1. What is Cognitive Stimulation Therapy
What is Cognitive Stimulation Therapy? A workshop for persons with dementia & their whānau
Dr Kathy Peri & Dr Gary Cheung
CST International Trainers

2. Outline What is CST? CST in NZ: past, current and future projects
CST live demonstration

3. Non pharmacological approaches in Dementia
Cognitive Intervention
(individual or group)
Cognitive training
Cognitive stimulation
Cognitive rehabilitation
Physical Exercise
(individual or group)
Aerobic exercise
Strength exercise
Le attuale prospettive non farmacologiche sempre insieme ad una corretta aliimentazione sono l’esercizio fisico ed il training cognitivo…... Un’ipotesi e’ se tale prospettive sono in grado di migliore l’IR cerebrale traducendo in una stabilita’ nonche’ un miglioramento delle funzioni cognitive.

4. CST (Spector et al. 2003)
A structured group treatment for people with mild to moderate dementia
Theoretical concepts of reality orientation, validation, reminiscence, and cognitive stimulation
Maximum number per group 7-8
Sessions twice a week for 7 weeks
Maintenance – (optional) – sessions once a week for 24 weeks
Both community and residential care settings
Delivered by health professionals

5. CST: Evidence & Guidelines
World Alzheimer Report 2011
Cochrane Review 2012
1.78 point change on MMSE
NICE Guidelines
Lancet commissioned report (Livingstone et al. 2017)
“Cognitive stimulation therapy is the psychological approach with the strongest evidence for improving cognition.”

6. CST: Development Reality Orientation Therapy (RO)
RO is a general approach to inpatient treatment for reducing confusion in geriatric patients
Confusion results from
under-stimulation of the patient
Care providers’ lack of insistence or expectation that the patient perform normal behaviour
Care providers’ non-reinforcement of desired behaviours when they are performed

7. Reminiscence therapy
Involves the discussion of past activities, events and experiences with another person or group of people
usually with the aid of tangible prompts such as photographs, household and other familiar items from the past, music and archive sound recordings.

8. CST: Key Principles And most all have……….FUN Mental stimulation
Opinions, rather than facts
Use of reminiscence
Respect
Person centered
Inclusion
Involvement
Choice
Build and strengthen relationships
Maximize potential
And most all have……….FUN

10. The 14 Main Activities Physical games Sounds Childhood Food
Current affairs
faces/ scenes
Word association
Being creative
Categorising objects
Orientation
Using money
Number games
Word games
Team quiz

11. International CST Picture
Australia
Brazil
Canada
Chile
China
Denmark
Germany
Greece
Hong Kong
India
Indonesia (Jakarta)
Israel
Ireland
Italy
Japan
Nepal
Nigeria
Philippines
Portugal
Singapore
South Africa
South Korea
Tanzania
Turkey
The Netherlands
United States

12. CST projects in NZ Past: Group CST feasibility study, 2014 (Te Pou)
1-day training workshops,
Individual CST feasibility study, 2016 (Dementia Auckland)
Current:
CogEx: CST vs CST+UpRight Exercise Programme (BRNZ)
CogYoga: CST vs CST+Chair yoga vs Chair yoga (BRNZ)
CST training programme & evaluation (BRNZ)
Examining the switch-on phenomenon (AUT masters student)
Individual CST as part of primary care cognitive impairment pathway (Guardian Trust, Dementia Auckland, East Health PHO)
Future:
Cultural adaptation (Māori and Pasifika)
Neuroimaging research

13. CST training programme & evaluation (2018)
- 10 workshops
- Online group supervision