Cognitive Stimulation Therapy (CST), a Psychosocial Intervention for people living with dementia

Description

CST is a well established , evidence based , group psychosocial intervention recommended in the NICE guidelines for people living with a mild to moderate dementia. It is a non-drug Intervention shown to improve cognition and quality of life which focuses on the use of multi-sensory stimulation, prompting learning skills and encourages personhood while using cognitive skills within a social and familiar setting. CST uses a structured holistic approach to stimulate and engage persons living with dementia. It uses mental stimulation, reminiscence, orientation and focuses on opinions rather than facts to enhance a person’s function. CST Involves a wide range of activites, including 14 themed sessions, for one to two hours , over seven weeks aiming to stimulate thinking and memory generally, including discussions of past and present events and topics of interest, word games, puzzles, music and creative practical activities. The use of CST has become widespread and is available in 29 countries across all for continents and is the most recognised and accepted post diagnostic psychosocial intervention for people living with dementia.As far as we are aware it is the first time in Limerick within CH03 that this intervention has been delivered .

Aim of Initiative

The aim of this initiative is to create opportunities for people living with dementia to participate in activities designed to encourage thought processes, the use of memory and social interaction. Each activity aims to actively stimulate and engage people with dementia while providing an optimal learning environment therefore, enhancing social benefits of a group and social participation, respect for one another and social inclusion.

Who is it aimed at

This initiative is for people living with mild to moderate dementia.

3 Steps critical to success

1. Working in collaboration with Cross Discipline professionals ( Advanced Nurse Practitioner and Occupational Therapist) our like minded approach, are openess to positive dialogue and support of another most definitely facilitated the CST group outcomes.
2. Without the generous support of local community services providing us with a comfortable space and other facilities our task would have been much more difficult. The empathy shown to our group – the little but vital supports such as tea, coffee , scones etc made our location a home from home and had a hugely positive impact on our participants.
3. Relative to step 1. – The ability of fellow professionals who could happily work together, source materials while being able to be at one in selecting particpants, both using our own professional backgrounds and experience all facilitated the successful outcome of the initiative.

3 Challenges in Planning / Delivery

1. Initial uncertainty in relation to a suitable working space and the availability of resources.
2. There was a delay in start up due to our realisation that planning and structuring our program took longer than expected.
3. One would hope that the sense of well being gained by the particiants will stay with them long after they have finished their CST intervention. The challenge for health professionals going forward is to be able to provide further person centred interventions which can continue to support their personal identity and quality of life.

3 Outcomes / Benefits

1. Throughout the sessions the facilitators aspired to identify how benficial this intiative was proving to be for the group. One way of capturing this was using a Patient Reported Outcome Measure (PROM) called the DEMQOL. The Demqol is designed to enable the assessment health-related quality of life of people with dementia. It is a 28 item interviewer- administered questionnaire answered by the person living with dementia. We provided the DEMQOL prior to the start of CST and again by the end of week 9 to allow us measure the progress of the sessions. While the DEMQOL allowed us to identify the impact of the sessions had had on their Quality of Life more importantly the personal responses of each individual were even more rewarding and helpful. So invigorated by our initial sessions we were prompted by the group to extend CST and were able to deliver Maintence CST for a further 12 weeks.
2. Establishing relationships with the community service manager again allowed us to offer a welcoming setting for the group with excellent support and back up from the community provider themselves enabling meaningful services for people living with dementia in a homely friendly surrounding.
3. By establishing this new CST intervention to Limerick it provided a new knowledge base for our colleagues in MTRR and ICPOP, the families of the particpants all of whom would have had little or no prior knowledge of CST. Thus, justifying its potential to offer such a service on a much wider scale within the HSE and Integrated services.