3.8 Maintenance CST – ongoing therapy

Aim

An analysis of the design, the implementation, and benefits of Maintenance Cognitive Stimulation Therapy (MCST) will be reported below.

Learning outcomes

After completing the topic, you will:

• Understand what MCST is and how it works,
• Learn how to develop a plan for running MCST.

Introduction

CST is important because, besides stimulating the mind, the individual or group sessions offer the opportunity to share experiences and talk with other people with dementia in a relaxed and supportive environment. Being part of the group or individual CST sessions helps to build self-esteem, so that they feel better about themselves as well as more confident to join in conversations and activities. Following the original CST course (normally for 7 weeks) it is useful to continue with Maintenance Cognitive Stimulation Therapy.

3.8.1 What is MCST?

Maintenance CST (MCST) is a longer-term programme, consisting of 24 additional, weekly sessions designed to follow from the initial (more intense) CST programme. MCST sessions are organized and run in the same way as the original CST courses (same principles, structure, and themes of sessions). More precisely, every session is themed (e.g. current affairs, my life, word games) and adheres to the consistent structure which characterises the original CST program, including an orientation-based activity (reminders of date, time and place.), refreshments, and a group song with which to begin ^[1,2].

3.8.2 Benefits of MCST

People living with dementia find it difficult to carry out everyday practical activities. It has a big impact on how they feel as an individual and it affects their confidence and self-esteem. Difficulties in speaking and following conversations can result in the person becoming withdrawn and isolated.

The findings suggest that MCST contributes to the maintenance of a range of different components of well-being relating to feelings, memory, and everyday life that would be expected to decrease over time for people with dementia receiving no intervention (Figure 7). Participants of MCST referred that the following benefits were also commonly experienced:

• enjoyment, having fun, and increasing levels of happiness
• a sense of belonging, being part of something, and making new social connections
• increased confidence in participants own ability and to try other new things
• improvements in communication, including reading and writing
• improvements in memory and mental ability
• having more energy and having the opportunity to be more active
• increased levels of physical activity ^[2,3].

Figure 7: Participants’ perceptions of overall quality of life had increased by the end of MCST ^[3]

Although data for carers’ surveys suggest that there was little change across the components of well-being support and self-care being measured, qualitative evidence from carers’ interviews paints a different picture. Feedback from carers suggested that they have seen benefits from MSCT program. They value the time it provides them to do things for themselves, which reduces the pressure and the stress that they experience in their caring role. An additional benefit for carers, that cannot be undervalued, is the improvements that they notice in the person they care for. They described this as an improved home life, and more confidence in what the person they care for is able to do ^[3].

Synopsis

Key points:

• There is good evidence for the benefits of continuing CST beyond the initial program. While people are still willing and able to do so, CST should be continued.
• There is an improvement in the quality of their daily lives of people with dementia and their carers during and after MCST.