"Cognitive stimulation therapy can address root causes of difficult behaviour. "

Cognitive stimulation therapy (CST) has been shown to provide both primary and secondary positive effects to individuals with dementia. The primary effects of CST relate to the individual with dementia and serve to reduce difficult behaviour.

• CST has been shown to produce significant improvement in the cognitive function of individuals suffering mild to moderate dementia (Orrell, 2012: 2). As discussed above, greater cognitive decline is associated with a lowered capacity for dealing with environmental stressors and an increased tendency to exhibit difficult behaviours (Cohen-Mansfield, 2001: 362). By slowing cognitive decline, CST addresses this cause of difficult behaviour.
• Participation in CST can also reduce feelings of boredom, loneliness and isolation in the individual with dementia. As outlined in the first model identified by Cohen-Mansfield (2001), these feelings of boredom, loneliness and isolation, prompt difficult behaviour when unaddressed. CST addresses the need for stimulation and interaction by providing activities of varying difficulties within the context of a caregiving relationship (Woods, 2012: 3).
• Individuals participating in CST sessions may also experience a pleasant tiredness at the end of the day, leaving to a better night's sleep without night-time wandering.

These effects of CST reduce instances of difficult behaviour and can remove key caregiver stressors.

The secondary effects of CST relate to the relationship between the caregiver and the care recipient and serve to further reduce caregiver stress.

• In a review of CST studies, it was found that delivering CST put no added strain on the family caregiver (Woods, 2012: 5). In fact, delivery of CST can even improve the well-being of caregivers (Orrell, 2012: 2).
• Studies have also found that CST leads to a significant improvement in the communication and the interaction between caregivers and individuals with dementia. (Woods, 2012: 2).
• These improvements help to facilitate a positive caregiving relationship and create positive memories surrounding the latter part of the care recipients life. Caregivers who are able to identify positive aspects to caregiving are better able to cope with stress and "find meaning in caregiving" (Merluzzi, 2011: 16).

In these many ways, the use of CST can reduce difficult behaviour, caregiver stress and, ultimately, elder abuse.