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Once a care home has completed its initial Cognitive Stimulation Therapy (CST) programme, a common question arises: what next? Residents have enjoyed the sessions, improvements have been seen, but how do you maintain those gains? That’s where Maintenance Cognitive Stimulation Therapy (MCST) comes in.
Maintenance CST is a follow-up programme to the standard 14-session CST course. It was developed after research showed that the benefits of CST - better cognition and quality of life, can fade over time unless stimulation continues. MCST provides ongoing sessions once or twice a week, often indefinitely, to keep the brain active and social connections strong.
The format is familiar: group sessions, each with a theme and structured activities. The difference is that MCST builds on skills and relationships formed in the initial CST phase. Sessions may explore new topics or revisit favourite themes with added depth or creativity.
Just as physical exercise keeps the body strong, cognitive stimulation needs regular practice to keep the mind active. Without ongoing engagement, cognitive decline tends to resume its natural pace. Maintenance CST helps sustain improvements in memory, attention, and communication for longer, giving residents a better quality of life.
Several studies have found that residents who continued with maintenance sessions after completing CST retained more cognitive function over six months than those who stopped. For care homes, this means better long-term outcomes with relatively low extra cost.
While CST is an introductory, time-limited programme (usually seven weeks), MCST is continuous. The pace can be gentler, and sessions often incorporate more social and creative activities. Facilitators and participants usually know each other better by this stage, so the focus shifts slightly from “learning” to “sustaining” and “enjoying.”
However, MCST still follows structured principles. It isn’t a casual chat group; it continues to target cognition, language, and engagement, using the same evidence-based framework.
MCST should be facilitated by staff trained in CST - ideally the same team who delivered the initial sessions. Their familiarity with the group helps maintain trust and motivation. Digital tools like the Ayla platform can support facilitators by providing new content and tracking progress over time.
MCST is best suited for residents with mild to moderate dementia who completed the initial CST course and enjoyed it. Even those whose dementia has progressed slightly can benefit, provided activities are adapted. The emphasis is on maintaining participation, not perfection.
Some NHS memory clinics and day centres offer maintenance CST, but many care homes deliver it in-house. Once you’ve completed the first CST cycle, you can roll directly into maintenance sessions with a fresh plan of themes and materials. Using a digital platform can simplify scheduling, activity selection, and data collection.
Residents who take part in MCST often show sustained or even improved confidence, speech, and social interaction. For families, it’s reassuring to see their loved one still thriving months after therapy began. For the home, it builds continuity - turning a short-term intervention into a core part of the care culture.
MCST also enhances staff satisfaction. Facilitators often describe the sessions as the most rewarding part of their week. Seeing residents smile, reminisce, and interact more naturally reminds staff why they joined the care profession.
From an operator’s perspective, MCST is a relatively low-cost intervention with significant upside. Once staff are trained, ongoing sessions mainly require time and coordination. Compared to medication or other therapies, the return on investment is high: better resident engagement, fewer behavioural issues, and positive feedback from families and regulators.
Maintenance Cognitive Stimulation Therapy is about continuity - keeping the spark alive after the initial CST course. For care homes, it’s a practical way to extend the benefits of therapy, strengthen relationships, and embed cognitive wellbeing into everyday care. If CST is the start of a journey, MCST is what keeps it going.
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