Blossom: A Comprehensive Approach to Cognitive Stimulation Therapy

Blossom was developed to stimulate cognition and train fine motor skills. It can be integrated into Maintenance Cognitive Stimulation Therapy for dementia sufferers, as well as Physical, Occupational, and Therapeutic therapies for stroke patients and other neurological diagnoses such as spinal cord injury, peripheral nerve injury, and MS. This insight comes from an Occupational Therapist at Hobbs Rehabilitation.

Understanding the MODEM Report on Cognitive Stimulation Therapies

The MODEM (Modelling Outcomes and Costs Impacts of Interventions for Dementia) project ran from 2014 to 2018. It was funded by the UK Economic and Social Research Council (ESRC) and the National Institute for Health Research (NIHR). The project was led by the London School of Economics and Newcastle University Institute for Ageing.

Cognitive skills are essential for thinking, learning, remembering, problem-solving, and communication. Various approaches exist to help people with dementia improve their memory and thinking skills. One effective method is Cognitive Stimulation Therapy (CST).

Key Points of the MODEM Report

• CST enhances memory and cognitive skills in individuals with mild to moderate dementia.

• Participants reported improvements in their daily lives after engaging in CST.

• CST is cost-effective and offers significant value for money.

• NICE (National Institute for Health and Care Excellence) and SCIE (Social Care Institute for Excellence) recommend CST for individuals with mild to moderate dementia.

  
  

What is Cognitive Stimulation Therapy?

Cognitive Stimulation Therapy consists of 14 structured sessions, each lasting 45 minutes. These sessions occur over seven weeks and cover various topics. To ensure continuity, each session includes familiar activities, such as a warm-up activity, a song, and a ‘reality orientation board’ with group information, including the date, time, place, and weather.

Group members choose a name for their group, and the sessions involve a range of activities designed to stimulate thinking, memory, and social interaction:

• Discussing current news stories

• Listening to music or singing

• Playing word games

• Engaging in practical activities, such as baking, which involves measuring ingredients and following recipes

  
  

These sessions are tailored for individuals with mild to moderate dementia. They aim to create a relaxed and enjoyable atmosphere, allowing participants to learn, express their views, and interact with others.

Why is Cognitive Stimulation Therapy Important?

Many individuals with dementia seek ways to enhance their memory and cognitive skills while coping with memory loss. Although some medications may help in certain stages of Alzheimer’s disease, they are not suitable for everyone and have limited effects.

CST is crucial because it not only stimulates the mind but also fosters a supportive environment for sharing experiences. Group sessions allow individuals to connect with others facing similar challenges. This connection helps build self-esteem, making participants feel more confident in conversations and activities.

Does Cognitive Stimulation Therapy Work?

Improved Cognitive Skills and Quality of Life

CST has been shown to significantly enhance memory and cognitive skills in most individuals with mild to moderate dementia. Participants reported improvements in their daily lives. Caregivers also noted enhancements in language skills and a greater willingness among individuals with dementia to engage in conversations.

These findings stem from two studies. In the first, a randomised controlled trial (RCT) divided participants into two groups. One group received CST alongside their usual care, while the other group only received standard care. Most participants lived in care homes. The results were corroborated by a second study, which included individuals living both at home and in care homes. The first trial found that CST was as effective as commonly prescribed medications for mild to moderate Alzheimer’s disease (usually donepezil). The second study confirmed that CST provided additional benefits beyond those of medication.

Smaller pilot studies of adapted CST versions in Chile and Japan have also reported positive outcomes in memory, thinking skills, and overall quality of life.

These findings are further supported by the Cochrane review on cognitive stimulation conducted in 2012.

What People Say About Cognitive Stimulation Therapy

The Difference It Made

Participants with dementia expressed that they were concentrating better and noticed improvements in their memory. They felt that engaging in group discussions helped them remember more effectively. One participant noted:

"It always makes a change when you have to concentrate on something; it’s more helpful for your memory... I think it makes you concentrate more in everything you’re doing really." (p.947)

A third of caregivers reported that their relatives showed improvements in memory and were more willing to engage in conversations outside the group. Staff members facilitating the groups observed enhancements in memory and participation in activities from previous sessions.

