Improve Quality-of-life and Stress Responses in Caregivers for Patients with Dementia

Improve Quality-of-life and Stress Responses in Caregivers for Patients with Dementia


By John M. de Castro, Ph.D.


“Mindfulness also happens to be a salvation for caregivers facing the ongoing stress from caring for a loved one with dementia. There is another reason mindfulness practice can be a game changer for dementia caregivers. Mindfulness can also help you provide care for your loved one with greater ease.” – Marguerite Manteau-Rao


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, there are an estimated 10 million caregivers providing 9 billion hours of care at a value of over $100 Billion dollars.


Caregiving for dementia patients is a daunting and all too frequent task. It is an intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. In the last year, 59% of the caregivers report that they are effectively on duty 24/7. Over time dementia will lead to loss of memory, loss of reasoning and judgment, personality and behavioral changes, physical decline, and death. 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. 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. It is sad that 72% of the caregivers reported relief when their loved one passes away.


Obviously, there is a need to both care for the dementia patients and also for the caregivers, for all types of caregiving but particularly for dementia. 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.  In today’s Research News article “Randomized Controlled Trial of Inner Resources Meditation for Family Dementia Caregivers.” See summary below or view the full text of the study at:

Waelde and colleagues employ a mindfulness meditation with mantra practice to treat caregivers for dementia patients. They recruited female dementia caregivers and randomly assigned them to receive either an 9-week, once a week for 90 minutes, group-based, meditation with mantra practice with encouraged home practice, or a psychoeducation with telephone support condition. They were measured before and after training and one month later for satisfaction with life, depression, self-efficacy, subjective improvement, mental status, and diurnal salivary cortisol slope, a measure of stress.


They found that at the one-month follow up the mindfulness meditation with mantra practice group had significantly greater improvement than the psychoeducation group in life satisfaction and diurnal salivary cortisol slope. This suggests that the intervention reduced stress and improved the caregivers perceived quality of life. There were not significant improvements in depression or self-efficacy, but this may have been due to the amount of home practice. Indeed, the greater the amount of meditation practice occurring at home the greater the decrease in depression and the greater the increase in self-efficacy. This suggests that, in order for the mindfulness meditation with mantra practice to be effective for reducing depression and for improving the caregiver’s ability to cope with stress, it must be practiced regularly at home.


These results are potentially important. They suggest that meditation may be an effective means to improve the physical and psychological conditions of dementia caregivers. It should be mentioned that no one dropped out of the meditation condition, indicating that it is tolerable within the framework of the taxed time availability of the caregivers.


So, improve quality-of-life and stress responses in caregivers for patients with dementia.


“Mindfulness practice is especially relevant to the predicament of dementia caregiving. It can give caregivers the inner resources to sustain themselves emotionally and physically over the long haul and is a tool they can always fall back on moment to moment, regardless of the intensity of the care relationship.” – Marguerite Manteau-Rao


CMCS – Center for Mindfulness and Contemplative Studies


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Study Summary

Waelde, L. C., Meyer, H., Thompson, J. M., Thompson, L. and Gallagher-Thompson, D. (2017), Randomized Controlled Trial of Inner Resources Meditation for Family Dementia Caregivers. J. Clin. Psychol.. doi:10.1002/jclp.22470




This randomized controlled trial examined the comparative effectiveness of 2 interventions for improving diurnal cortisol slope and life satisfaction and reducing stress symptoms among older female dementia family caregivers.


Thirty-one family dementia caregivers were randomized to 8 weeks of Inner Resources for Stress mindfulness meditation and mantra training (IR) or psychoeducation and telephone support (PTS).


Intention-to-treat analyses revealed statistically significant pre-post improvements in diurnal cortisol slope and overall life satisfaction, but not depression or self-efficacy, in the IR relative to the PTS group. Adherence to between-session meditation practice was significantly associated with decreases in depression and self-reported improvements in ability to cope with stress. In addition, IR participants rated the overall benefits of the program more highly than the PTS group.


These results indicate that mindfulness meditation and mantra has promise as a feasible and effective caregiver intervention for quality of life and physiological responding to stress.


Improve Psychological Health of Veterans with a Mantra

Improve Psychological Health of Veterans with a Mantra


By John M. de Castro, Ph.D.


“Asking for clarity provides a way to begin to see a path out of the pain of personal issues. With spiritual support the pain begins to be released, the path becomes clearer and the next step to create the rest of life begins to emerge.” – The Merritt Center


Alternative and Complementary techniques have been growing in acceptance and use over the last couple of decades. With good reason. They have been found to be beneficial for physical and mental health. Contemplative practices have been shown to improve health and well-being. These include mindfulness practices, meditation, yoga, mindful movement practices such as tai chi and qigong, and spiritual practices such as contemplative prayer. One ancient practice that is again receiving acceptance and use is mantra practice.


