© Howard Gardner and Matthew Call
Note from Howard:
I recently received a heartfelt letter from Matt Call a veteran dementia practitioner, and Melissa Mirabello a long-time teacher, about their work in Florida, USA. MI theory had sparked in them a creative response to dementia care. They’ve developed a diagnostic questionnaire for dementia sufferers—this instrument can be administered by caregivers. The hope is to discover strengths in different intelligences for better-targeted care; in the best-case scenario, holistic and sustainable practices can improve the lives of those with dementia.
On a personal note, by integrating MI into his diagnostic routine and designing care based on his findings, Matt believes that his work life has been transformed and thousands of individuals have benefited. MI Theory has endless positive ripple effects; Matt’s work testifies to the potential of the framework ability to instill hope and foster progress in people’s lives.
In a nutshell, MI provides practitioners with a means of identifying suitable activities and materials that keep individuals engaged, providing much needed stimulation that helps to slow their decline. Currently, Matt and Melissa are developing a comprehensive educational framework, one focused on holistic approaches and strategies for enhancing and improving dementia care. As is the case with other “Good Practices” entities mentioned on this website, Matt and Melissa seek to apply the theory of multiple intelligences in a thorough and beneficial way.
The following examples describe how using MI theory to develop care strategies and materials can improve the lives of patients suffering from dementia.
testimony in Matt’s words:
Visual/Spatial
Scenario: A woman who cannot verbally communicate develops a series of urinary tract infections as she is not able to relay that she needs to use the bathroom or that she has soiled herself. With each infection, she experiences physical pain and exacerbated dementia symptoms, like increased confusion. On one occasion, the woman was hospitalized because the condition spread to her kidneys as it was not treated quickly enough.
Care based on MI results: Upon meeting with the woman’s family, I learned that she was a children’s book illustrator. After completing an MI survey, which showed a high level of visual/spatial intelligence, I suggested using the Picture Exchange System, an augmentative communication tool where people relay information using pictures. I was able to teach the woman how to use the system and she was then able to request the bathroom by simply pointing to a picture of a toilet, which decreased her incidents of UTI’s significantly. (It’s important to note that those with dementia who do not possess visual/spatial intelligence have a very hard time using this augmentative communication tool.)
Bodily-Kinesthetic
Scenario:
After her husband loses his ability to write, a woman begins contemplating placing him in memory care, as she believes there is nothing anyone can do to help her husband. She decides to contact me before making the decision to place him in a facility.
Care based on MI results:
After speaking with her, I discovered that the man was a former engineer who learned best through movement. I told her about your MI theory and how we can tap into her husband's strengths to reteach him how to write. For several weeks, the woman and I employed a hand-over-hand technique, which helped him regain the ability to write.
Musical
Scenario: A woman who lives at home frequently becomes combative toward her caregivers during self-care activities like bathing and toileting. Her doctor prescribes her an antipsychotic to help calm her, but the medicine sedates her so much that she sleeps much of the day. Not liking the affects the medication has on her, the family contacted me to help.
Care based on MI results: After conducting an MI survey on the woman, a former music teacher, it showed that she had a high level of musical intelligence. I suggested playing music during these activities, which helped eliminate much of her aggression, without the need for medication and its side effects.
Linguistic-Verbal
Scenario: A former teacher begins having trouble naming objects and action words. This ability loss causes her to isolate from others because she didn’t want people noticing her impairment.
Care based on MI results: While interviewing the family it was obvious that she had a love of words. To help combat her anomia, I suggested activities that aligned with her verbal intelligence, including rhyming, naming synonyms, and word searches. Not only did the woman enjoy engaging in these activities; but she became more sure of herself and her ability to communicate.
Logical-Mathematical
Scenario: A woman who worked as a bookkeeper for over a decade leaves her job to help her
husband run his delicatessen. As time passes, her husband notices that she is becoming increasingly forgetful, e.g., not filling orders and even not remembering to turn off the meat slicer. Because of this, the man tells her that she cannot help him anymore, which devastates the wife.
Care based on MI results: After meeting with the husband (who mentions the wife’s sadness of not being able to help him with his work), I suggested that there may be something she can still do. After learning that she was a former bookkeeper, who has always loved numbers, I asked if she’d ever done any number-related tasks at the deli, which she had not. I proposed he have her do things like taking inventory of supplies and counting cash at the end of the day. I informed him that her work would need to be checked, but he should try it since it will help her feel like she's contributing. To his surprise, she did much better than he thought she would and the activities gave her a sense of purpose.
Interpersonal
Scenario: A man who was an athletic director spends little time at home engaging in therapeutic activities that his wife got for him to keep him busy while she worked.
Care based on MI results: After the wife contacted me, I conducted a MI survey which suggested that he he possessed interapersonal intelligence. I suggested that she have him attend a day program where he could be around others which she agreed to. The man did very well there, participating in all of their group activities.
Intrapersonal
Scenario: A short time after moving to a memory care facility, a woman was losing a significant amount of weight and the staff believed it was dementia-related. This type of weight loss can cause a person to be placed on hospice.
Care based on MI results: After speaking with the woman’s family, I discovered that this woman had always enjoyed journaling. I also determined that the woman possessed intrapersonal intelligence and may prefer eating alone. The woman spent the next meal away from her peers and ate all of her food.
Naturalist
Scenario: A woman residing in a memory care facility suffers from major depression and is unwilling to participate in therapeutic activities, spending most of her time in bed and also neglecting self-care. After antidepressants did little to help the woman and other interventions failed, the family contacted me to intervene.
Care based on MI results: While talking with the family, I learned that the woman has a life-long passion for the outdoors. I conducted an MI survey that showed that she possessed a high level of naturalistic intelligence, much more than other intelligences. I suggested the facility implement activities that cater to her love of the outdoors, e.g., creating an outdoor garden and purchasing picture books of animals. These holistic interventions improved her mood considerably more than pharmaceutical interventions.
Positive outcomes based on MI-inspired strategies:
Helps people stay in their homes longer
Helps people relearn skills
Helps people feel more comfortable and even live longer
Reduces people’s need for harmful medications
Helps caregivers with practical, sustainable strategies
Reduces caregiver stress
Offers individualized, suitable activities
Here is a link to a TV news story on Matt’s work: A Woman Says Therapy is Helping Her Husband with his Dementia
Here is a link to Matt’s website: The Center For Holistic Dementia Care