“Anything that’s going to assist in the road we’re on is worth it” - Exploring the experiences of delivering individual cognitive stimulation therapy (iCST) for informal dementia caregivers: A thematic analysis.

The number of people living with dementia in the UK is expected to continue to rise, as the population continues to age. Dementia has physical, psychological, social, and economic impacts, affecting not only those diagnosed with the disease, but also those who care for them. This thesis aims to gain insight into means of supporting both people living with dementia, and their informal caregivers, with the hope of adding to the evidence base considering how best to meet the needs of this population. Paper one is a literature review considering if acceptance and commitment therapy (ACT) helps informal dementia caregivers with their wellbeing, namely levels of depression, anxiety, and burden. Ten papers were identified, critically appraised and synthesised. The included articles highlighted that ACT led to reduced levels of depression, anxiety, and burden, with promising results regarding use of virtual delivery and longevity of positive effects. However, the included papers were limited by methodological constraints, primarily use of small, volunteer samples and single-arm designs, making it hard to draw generalisable conclusions. The research area remains small and more large-scale research, making use of more diverse samples, is recommended to strengthen the current evidence base. Paper two is an empirical research paper which explores informal dementia caregiver’s experiences of attempting to implement individual cognitive stimulation therapy (iCST) following their engagement in an iCST ‘train the carer’ group. Seven participants engaged in a semi-structured interview, which were analysed using reflexive thematic analysis. Three overarching themes were identified: formal versus informal intervention, perceived benefits of the intervention, and perceived barriers for caregivers. This empirical study highlights clear benefits of iCST for people living with dementia, informal caregivers, and the caregiving dyad together. However, there were barriers to implementation of iCST namely the formality and demands of the intervention, as well as competing demands for caregivers, which led to low implementation. Future research exploring how to make implementation of iCST more feasible for dyads, utilising larger and more diverse samples is recommended. The final paper in this thesis is an executive summary which provides an overview of the completed empirical paper. It has been written in a style which is accessible and has been reviewed by the research participants to ensure that it accurately captures their views.