cogs 10 th International Dementia Conference April 2018 Jackie Tuppen RN, SP, B.Sc Hons Admiral Nurse and Specialist Practitioner

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1 cogs 10 th International Dementia Conference April 2018 Jackie Tuppen RN, SP, B.Sc Hons Admiral Nurse and Specialist Practitioner

2 cogs Cogs Club: an innovative model of support in early dementia

3 Cognitive Stimulation Therapy Research literature has highlighted the clinical effectiveness of CST. (Spector, 2003; Orrell, 2005; Spector, 2006) 14 sessions of 2 hours of themed activities over seven weeks (2 sessions a week)

4 Links to CST Cognitive stimulation, music, reminiscence and orientation are part of a typical Cogs day. These interventions improve participants sense of well being (Spector et al 2011). Researched and validated interventions enable the Clubs to address a key theme of the National Dementia Strategy (2009) high quality care and support for the person with dementia and their carers.

5 A typical day in a Cogs Club Research suggests that people experiencing memory problems do not like change. therefore, a structured approach is important

6 Commences at 10 a.m. Welcome, Discuss the name of the club. Theme song. Orientation to time place etc. Discussion about some things currently in the newspapers After tea around a.m. -An activity based on Cognitive Stimulation Therapy Lunch break about p.m. Encourage conversation which aims to build trust and rapport The afternoon session starts about 1.00 p.m. This is Movement to Music. Can alternate between seated and standing activities Last session starts about 1.45p.m. Members choose their final activity which may be board games, then around 2.30 p.m. the activities end. There is tea and biscuits whilst we read the summary and discuss the day. Some clubs end with a song All members have departed by 3.00 p.m.

7 Members Individuals with memory problems who have been referred to the group. Selection Criteria: A degree of insight into their difficulties. Adequate communication and language skills. Mild to moderate Dementia. A wish to attend the group. There is no age limit

8 Meeting a need Carers and people with dementia were asking for an alternative to Day Centres Cogs Clubs fill a gap in the services for people with mild to moderate Dementia Carers wanted time for themselves. Cogs Club gives them 5 hours respite People with dementia and their carers were becoming isolated even at this early stage.

9 The concept of Resilience A primary goal of any psychosocial intervention in early dementia must be to build resilience, helping people find within themselves the resources to adjust to a new way of life. Guss et al 2015 Cogs Clubs provide a platform for the person with dementia and their families to adapt positively to the challenge of dementia

10 Resilience Researchers found that interventions which facilitate autonomy, social connectedness and competence, such as interest and activity groups, are likely to be simple, resource efficient, but effective. Gallacher et al 2012 regularly doing activities that challenge the brain can contribute to resilience by helping to build up a cognitive reserve. Alz: Soc: Toronto 2016

11 2013 evaluation The evaluation of 12 clubs was in two parts: Firstly questionnaires were given to members, carers and facilitators of the clubs This was followed by well being behavioural observations at 2 clubs to complement the findings of the questionnaires

12 Response to questionnaires In Oct 2013 members, relatives and facilitators from 12 clubs were given questionnaires. 58/75 members, 63/73 carers and 40/48 facilitators responded, giving an excellent return rate of 77.33%, 86.3% and 93.02% respectively.

13 Observation results An independent observer, from Dementia Pathfinders, visited 2 clubs to observe members participation. This was based on observed behavioural indicators of well-being in a person with dementia, and aimed at adding a further dimension to the information provided in the questionnaires. All the elements of well-being (in varying degrees ) were observed in members of the groups

14 Carer Motivations Carer report that their relative : has a good laugh, is well looked after, and the Club has helped confidence, and is very warm and friendly, For themselves they say the club is: excellent makes a difference, frees up time, respite, been a lifeline

15 Members motivations Members reported that they are: Happy, and the stimulation at the club has improved my concentration, keeps my mind active, plus they are in company with other people equal to myself, and the structure of the club means that I m aware what is coming up

16 Facilitators motivations Facilitators report that working in a club has: improved confidence, sense of self worth, plus they feel their input is making a difference to others. There is a fulfilling feeling, and a sense of satisfaction in seeing how the group enjoy themselves

17 Key ingredients that address resilience Canadian Journal 2016 found factors associated with resilience could be organized under three major themes: active and purposeful living, perspective, and resources The responses to the evaluation indicate that these themes are running through a typical day at Cogs Club

18 In Conclusion Cogs is a low level, simple intervention with early evidence of benefits in maintaining health, resilience, well-being and social connections for people with mild to moderate dementia. The clubs provide an environment which is friendly, lively, safe and normal. Carers meet others in the same situation and form their own support network.

19 For information about starting a club, referral criteria, staff, venues, costs, organisations running clubs etc see: or contact jackie.tuppen@hotmail.co.uk

The benefits of groups that provide cognitive stimulation for people with dementia

The benefits of groups that provide cognitive stimulation for people with dementia Cogs clubs offer mental exercise, music, movement and friendship for their members, and respite for carers. Founder Jackie