The project concluded that making evidence-based interventions widely available is vital for improving the quality of life for individuals with dementia and their families while ensuring efficient resource use.

A training manual and DVD have been developed to guide planning and running the sessions, along with methods to track progress. This material has been translated and adapted for use in other countries.

Additional Benefits of Blossom in Rehabilitation

Blossom's innovative design provides engaging and dignified rehabilitation tools. It helps individuals with motor and cognitive challenges regain independence and improve their quality of life. The integration of Blossom into therapy sessions can enhance the effectiveness of cognitive stimulation, making it a valuable resource for both therapists and patients.

Conclusion

Cognitive Stimulation Therapy is a powerful tool for individuals with dementia. It fosters cognitive improvement and enhances quality of life. By participating in CST, individuals can find support, build connections, and engage in meaningful activities. Blossom by Orlando Ely stands at the forefront of this approach, offering innovative solutions for rehabilitation.

Read More on How Blossom Benefits Stroke Rehabilitation and Dementia Care.

References

1. Woods B, Aguirre E, Spector AE, Orrell M (2012) Cochrane Review: Can cognitive stimulation benefit people with dementia http://www.cochrane.org/CD005562/DEMENTIA_can-cognitive-stimulation-benefit-people-with-dementia

2. Spector A, Thorgrimsen L, Woods R, Royan L, Davies S, Butterworth M and Orrell M. (2003) Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia. British Journal of Psychiatry 183, 248-254. https://pubmed.ncbi.nlm.nih.gov/12948999/

3. Spector A, Thorgrimsen L, Woods RT, Orrell M. Making a Difference: An Evidence-Based Group Programme to Offer Cognitive Stimulation Therapy (CST) to People With Dementia. London: Hawker Publications; 2006.

4. Aguirre E, Spector A and Orrell M (2014) Guidelines for adapting cognitive stimulation therapy to other cultures. Clinical Interventions in Aging 2014:9; 1003–1007. https://pubmed.ncbi.nlm.nih.gov/25061282/

5. Aguirre, E., Z. Hoare, A. Streater, A. Spector, B. Woods, J. Hoe and M. Orrell (2013). “Cognitive stimulation therapy (CST) for people with dementia--who benefits most?” International Journal Of Geriatric Psychiatry 28(3): 284-290. https://toolkit.modem-dementia.org.uk/studies/cognitive-stimulation-therapy-cst-for-people-with-dementia-who-benefits-most/

6. Miranda-Castillo, C., F. M. Tapia, A. R. Herrera, F. M. Ghigliotto and L. S. Guerra (2013). “Implementación de un programa de estimulación cognitiva en personas con demencia tipo Alzheimer: un estudio piloto en chilenos de la tercera edad. = Implementation of a cognitive stimulation program for people with Alzheimer disease: A pilot study in a Chilean elderly sample.” Universitas Psychologica 12(2): 445-455. https://www.redalyc.org/pdf/647/64728763012.pdf

7. Yamanaka, K., Y. Kawano, D. Noguchi, S. Nakaaki, N. Watanabe, T. Amano and A. Spector (2013). “Effects of cognitive stimulation therapy Japanese version (CST-J) for people with dementia: a single-blind, controlled clinical trial.” Aging & Mental Health 17(5): 579-586. https://pubmed.ncbi.nlm.nih.gov/23550665/

8. Knapp M, Thorgrimsen L, Patel A, Spector A, Hallam A, Woods B and Orrell M (2006) Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis. British Journal of Psychiatry 188: 574-580. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/cognitive-stimulation-therapy-for-people-with-dementia-costeffectiveness-analysis/510EF3EEA852079CB0BBFD8DE9B849B5

9. National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence (2006). Dementia: supporting people with dementia and their carers in health and social care. Clinical Guideline 42. NICE/SCIE, London www.nice.org.uk/guidance/cg42

10. Hodge S and Hailey E (2015) Memory Services National Accreditation Programme Third Annual Report 2013-2014. https://www.england.nhs.uk/wp-content/uploads/2018/01/dg-cognitive-stimulation-therapy.pdf

11. Streater A and Orrell M (2015) CST in care homes: results of evaluation. Journal of Dementia Care 23(6): 12-14

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