I had some lovely feedback the other day, from Michaela Sheridan-White, who is an Occupational Therapist working in Older People's Mental Health Services in Derbyshire. She wrote as follows:
"I just wanted to say a big 'Thank You' for all the hard work you've put into this site.
I came across it a few weeks ago when we went into the 2nd lockdown and all our CST groups were cancelled, again. We talked about Virtual CST groups, would our client group be able to engage virtually?
A lot of the staff were unsure and wary of the technology. I found this site and thought, well obviously it can be done and can be done successfully. Within a week we got our first vCST group set up using inspiration from your Childhood session and i've just found the recent session on Decimalisation. Fabulous!
Thanks for putting all your work out there for others to adapt and use, it's really helpful."
This inspired me to write a short article about how we have established our 'vCST Zoom Groups' here in the Cardiff and Vale Young Onset Dementia Service.
To begin with, we now have three 'vCST Zoom Groups' (other providers are available). They are:
- Tuesday 'vCST Quiz Group'
- Wednesday 'On Line Thai Chi Group'
- Thursday 'vCST Friendship Group'
Each run for about an hour, more or less. There are about 25 clients and supporters participating across the three groups.
'Tuesday vCST Quiz Group'
To explain the differences between the Tuesday and Thursday groups, the first is for people who enjoy and cope well with a quiz format - the content is mostly reflected in the 'Simon CST Dementia Blog' pages.
We pick a theme, which is usually related to a calendar event, and the format is fairly formulaic in so much as how the content is managed.
- We start with 'Introductions' and a 'Discussion Question', based on the theme.
- We then have 'Idioms', which are well known phrases and proverbs, again linked to the theme, which members complete by collectively shouting out the answer. This seems to help people get into the mood for the quiz to come and makes them feel more confident in their recall ability.
- We then have a singalong 'Themed Song', which is again aimed at helping members relax and feel engaged in the group activity.
- We then enter into the 'Themed Music & Picture Quiz', which has about 40 questions split into four or five rounds, with a themed song between each round. Songs are selected carefully, with the aim that they will be held in long term memory.
- We then ask members to loosely tot up their scores and award a 'Virtual Prize' to the winner. Again, this is linked to the time, so for our 'Australia Day' session we had a jar of 'Vegemite' and this led to a discussion about who loves or hates 'Marmite'.
(I just wanted to note briefly that engagement and enjoyment are far more important than competition and all performance is celebrated. For example, someone singing along or getting up to dance is applauded as much as a right answer.)
- We finish with 'Thanks and Goodbyes' and outlining the rest of the week's vCST activities and the theme for the next 'vCST Quiz'.
- Also added on to the Blog is a 'Practical Activity', again linked to the theme, for members to complete later with their supporters if they wish, which helps carry on the session into one to one work at home. For example, the 'Celebrating Scotland' session had a suggestion to download templates (or draw freehand) for 'Making Your Own Tartan'.
'Thursday vCST Friendship Group'
The Thursday group is somewhat different and could be described as being aimed at people with more significant cognitive problems, or perhaps those who are living alone. However, that being said some members attend both groups, such is their level of enjoyment.
The outline of this session is as follows:
- 'Welcome' and 'Orientation' regarding, day, date, season etc.
- 'Introductory Song', which is selected by members and repeated each week, to aid memory.
- A 'Reminiscence Based Story', which aims to engage members in discussion and story-telling about earlier life and experiences.
- A 'News Round Up' of the week's top (usually good) news stories and the funniest social media videos and photographs.
- A couple of 'Themed Songs' for singalongs are included for enjoyment.
- The session ends with a fifteen minute or so 'Relaxation' session, with a script read out by the facilitator and some suitable music and video images playing quietly in the background.
I wanted to say something about method, as starting out with virtual CST work can be daunting at first. (We have offered several colleagues the opportunity to join and observe sessions to help get them started.)
First things first, usually most of our clients who participate have a supporter to assist them with the technology. This is not always the case, however. Some members are more tech savvy and after a bit of instruction are able to guide themselves through. (It's worth noting that once members are online, the work is done our end to navigate through the materials!) A few members living alone have needed a paid care staff session to be arranged to help them join the sessions. I believe on a couple of occasions, assistance with accessing the tech has also been provided.
We use 'Zoom' to facilitate the sessions, but 'Skype' works just as well.
An email is sent out to members about an hour ahead of the session, by way of a reminder for them to join. It also directs them of what to bring to the session, for example, wear clothes suitable for a discussion about 'Hippies'! We also ask members to bring stories about themselves, places visited etc to enliven the session and make it more personally meaningful.
So, members click on the link in the email to join and the facilitator 'lets them into the room'. We can see all of their faces in the 'chat room gallery'. This really helps us judge engagement and perhaps ask a prompting question of someone who seems to be 'drifting off', for want of a better word. Also members can wave or put their hands up if they want to tell us something about their views or experiences.
The 'host' of the session can share their screen via 'Screen Share'. This has been a little tricky to get used to, as you also need to remember to 'Share Computer Sound'. Once this has been sorted, we can share the photos, videos and 'You Tube' music videos for everyone to enjoy.
There is a little bit of 'mastering the technology' time needed, but a few dummy runs pretty much helped us iron out the glitches. The only 'fly in the ointment' sometimes is a dodgy internet connection, either our end or members ends, but there isn't much we can do about that. Members appreciate the difficulties and generally take any problems with patience and smiles.
If someone 'drops out' for any reason, we follow them up via a telephone call to check they are all right.
All of our groups seem to be highly valued. Members returning each week to reconnect is testament to this. We have had lots of plaudits of our vCST work as well. Here are just a few comments recently received:
Mrs G - "Thanks for keeping us connected in these most difficult of times. The sessions have helped us feel supported and less isolated."
Mrs W - "Thanks for session the other day. We haven't laughed so much in ages."
John - "I can't thank you enough. These sessions really are essential to my well-being."
So there we go. Why not give virtual Cognitive Stimulation Therapy sessions a try? During lockdown, people with dementia have had greatly reduced access to such activities and it looks like it will be a while before we can return to face to face group work. Our experiences have shown that vCST work is not only possible, but also it has become an essential 'new arm' in our support network.