In today’s Research News article “Multi-site evaluation of a complementary, spiritually-based intervention for Veterans: The Mantram Repetition Program”

Butner and colleagues investigate the effectiveness of a form of mantra practice, Mantram Repetition Practice (MRP) on the mindfulness, mental health, and spirituality of veterans. The MRP involves the repetition of a sacred word or phrase over and over again to slow the individual down and produce one-pointed attention. It is effectively a mindfulness meditation practice, except that there are no formal practice periods. The participant is trained to engage in MRP during their daily activities, periodically and as needed, particularly during times of confusion and stress. The individual selects a sacred word or phrase for use in MRP from a list that have particular meaning to them and within their preferred religious practice. Typical Christian words and phrases are “My God and My All”, “Jesus, Jesus”, “Son of God”, “Hail Mary”, “Mother of Jesus”, “Lord Jesus Christ”, “Son of God, have mercy on me.”


Butner and colleagues recruited veterans and measured mindfulness, physical and mental health, and spirituality before and after an 8-week Mantram Repetition Program (MRP) training. The veterans attended weekly training sessions, were encouraged to do homework and to use the MRP during their daily lives. Typical times were while waiting, doing mechanical tasks such as doing dishes, exercising, when encountering annoying situations, while eating, before bed, and to manage unwanted emotions. They found that after 8-weeks of MRP training and practice the veterans demonstrated significantly higher mindfulness and spirituality including greater peace, more meaning in life, and greater faith. After training the veterans also had significant reductions in psychological distress, including reduced somatization, depression and anxiety.


It should be noted that there was not an active control group. Improvement was documented by comparing before to after training scores. Because of the lack of active control, there are many confounding, alternative, explanations for the findings. These include participant expectancy effects, experimenter bias effects, simple improvement over time, occurrences between the beginning and end of the treatment period, etc. The results clearly demonstrate that the veterans improved substantially over the 8-weeks. It will remain for future research to verify that it was the Mantram Repetition Practice (MRP) and not a confounding variable that was responsible for the changes.


These caveats notwithstanding, the finding for MRP are compatible with those produced by other mindfulness programs with the exception of increased spirituality. It is possible that MRP produces its beneficial effects due to its development of mindfulness. Alternatively, spirituality, by itself, has been shown to be related to better physical and psychological health. So, MRP may be effective due to its improvement of spirituality in the veterans. It may also be that the combination of increased mindfulness and increased spirituality improves effectiveness or that the two have additive effects.


So, improve psychological health of veterans with a mantra.


“The veterans experiences with spirituality were real and unique, significantly contributing to growth. They needed the inclusion of Christian spirituality as part of their process in posttraumatic growth, and it was the key element in them moving forward.” – Sharon Flowers


CMCS – Center for Mindfulness and Contemplative Studies

Calm your Mind and Brain with a Mantra


“Chanting a mantra at the beginning of your meditation helps you clear the mind and takes you deep within the self. Chanting a mantra at the end of meditation helps you seal the meditation. It helps you bring the awareness of the meditation down into your daily life.” – Rama


Mantras are a very common component of many contemplative practices. Transcendental Meditation for example emphasizes mantras. Mantra is a Sanskrit word for “sound tool.” It is literally a tool employing sounds used in contemplative practice. It is a sound, e.g. “om”, or a phrase, e.g. “Love is the only miracle there is” that is repeated over and over and over during a contemplative practice.


Mantras are claimed to be helpful in contemplative practice and to help improve physical and mental well-being. But, there is very little empirical research on mantras or their effectiveness. One problem in studying mantras is that they are embedded in a contemplative practice. It is difficult then to separate the effects of the mantra from that of the overall practice. So, it is important to study mantras while extracting them from the practices.


In today’s Research News article “Repetitive speech elicits widespread deactivation in the human cortex: the “Mantra” effect? Brain and Behavior”

Berkovich-Ohana and colleagues do just this.

They study the effects of repetitive speech, devoid of its spiritual or meditative context, on the activity of the brain. They simply had participants repeat the word “one” over and over again for 8-minutes while resting in an f-MRI scanner. They found that during repetitive speech there was an overall reduction in brain activity. In studies of meditation it has been reported that there is a reduction of activity in some areas and an increase in others. So, it is remarkable to observe a reduction without an increase elsewhere.


They found that the reduction in brain activity was particularly focused on a set of structures that has been labelled as the default mode network (DMN). The DMN has been found frequently in the past to be the areas that are active during mind wandering and internalized self-referential activity. In support of this, they obtained reports of the participants experience during repetitive speech and found that there was a marked reduction in thoughts and sensations experienced. Hence it appears that the repetitive speech reduced brain activity in association with reduced mental activity.


These results clarify why mantras are so often used in contemplative practices. They quiet the mind and they quiet the brain. This is exactly the initial goal of contemplative practice. So, mantras can be of great help in establishing the exact mental and physical state desired in contemplative practices.


So, incorporate mantras in your contemplative practice and calm your mind and brain.


“You are a cosmic flower. Om chanting is the process of opening the psychic petals of that flower.”  ― Amit Ray


CMCS – Center for Mindfulness and Contemplative Studies