“Many of us follow the commandment ‘Love One Another.’ When it relates to caregiving, we must love one another with boundaries. We must acknowledge that we are included in the ‘Love One Another.” ― Peggi Speers
Providing needed care for others, particularly loved ones can be very satisfying and rewarding. It may be an opportunity to provide care for someone who provided care for you. It may be an opportunity to express your love for another in a tangible way. It can be a joyful experience. But, particularly over time, caregiving can wear the caregiver out and the stress and sacrifices required begin to take their toll. As a result caregivers experience high levels of anxiety and depression, sleeplessness, physical exhaustion, weakening of the immune system can occur, opening the caregiver up to diseases, burnout, and feelings of hopelessness. All of which leads to an increase in the mortality rate of caregivers.
Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. Dementia patients require caregiving particularly in the later stages of the disease. Alzheimer’s disease is the most common type of dementia and accounts for 50 to 70 percent of dementia cases. Other types of dementia include vascular dementia, mixed dementia, dementia with Lewy bodies and frontotemporal dementia. For Alzheimer’s disease alone, in 2008 there were an estimated 9.9 million caregivers providing 8.5 billion hours of care at a value of $94 Billion dollars.
Caring for an individual with dementia can be particularly challenging. Over time dementia will lead to loss of memory, loss of reasoning and judgment, personality and behavioral changes, physical decline, and death. If this isn’t bad enough, a little appreciated consequence is that few insurance programs cover dementia care outside of the hospital. So, medical expenses can produce extra financial strain on top of the loss of income for the caregiver.
Dementia is particularly difficult for caregivers and can produce higher levels of stress than other forms of caregiving. The memory and personality changes in the patient may take away all those characteristics that make the loved one identifiable, unique, and endearing, producing psychological stress in the caregiver. The feelings of hopelessness can be overwhelming regarding the future of a patient with an irreversible terminal degenerative illness. In addition, caregivers often experience an anticipatory grief associated with a feeling of impending loss of their loved one.
Obviously, there is a need to care for caregivers, for all types of caregiving but particularly for dementia caregivers. They play an essential and often irreplaceable role. So, finding ways to ease the burden is extremely important. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving (see http://contemplative-studies.org/wp/index.php/category/research-news/caregiving/). In today’s Research News article “Feasibility of Central Meditation and Imagery Therapy for Dementia Caregivers”
Jain and colleagues provided an 8-week meditation and guided imagery mindfulness program to caregivers for family members with dementia. The practice resulted in significant reductions in the caregiver’s levels of anxiety and depression. It reduced levels of insomnia and increased mindfulness. These improvements were still evident three months later. On a more subtle level the caregivers reported qualitative shifts in their relationships with the dementia patients, including greater understanding and compassion, improved ability to manage their day-to-day caregiving, and reduced arguing.
Mindfulness practice focuses the individual on the present moment. This reduces worries about the future and ruminations about problems in the past. This is very helpful for dementia caregivers making them better able to attend to what is needed now and to spend less time catastrophizing, feeling remorse, or experiencing anticipatory grief. Mindfulness practice is also known to reduce the psychological and physical responses to stress. This would obviously be helpful for the caregiver. Finally, mindfulness practice is known to improve emotion regulation so that the caregiver can allow themselves to feel and experience their emotions but at the same time respond to them in a constructive and productive way. This has to be very helpful in dealing with the sometimes overwhelming emotions consequent upon dementia caregiving.
The Jain and colleagues study was a pilot program and as such had only a small group of participants and no control group. The results are exciting enough that it is certainly justified to launch a major randomized controlled trial of the effectiveness of mindfulness training to ameliorate the negative consequences of dementia caregiving.
So, ease caregiver problems with mindfulness.
“Many caregivers share that they often feel alone, isolated, and unappreciated. Mindfulness can offer renewed hope for finding support and value for your role as a caregiver…It is an approach that everyone can use. It can help slow you down some so you can make the best possible decisions for your care recipient. It also helps bring more balance and ease while navigating the caregiving journey.” ― Nancy L. Kriseman
CMCS – Center for Mindfulness and Contemplative Studies