Cognitive stimulation therapy is the only proven non-drug treatment for dementia
Dementia Awareness Week (14-20 May) recognises the fact 850,000 people in the UK live with a form of dementia and there is no cure. It’s now the leading cause of death in the UK and while new medications are being tested to find a cure, there’s very little to help those already living with the condition, other than medications to help manage the symptoms. However, a proven non-drug therapy is now available to those with mild to moderate dementia.
Award-winning home care agency SweetTree will be offering group Cognitive Stimulation Therapy (CST) to its clients from the summer to improve quality of life and brain function of those living with dementia. CST has been spearheaded by Dr Aimee Spector, SweetTree’s senior consultant, a Clinical Psychologist and a senior academic at University College London.
Cognitive Stimulation Therapy (CST) is a positive and established practice that has achieved positive outcomes for improving quality of life and cognitive function, including memory and language skills. It was first developed in 1998 when there were no scientifically proven non-drug therapies available for those with dementia. Dr Aimee Spector says: ‘CST involves putting people into small groups where each session has an activity, things like word games, number games, discussions of current affairs, discussions of pictures and faces and within those activities the aim is to improve mental function through specific skills that people with dementia don’t get to use very much. We encourage use of thinking patterns, using the memory and language and getting people to exercise planning and organising skills in a different way. The principles are quite complex but the treatment is presented in a basic manner.’
The treatment consists of 14 sessions and 18 key principles and treatment typically lasts for seven weeks. It has been recommended by NICE who changed its guidelines on dementia based on the findings of CST in 2006. ‘It was the first time any non-drug treatment had been recommended for cognitive symptoms of dementia,’ says Dr Spector. ‘Since then it’s been taken up by the NHS and the Memory Services National Accreditation Programme has confirmed that 85% of memory clinics routinely offer it to those who need it.’
Study results for CST have been positive. ‘The first big trial on CST was published in 2003,’ adds Dr Spector. ‘We had 201 participants on the study, which was a randomised, controlled trial. Half of the participants received CST, while the other half received usual care. We gave them standardised measures at the start and at the end to see the differences. Within seven weeks of CST (14 sessions), those who had received CST treatment significantly improved in cognition and quality of life.’
CST in everyday life
Those caring for a loved one with dementia can include the principles of Cognitive Stimulation Therapy in the day to day lives of those living with dementia. Key ways to do this include:
Focus on opinions rather than facts
Ask the person you are caring for to give their views on a photo or image based on their opinion, not factual information. Don’t ask: ‘Who is this in the photo?’ Instead ask: ‘What do you think of when you look at this person?’ ‘What age do you think she is?’ ‘Do you think she looks happy?’ This way there is no right or wrong, the person will not feel that they have failed and asking their opinion emphasises that it still matters.
Generating new ideas, thoughts and associations
CST is about building new associations rather than solely focusing on past events and memories. Ask the person what they like in the way of food, surroundings or their hobbies based on now, not on the past. ‘We encourage new ideas and associations,’ says Dr Spector. ‘Ask what they prefer, or what are they more interested in.’
Mental Stimulation
Give people tasks which challenge them to think slightly outside the box. This gives the brain some exercise and enables people to retain their skills. ‘Much of it is about getting people to express opinions in the right environment,’ says Dr Spector. ‘If they make a mistake it doesn’t matter as they will be around others in the same situation.’