The Importance of Category Sort Exercises for People Living with Alzheimer’s
We walked into the Alzheimer’s unit after our lunch break and instantly heard the raised voices. There was a real donnybrook going on in the dining room and we rushed over to see if we could help. Dave, usually a quiet, reserved man was pounding the table in front of him, his face red, his voice raised,
“You don’t know what the heck you are talking about! A tractor is a living thing. I ought to know. I drove the same derned tractor for forty years and we were friends. We were out in all weather together working from sunup to sundown every day the Lord gave us. Don’t you try to tell me that my tractor wasn’t a living thing!”
Dave and the group at the dining room table were playing a word game that we brought in earlier that morning, a category sort game developed by Dr. Maria Montessori.
In this category sort exercise we use cards with large print. One card says LIVING on it, one says, NOT LIVING. We place these cards on a table and then bring out cards that describe things that may be living or not living. We try and make these words interesting so that people have to take a moment and think about the exercise. For this particular, rural long term care home, we created a Living/ Not-Living Category Sort using items from the farm: chickens, barn, hay, and of course, TRACTOR.
We joined the group as they continued to argue about whether or not a tractor was a living thing. Most of the group agreed that a tractor was a machine and therefore not living, but some people were persuaded by Dave’s passion and his long experience as a farmer. Finally the group agreed to place the word tractor in the middle of the two categories to signify that they were unsure of its status.
We sat quietly watching while this drama unfolded before us. This is one of the main goals of creating the category sort exercises; we hope that people will engage with each other, discuss and even argue together. Dr. Montessori understood full well the importance of categories for organizing the mind. Now that medical science can use FMRI to study how language impacts the brain, we know that categories of different objects are stored in different parts of the brain. Using category sort exercises and games helps stimulate the brain and also stimulates conversation.
In creating category sort games, make sure that the print is large enough for older people to read and that the categories you use for comparison have some relationship to each other. Our goal is not to confuse people, but rather to help them organize their minds. Alzheimer’s has enough confusion already; we don’t want to add to it. In Lewis Carroll’s Alice in Wonderland, Alice began to understand that the Hatter was a Mad Hatter when he asked her the infamous question,
“Why is a writing desk like a raven?”
The sensible answer is, of course, that a raven and a writing desk have nothing in common. So, the categories that you create can be opposites, but opposites that are within the same arena. For example, you might create an exercise that would list items found in winter clothes (coat, scarf, boots) or items found in summer clothes (shorts, swim suit, sun hat). Participants would then have to decide which clothes went under the summer category and which clothes would be under the winter category. You would not have a category sort exercise of things found in a forest or things found in a church, as these two categories bear no relationship to each other. But you could create exercises using items found in a forest and items found in a desert (two opposite types of topography) or things you would see in a church, things you would see in a synagogue (two different places of worship).
These sorts of word games are only limited by your imagination. They can be played anywhere by any one. Word games are a wonderful way to reconnect when a family goes to visit a loved one. Or, they are great for bridging the generational divide, having older people play these types of games with younger people or children. The person who is the group leader for these games is also an interesting part of the equation. A group leader could be a nurse, or an aide, or a family member. A group leader could also be someone living with Alzheimer’s who is able to read and who understands the purpose of the game. We were once beginning a category sort game at a memory enhancement center, when a gentleman asked if he could be the group leader for this game. We were surprised by this request as the man was 102 years old. He did a marvelous job of holding up the signs and reading them aloud and ran the entire game without any help from us, or anyone else!
For those people who have problems with their eye sight or can no longer read, they can listen to the list of category objects as they are read aloud and still join in the conversation, discussion, and argument about what things go in which category. Be prepared for some interesting ideas when you play the category sort games. A woman once convinced her friends that a fire truck was a living thing because it moved and it saved lives. Hard to argue with that kind of logic!