Pioneers of a therapy which slows the progress of dementia are disappointed that more community-based techniques have not been recommended in official guidelines.
Cognitive Stimulation Therapy (CST), which aims to exercise different areas of the brain through a series of focused activities in a socially-engaging context, was the only non-drug treatment recommended to stimulate cognition, engagement and independence in new dementia care guidelines from the National Institute for Health and Care Excellence (NICE) launched last week.
CST was developed by clinical psychologist, Dr Aimee Spector, and a team at University College London. Aimee has provided the therapy to clients of South Hampstead-based SweetTree Home Care Services over the past year. The technique has demonstrated significant improvements in both quality of life and memory of people with dementia.
Although the condition affects nearly one million people in the UK, the new NICE guidelines suggest limited progress in developing treatments over the past 12 years. SweetTree’s Director of Operations, Nicki Bones, said: “It is disturbing that so little has changed in all these years.”
SweetTree, which was rated ‘Outstanding’ by the Care Quality Commission earlier this year for its home and live in care services in the capital, is committed to developing dementia care in the community.
Aimee explained: “Drug treatments are not suitable or beneficial for many people with dementia, so it is essential to consider non-drug alternatives.
“CST helps to normalise people’s experiences and reduce the stigma of living with dementia. It can also provide a social connection for those taking part in group therapy.”
Aimee ran a CST group for SweetTree clients, and has trained SweetTree staff to provide individual CST (iCST) sessions in clients’ own homes.
CST treatment involves themed activity sessions, including word games and puzzles, which aim to engage and stimulate clients. While CST is now routinely offered in many NHS memory services, its offering in homecare services is novel and innovative, providing a service for clients who need stimulation and engagement but are not necessarily yet needing formal care.
Each session is different, with the level of difficulty being changed depending on each client’s cognitive ability, to ensure sufficient challenge.
Aimee explained: “When working with people with dementia, the changes you see are often quite small. NICE looks at big clinical trials in making its recommendations and considers both effectiveness and cost-effectiveness.
“CST is proven cost-effective because it doesn’t require high levels of training or equipment.”
Age UK now widely offers CST in local branches and the therapy is being used in over 27 countries across five continents.
Ellen Holden, SweetTree’s iCST facilitator, is currently working with clients in their own homes and says this makes them feel more comfortable.
She works with two men together who had met at Aimee’s group sessions and said: “It seems like they’ve been friends their entire lives, they are usually crying with laughter.
“Their wives say they their mood has lifted and they have seen improvements in their short-term memory. They both look forward to their next session and remember that it’s going to happen.”
One London-based client, who took part in Aimee’s group, said: “It’s been great, I’ve had a lovely time. It has been something very different and we’re privileged to have got on the course.”
With another 225,000 people in the UK expected to develop dementia in the next year, Aimee and SweetTree hope to see further research and the ongoing development of therapeutic dementia care to help improve the lives of those with the condition.