What is Cognitive Stimulation Therapy A workshop for

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

Outline 1. What is CST? 2. CST in NZ: past, current and future projects 3. CST live demonstration

Non pharmacological approaches in Dementia Physical Exercise (individual or group) 1. Aerobic exercise 2. Strength exercise Cognitive Intervention (individual or group) 1. Cognitive training 2. Cognitive stimulation 3. Cognitive rehabilitation

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

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. ”

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

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.

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

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

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 https: //youtu. be/OAO 4 IM 4 SAUk

CST projects in NZ Past: § Group CST feasibility study, 2014 (Te Pou) § 1 -day training workshops, 2015 -2017 § Individual CST feasibility study, 2016 (Dementia Auckland) Current: § Cog. Ex: CST vs CST+Up. Right Exercise Programme (BRNZ) § Cog. Yoga: 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

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

14 k. peri@auckland. ac. nz g. cheung@auckland. ac. nz