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Living well with dementia

Living well with dementia. Extending the evidence base for Cognitive Stimulation Therapy (CST). What is CST ?. A structured group intervention for people with mild / moderate dementia Recommended in the NICE guidelines for Dementia (2006) World Alzheimer’s Report 2011:

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Living well with dementia

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  1. Living well with dementia Extending the evidence base for Cognitive Stimulation Therapy (CST)

  2. What is CST ? A structured group intervention for people with mild / moderate dementia Recommended in the NICE guidelines for Dementia (2006) World Alzheimer’s Report 2011: “CST should be routinely offered to people with early stage dementia”. Cochrane review 2012 Established benefits of CST: • Cognitive functioning ( improvements equivalent to the anti dementia drugs) • Quality of Life /wellbeing • Mood/confidence Provided in most KMPT Memory Assessment Services

  3. What is CST ? It comprises 14 group sessions covering a series of themed activities aimed at stimulating specific cognitive processes e.g. executive functioning, language Themed activities include: Food, childhood, sounds, categorising objects, current affairs, using money Orientation and memory are addressed indirectly to avoid experiences of failure It is delivered in an inclusive and empowering way allowing choice It aims to provide a pleasurable experience- fun Specific staff training required is minimal: Brief manual provided and maximum 1 day training course

  4. Local interest • Extending CST groups beyond 14 sessions- seems beneficial • What training is needed for staff to be effective?

  5. SHIELD Support at Home, Interventions to Enhance Life in Dementia 3 Cognitive Stimulation Therapy studies University College London Prof Martin Orrell

  6. The research projects • Study 2 : Evaluation and Comparison of the Effectiveness of Staff Training in Maintenance CST- staff are the “ subjects” • Study 3 : What is the effect of providing 24 weeks of maintenance CST over and above standard CST ( 14 sessions) ?

  7. Why get involved ? Benefits for : me: Service line role to promote research; help develop the psychosocial evidence base service users: enhance provision and quality of CST across the trust; provide extra treatment for staff: use their therapeutic skills ,develop research experience ; extra staff training in CST for the trust : reputation; FT research requirements ; research targets

  8. Getting started Summer 2011 Identify the local PI : • Negotiations between UCL & KMPT & CLRN • Local Research Approvals • Identify “interested” sites and staff

  9. The cast 5 sites – Tunbridge Wells ,Thanet, Maidstone, Canterbury and Sittingbourne 24 staff - OTs , Nurses, support workers, therapy technicians, assistant psychologist Research nurse- K&M Comprehensive Local Research Network( CLRN)

  10. Summer 2012Lift off …. Induction to the studies from UCL researcher 24 Staff consent for study 2 22 Staff complete baseline questionnaires

  11. The “ real” study – study 3 Recruitment of participants from those who’ve recently received a diagnosis of dementia in Memory Assessment Services. • 46 people screened • 38 people consented • 38 Baseline assessments completed : QoL- AD; CDR; MMSE

  12. Forms…

  13. What then? 5 groups started and ran for 14 sessions +24 sessions maintenance Groups involved about 8- 10 members Assessments completed at baseline, end of 14 sessions and end of 24 maintenance sessions for research participants.

  14. Autumn 2013 • All CST groups have finished • 18 follow up assessments are completed so far (5 dropped out due to ill health/ died) • UCL study team doing a focus group with 9 staff to hear their observations • 18 Staff have completed their final on line assessments – study 2 ( 22 staff started)

  15. The outcomes for participants Formal data not yet analysed, but • Locally, staff observed improvements in • confidence • social functioning • skills • mood i.e. Living better with dementia

  16. The staff experience

  17. How was it? The voices of some participants Heidi Suzanne

  18. What have we learned ? • Research takes time and energy • KMPT staff can really step up to the plate- but exhausting without a research supportive environment • 5 sites and 2 studies at once was maybe over ambitious !

  19. What next….. • Plans to engage with new multi site study -IDEAL • Develop our own research study and get research funding to implement it

  20. Thanks for listening

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