1. Cognitive Stimulation Therapy enhances residents' cognition and psychological wellbeing in Selwyn Village care homes
Orquidea Tamayo Mortera, Group Diversional Therapist
Alzheimers New Zealand Conference
TACKLING DEMENTIA: IT’S EVERYBODY’S BUSINESS
Thursday 25th October, 2018

2. “Me mātua aroha ki te tangata, hei manaaki tika i a rātou”
To care for al older person

3. Contents 01
What is Cognitive Stimulation Therapy (CST)? 02
Why is CST so important for older adults in Selwyn care homes? 03
Breaking Barriers 04
How can I best support CST in my home? 05
Ongoing CST Research 06
Conclusions

4. Loneliness and Depression among older people living in long term care settings in New Zealand are a significant issue. Bogati, R. 2016
For example, current treatment approaches for depression are done mostly through anti depressants medication and overtime people are overcome by the ‘wilting flower syndrome’
There is a huge need for practitioners to develop, recommend and prescribe other type of intervention programs that are appropriately targeted, evidence-based and evaluated.
Interventions that are non-drug base.

5. 01
What is Cognitive Stimulation Therapy (CST)?

6. What is CST? Cognitive Stimulation Therapy
Evidence-based intervention aiming to improve cognitive functions in people with dementia
Group treatment for people with mild to moderate dementia
Engagement with themed activities that are enjoyable
Developed by Spector and her colleagues (2003) in the UK
Practiced internationally including New Zealand
The only non-drug intervention in the UK recommended for cognitive symptoms and maintenance of function

7. Quick Overview Small social groups Meeting twice weekly for 7 weeks
Each session takes around mins
Participants choose a group name and a “theme song”
Use of a “reality orientation board”
Group activities are structured and manualised but not prescriptive
Introduction
Main theme activity
Closure
- (6 -10 participants and 2 facilitators)
- (first CST)
– 10mins (welcome, use of white board, theme song, warm-up, current events, and refreshments)
– 25mins (e.g. games, sounds, childhood, food, quiz), providing two levels (A & B)
– 10mins (summary, theme song, reminder of next session, farewell)

8. 02
Why is CST so important in Selwyn homes?

9. Why is CST important in Selwyn homes?
We cater for people with Cognitive Decline and Mild to Moderate dementia
Suitable and can be easily adapted for our settings
CST principles align with our Selwyn Way
Enhances peoples opinions rather than facts
Maximises peoples potential
Helps people to build and strengthen relationships
(hospital, rest home, day care)
(person-centred, respect, growth, involvement, resilience, belonging, contentment, involvement, inclusion, choice, fun, spirituality, individuality)
(implicit learning)
(just right challenge)

10. The Facilitators Role Before CST During the Session After CST
Meet 3-4 weeks prior to starting CST
Develop the plan in consultation with GDT
In consultation with Care Leads, Families and Residents (where applicable) to confirm the list of participants
Provide a copy of the CST plan to Care Leads, Families and participants
During the Session
Please refer to the Quick Overview Slide
After CST
Meet with the Co-Facilitator for 15mins and fill in the Monitoring Progress Form (MPF) together.
Provide a copy of the MPF to the Care Lead, so that the information can go on Lee Care (unless you work in the house and you have access to all the residents Lee Care Daily record)
Quickly discuss details for the upcoming session
Together clear the room and put things back in place
Before the Session begins
Meet with the Co-Facilitator 15mins before the session to review the theme
Quickly review the running of the session
Together do all the set up

11. Switch-On Phenomenon
Positive changes in participants observed by staff, family and facilitators
New found confidence
New found capability
Positive effect on mood
Improved memory
Vastly improved communication skills
Positive experiences of being in smaller groups
(opportunity to be heard and to be spoken to as a normal person)
(constructive and positive criticism –provoking topics)
(remembering jokes)
(learning a song together)
(‘making sense’ when replying)
(open and honest conversations)

12. “I feel that my opinion is valid in this group”

13. 03
Breaking Barriers

14. Breaking Barriers
Limited organisational culture & platform for change and to implement Non-pharmacological or Complementary therapies that are evidence base practice
Lack of engagement as CST not regarded as a treatment by some health professionals
Lack of trained staff to facilitate CST
Limited time and human resources
Limited financial resources for CST equipment
Adapted CST
CST, Maintenance CST and iCST
Research opportunities
Education for Management and Clinical Leaders
Presentations for RN’s, Care givers
CST Training for Selwyn Team
Hard to have two staff off the floor (explaining how having 8 residents for CST actually works because the ratio is 1Caregiver for 8 Staff)
Fundraisings and lots of creativity with family and volunteers support
Introducing CST

15. We should be breaking barriers to enhance our elders lives, not building walls.

16. 04
How can I best support CST in my home?

17. How can I best support CST in my home?
Learn about the importance of CST and educate your team
Talk to the families about the potential benefits of CST
Remind and motivate your residents about the benefits and positive outcomes of participating in all the sessions
Remind your team to support residents attending CST
Don’t send people on trips on the day and the time that CST is taking place please
If residents attending CST are on a trip on that day, please plan in advance and remind the Driver/AC/DT/CG/V to support the residents to get back home in time for CST
to arrive 5mins before the CST session begins and not 15mins after the session has already started (respect those who arrive on time, but also remember that facilitators need to focus on the set up and the running of the session)

18. If a resident needs to take medication during CST, plan ahead.
Support residents to plan visits or appointments that won’t clash with CST (e.g. GP, Podiatrist, Hairstylist, Family visits, Dentist, Audiologist )
Support the facilitators, they are enriching the lives of our elders.
Support residents with personal cares before the CST session
Most facilitators are medication trained, and could easily deliver the medication avoiding unnecessary interruptions during the session
Support residents attending CST to go back to their preferred place when the session has finished. (Facilitators need to have a quick catch up, clear the space and record notes)

19. 05
Ongoing CST research

20. Ongoing CST Research CST Research (Ongoing) Cogex (CST + Exercises)
CSTY (CST + Yoga)

21. “I am happy to belong to this group. I don’t want the sessions to end

22. 06
Conclusions

23. Conclusions
CST provides engaging and challenging brain activities for individuals. The element that makes CST so effective is the social interaction that is inherent in the therapy, which provides meaning and purpose to an individual’s life despite their physical or cognitive abilities.
This therapy is human-to- human contact, we are wired to interact with other humans.

24. Thank you