Is Virtual Cognitive Stimulation Therapy the Future for People with Dementia? An Audit of UK NHS Memory Clinics During the COVID-19 Pandemic

Abstract

Access to psychosocial interventions for people with dementia, such as Cognitive Stimulation Therapy (CST), has been restricted during the COVID-19 pandemic. Some services have shifted to provision via videoconferencing, but the prevalence of this is unknown. This audit aimed to understand provision of virtual CST (vCST) within National Health Service (NHS) memory clinics throughout the UK and Channel Islands and investigate plans for ongoing CST provision. A cross-sectional survey was circulated to NHS memory clinics, which included closed and open-ended questions to generate quantitative and qualitative data. Thirty-three memory clinics responded to the survey. During the pandemic, 55% of respondents offered vCST, whereas 45% offered no CST. Of those offering vCST, 80% plan to continue with a hybrid model of separate face-to-face and vCST groups, whilst 20% intend to deliver face-to-face CST only. Reported positive aspects of vCST were participant and staff enjoyment, perceived improved digital confidence in participants, and improved accessibility for those who cannot attend face-to-face groups. Negative aspects related to digital poverty, limited digital literacy, support needed from carers, the impact of sensory impairment on engagement, and staff time commitment. Virtual CST has been a feasible alternative to face-to-face services during the pandemic but should not completely replace in-person groups. A hybrid approach would increase accessibility for all. Future research should explore efficacy of vCST and seek to understand patterns of exclusion from such digital interventions.

Online Cognitive Stimulation Therapy for Dementia in Brazil and India: Acceptability, Feasibility, and Lessons for Implementation

“…A major barrier in both sites was access to technology and computer literacy. This issue was also highlighted in studies of vCST in UK settings [23,24]. A survey of the digital divide in India found that just 38% of households are digitally literate [42].…”

“…However, during the CST-International study, access to face-to-face health care services was rapidly restricted due to the COVID-19 pandemic [ 21 ]. CST started to be delivered virtually in international settings including the United Kingdom and New Zealand [ 22 , 23 ], but a standardized protocol was not available. An international collaboration resulted in a framework for global delivery, which was field-tested in Brazil and India, alongside the United Kingdom, Hong Kong, and Ireland [ 24 ].…”

Virtual Group Cognitive Stimulation Therapy for Dementia: Mixed-Methods Feasibility Randomized Controlled Trial

“…Cognitive stimulation therapy is becoming more widely implemented virtually in services in the UK; a recent survey of 33 memory clinics found that 80% of these clinics intended to offer a mix of virtual and face-to-face CST groups as a long-term option ( Fisher et al, 2023 ). In the current study, several people with dementia and caregivers declined to join the study due to worries about setting up Zoom, having unstable internet, and lack of devices.…”

“…Meanwhile, a team from New Zealand documented their success in moving CST groups online during the pandemic ( Cheung & Peri, 2020 ). A survey of 33 UK memory services ( Fisher et al, 2023 ) found that during the period of COVID-19 restrictions, 55% offered CST group sessions virtually through video conferencing platforms. Critically, 80% of services stated that they planned to continue with a hybrid model long-term, with the remaining 20% intending to deliver face-to-face CST only.…”

Online Cognitive Stimulation Therapy for Dementia in Brazil and India: Acceptability, Feasibility, and Lessons for Implementation (Preprint)

“…However, during the CST-International study, access to face-to-face healthcare services was rapidly restricted due to the COVID-19 pandemic [21]. CST started to be delivered virtually in international settings including the UK and New Zealand [22,23], but a standardised protocol was not available. An international collaboration resulted in a framework for global delivery, which was field-tested in Brazil and India, alongside the UK, Hong Kong, and Ireland [24].…”