, frustration and depression can set in. The resulting downward spiral can lead to behavioral problems that are difficult, if not impossible, for family and caregivers to manage.

"A person progressing in Alzheimer's is experiencing a lot of failure," said Leigh Dillaman of the Alzheimer's Association's Greater Pennsylvania Chapter. "It's so good to give them activities at which they can succeed. It takes the focus off what they can not do, and gives them something they can do."

"We are just getting our arms around how best to meet the needs of these people and manage them in a way that they are not disruptive to other residents. And yet they still have things to gain and use the skills they have," said Mark Karaffa, director of community education for behavioral health at Butler Memorial Hospital.

The Montessori method, when applied to dementia, focuses on ensuring a rich environment that engages the person both physically and mentally. Patients are offered meaningful tasks rather than busy work.

The concept of applying Montessori to the care of dementia patients was first developed at the Myers Research Institute near Cleveland by Dr. Cameron Camp. The philosophy and techniques have since spread worldwide.

Camp spoke last year to an audience of local service providers during a seminar arranged by Karaffa, who said he "stumbled" on the technique and was intrigued.

A search for information eventually led him to meet Camp and tour the Myers Institute. Karaffa said personnel from at least 35 other area organizations and facilities have also toured the Ohio center or taken formal training. He calls the method "elegantly simple."

Caregivers on the front lines tend to agree.

"It makes so much sense. It's like, 'Why didn't we think of this before,'" said Paula Sypulski, who directs the adult day care program at Concordia Lutheran Ministries in Cabot.

"It makes sure they are not just keeping busy, but are doing purposeful things that keep them cognitive as long as possible."

On a recent afternoon at the center, a group of women worked to plant seeds for a future garden. The women smiled as they remembered their favorite flowers and vegetables from their own gardening experiences.

At another table, two men worked diligently on birdhouses adorned in Pittsburgh Steelers colors.

One of the men was 94-year-old Howard Lang, a retired crane operator and local farmer for more than 50 years. Lang has never been one to sit idle, his son Blaine Lang of Cabot said. So the result of a stroke 20 years ago left him depressed and frustrated with his decreasing ability to do the things he always enjoyed.

"That place has been a godsend," Blaine Lang said.

While most of those who attend the Concordia center are considered high functioning, the techniques can be used for any stage of dementia.

Montessori is also being used for younger people like Barry Duerr of Sarver, who has short-term memory loss due to a head injury suffered in a motorcycle accident. Both Duerr and his mother, Grace Duerr, attend the Concordia program. It's a chance for mother and son to spend some time together, said Barry's sister, Dianne Morrison of Sarver.

"It gives them a sense of self-worth. It's hard for my brother, to have your little sister breathing down your throat all the time. He's more light-hearted when he's (at the center)."

Darlene Christy, quality assurance coordinator for the dementia and intermediate care units at Sunnyview Home in Butler, has already seen some Montessori success in patients with moderate impairment.

Signs in large print serve as reminders for people who continually ask questions, Christy said, helping them to feel more secure in their environment.

Christy gave another example of the theory in practice. The staff made a large print book telling the story of a patient's life as a teen. The patient "was able to read it, and it's the first time she's read in ages," Christy said. "When she reads this book, she knows, 'That's me!' It's accomplishment, pride. She might not remember what she did yesterday or last week, but she knows this book is about her."

"It's also a nice way to incorporate the family into their everyday lives," Christy added. "The (patient) might not know that this is their daughter, but the family can participate in things the resident is interested in."

There is no one-size-fits-all program with Montessori, the caregivers all agreed. It's a philosophy that is adaptable to suit any age, any stage of the disease and in any setting, including the home.

And there is no need for expensive materials, Dillaman said. "It utilizes materials that are right there in your home — egg cartons, cotton balls — everyday objects."

"That's the genius of what Dr. Camp came up with," Karaffa said. "Some of these things are very simplistic in their nature, but they have a purpose and the results have helped people stay in their surroundings, rather than getting referred out because of behavioral problems."

For more information on Montessori or the Myers Research Institute, log on to www.myersresearch.org.