“While we can’t reverse aging, regular mental activity — including cognitive exercises and regular cognitive engagement — helps keep cognitive skills stronger for longer. It’s like exercising your body.” Dr. Daniel Fenton
What if you could make small changes and have more intentional conversations with your loved one that actively stimulates their brain? You’re not doing one more thing, you’re simply being more deliberate about conversations you’re already having, while sneaking in more benefits along the way.
We are Sue Ryan and Nancy Treaster. As caregivers for our loved ones with Alzheimer’s and other types of dementia, we understand how meaningful it is to find ways to help our loved ones function at their best for longer. We’re sharing insights about cognitive stimulation therapy (CST) from Dr. Daniel Fenton, head of neuropsychological services at New Days, a virtual clinic specializing in care for people with mild cognitive impairment and early-stage dementia.
Let’s explore three essential tips for bringing cognitive stimulation therapy into your everyday conversations at home.
What Is Cognitive Stimulation Therapy — and Why Does It Matter?
Cognitive stimulation therapy, or CST, is an evidence-based approach for people experiencing mild to moderate cognitive decline, including mild cognitive impairment (MCI) and early-stage dementia. Rather than trying to repair damaged memory systems, CST focuses on helping people use the cognitive abilities they still have — and use them more effectively.
CST involves guided activities and conversations: discussing current events, solving word problems together, or reminiscing about meaningful experiences. All of these stimulate thinking, communication, and cognitive processes like attention in a supportive and social environment.
One of the most compelling pieces of research Dr. Fenton shares is:
The cognitive benefits of cognitive stimulation therapy are comparable to certain dementia-related medications — with the added advantage of social engagement and emotional connection that no medication can provide.
Tip 1: Create a Simple Structure
CST works best when it follows a consistent, predictable, three-part structure that helps your loved one feel oriented and comfortable.
Part One: Orientation
Begin by grounding your loved one in the present moment. Rather than asking quiz-style questions like “What day is it?” — which can feel like a pass/fail test — simply tell them. Share the date, the month, the year, and where you are physically. If there’s an upcoming meaningful event — such as a birthday, an anniversary, a graduation — mention this too. Orienting them creates a friendly and stable foundation for the conversation ahead.
Part Two: The Activity
Dr. Fenton explains:
“Part Two is the heart of the session — the ‘meat and potatoes.’ We’ll cover specific activity ideas in Tip 2.”
Part Three: Wrap-Up and Reflection
Part three is perhaps the most important piece of all. Wrapping up and reflecting on the activity. We’ll explore this in Tip 3.
Tip 2: Leverage These Types of Activities
Many activities fit the goals of CST. The key principle across all of them is to focus on reasoning and opinion, not recall. This is not a test. The goal is simply to get the gears turning and keep the brain engaged.
Here are some of Dr. Fenton’s favorite activities to try at home:
Discuss a Current Event: Read a short news story aloud and ask opinion-based questions: “What do you think about this?” or “What do you think will happen next?” or “How would you have handled that?” There are no wrong answers — you’re stimulating reasoning, not testing memory.
Name as Many Animals as You Can: This isn’t about speed. Encourage your loved one to name as many animals as they can think of. Both “dog, cat, fish” and “alpaca, lemur, flying tree squirrel” are great responses. These simply engage the brain at different depths. Both are equally valid and both are definitely worth celebrating.
Pack for a Trip: Ask your loved one what they’d pack if they were climbing Mount Everest in Tibet tomorrow, and the following week, they were lounging on a beach in Hawaii. This kind of scenario requires conceptual thinking — what neuropsychologists call cognitive set shifting — which is a deeper level of executive functioning.
Word Association: Offer a single prompt word — “beach,” “desert,” “jungle” — and ask your loved one to describe what comes to mind. There’s no right answer. The goal is pure stimulation: getting them to think, imagine, and express.
Reminiscence with Photo Albums: Pull out an old photo album and go through it together page by page. Point to photos and ask: “What’s going on here?” or “How do you think you felt in this moment?” Emotion-based questions like: “What do you miss most about that time?” are especially powerful. These deepen engagement and make the conversation feel meaningful rather than clinical.
Tip 3: It’s Important to Wrap Up and Reflect
The wrap-up is a critical part of every CST session — and it’s easy to overlook. Here’s why it matters so much:
It reinforces the experience: Revisiting the main ideas from the activity helps your loved one process and organize what just happened. This supports their thinking, attention, and comprehension.
It anchors the emotional memory: Your loved one may not remember the specific content of your conversation. This is okay. What they will hold onto is how the conversation made them feel. By intentionally highlighting positive emotions at the end of the session — warmth, laughter, pride, connection — you help this feeling linger long after the details have faded.
It builds confidence: Many people with cognitive decline worry about making mistakes. Ending each session by emphasizing what went well — thoughtful ideas, creative answers, good participation — helps boost confidence and motivation to engage again the next time.
Take Action: You Can Start Today
Cognitive stimulation therapy doesn’t require special training or additional time carved out of your day. It’s about being more intentional with the conversations you’re already having, structuring them in a way that keeps your loved one’s brain active, socially connected, and mentally engaged.
Start simply:
- Begin your next visit with a brief orientation — share the date, the season, an upcoming event.
- Choose one activity from the list above and try it together.
- Wrap up by reflecting on one thing that went well, or one moment that brought a smile.
The more consistently you use this structure, the more comfortable and beneficial it becomes — for both of you!
You can find more information from our expert guest at NewDays.ai, where Dr. Fenton and his team offer one-on-one virtual cognitive stimulation therapy as well as access to Sunny, their AI brain trainer, for daily engagement. You can sign up for a free account, schedule a free consultation, and/or book your first appointment directly on their website.
Have you tried structured conversations or reminiscence activities with your loved one? What has worked well for you? Share your experiences and additional tips on our Facebook or Instagram pages to help other caregivers in similar situations.
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