Unlocking memories

Allegro Senior Living partners with OT Services to offer cognitive stimulation therapy to residents

by Michele Berhorst • October 24, 2023

Pat Nellis, OTD, OTR/L, (middle)  engages with cognitive stimulation therapy  group members who are sharing their thoughts and feedback about the session.  

Changes in memory are common among older adults. For those with dementia, they can range from mild to severe as the disease progresses. Staying mentally stimulated and socially engaged can be key to retaining quality of life and wellness for older adults living with dementia. That is why Allegro Senior Living, a family-owned company based in St. Louis, offers a cognitive stimulation therapy (CST) program for their community members. Patricia Nellis, OTD, OTR/L, director of the Division of Clinical Operations for the Program in Occupational Therapy, oversees and delivers the CST program. The partnership began when Elizabeth Dodd, Allegro’s assistant vice president of sales and marketing, reached out to Nellis about setting up a resource or social activity program.

“We had previously worked with Elizabeth at The Sheridan at Laumeier Park, another senior community that offered memory care, in 2019. When she moved to Allegro, she saw an opportunity to partner with us again. We talked several times and had a meeting on site,” Nellis explains. “Unfortunately, the COVID pandemic put the program on hold until it was safe to resume group activities. We were finally able to launch the program in fall 2022.”

CST is an evidence-based treatment developed in the United Kingdom for people with mild-to-moderate dementia. It is well known there and is considered to be effective and evidence-based, but it is only now gaining traction in the U.S.

“It's a non-pharmacological intervention designed to supplement other medical interventions and is delivered as a structured group activity. The program consists of two sessions of themed activities per week for seven weeks,” Nellis says. “The goal is to actively stimulate and engage people by soliciting intact long-term memories and bringing them into the current moment through conversations, activities and participation.”

Nellis starts each session with a warm-up activity: discussing a current event and stretching. Each group has a name and a group song that everyone sings to help focus participants and build camaraderie. From there, each session follows a theme that facilitates conversation to connect past memories to the present day. There may also be an on-topic activity that can integrate other sensory inputs such as smell, hearing, taste or touch to evoke memory. It’s a psychologically safe environment where residents can share thoughts and opinions openly. For Nellis, it is rewarding to see the “a-ha moment” when a participant unlocks a forgotten memory. That moment can even uncover an unused skill or talent in someone who has shut down due to dementia.

“We had a woman from memory care in a group who wouldn’t open her eyes. Early on, hearing one of the songs made her open her eyes. She started to open up and sing along. Clearly, she had been in a choir and had a strong voice. We told her, ‘Oh my goodness, you're a singer, and you have so much to offer!’” Nellis recalls. “As the session progressed, she participated more and more. She’s currently a ‘return member’ in the latest group, where she is so much more alert, present and aware. It really comes down to the quality of life – I’m still here. I still have meaning. I have something to share,” Nellis says.

The groups are spaces to discuss different cultures and listen to the life experiences of others. “One woman lived through World War II in Great Britain. Her family lived in air raid shelters, and her mother's job was to look for injured people following a raid. It’s amazing information that people share,” Nellis says. “They are all storytellers, and the stories have a lot of meaning, which is attached to who they are.”

Participants are also interested in learning about topics that are popular among younger generations. “We did a presentation on Pokémon, which went over surprisingly well. Pictures were shared on a large-screen TV, and cards were passed out for them to see and touch. It led to an interesting conversation about what superpowers they wanted to have and why,” Nellis recalls.

Another positive outcome of the CST program is building community and connection among Allegro residents. "One group started having lunch together after sessions to continue the conversations. They know each other much better now,” Nellis says.

Allegro Senior Living shares in the excitement surrounding the success of the program and the improvements seen in their residents.

“We are thrilled to continue working with Washington University occupational therapists in offering CST to our residents at Allegro Richmond Heights. It is exciting to see how many individuals participating in this program have improved their motor skills, relationship-building, and overall quality of life," says Douglas Schiffer, President and Chief Operating Officer of Allegro Senior Living. “This outcome goes hand-in-hand with our commitment to providing communities where our residents can Live Beautifully.”

The CST program is currently running its third session and is being led by occupational therapists Kaylee Breitenbucher, MOT, OTR/L, and Anna Perlmutter, MSOT, OTR/L. WashU OT doctoral students are also participating in sessions as part of their capstone projects.