Improve the Psychological Well-Being of Dementia Patients and their Caregivers with Mindfulness

Improve the Psychological Well-Being of Dementia Patients and their Caregivers with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness training eases depression and improves sleep and quality of life for both people with early-stage dementia and their caregivers. . . . Mindfulness involves attentive awareness with acceptance for events in the present moment. You don’t have to be drawn into wishing things were different. Mindfulness training in this way takes advantage of people’s abilities rather than focusing on their difficulties.” – Marla Paul

 

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. Caregiving for dementia patients is a daunting intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. This places tremendous psychological and financial stress on the caregiver. Hence, there is a need to both care for the dementia patients and also for the caregivers. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving. In addition, mindfulness training has been found to help protect aging individuals from physical and cognitive declines.

 

In today’s Research News article “Mindfulness Training for People with Dementia and Their Caregivers: Rationale, Current Research, and Future Directions.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00982/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_686352_69_Psycho_20180626_arts_A ), Berk and colleagues review and summarize the published research on the application of mindfulness training for the treatment for dementia patients and their caregivers.

 

They find that the published research reports that mindfulness training improves the psychological well-being of caregivers for dementia patients. It significantly reduces depression and anxiety and improves self-efficacy. Studies of mindfulness training for the dementia patients themselves report improvements in attention, memory, cognition, and quality of life. When the patients and their caregivers were both trained in mindfulness there were significant improvements in stress responses and mood in both.

 

These are important findings that strongly suggests that mindfulness training is a safe and effective means to improve the psychological well-being of both the dementia patient and their caregiver. Given the great difficulty and stress produced by dementia on both the patient and caregiver, these improvements are very important to relieve or at least mitigate the suffering of both. This suggests that mindfulness training should be routinely provided for dementia patients and their caregivers.

 

So, improve the psychological well-being of dementia patients and their caregivers with mindfulness.

 

“The dementia journey is hugely challenging and provokes in us a great deal of frustration, fear and dread—understandably. But as much as dementia is described as a journey of loss, it can also become a journey of love and understanding. At times, love needs to be gritty and determined; at other times, it will be sweet. At all times it must be unconditional.” – Alice Ashwell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Berk L, Warmenhoven F, van Os J and van Boxtel M (2018) Mindfulness Training for People With Dementia and Their Caregivers: Rationale, Current Research, and Future Directions. Front. Psychol. 9:982. doi: 10.3389/fpsyg.2018.00982

 

Abstract

The world population is aging and the prevalence of dementia is increasing. By 2050, those aged 60 years and older are expected to make up a quarter of the population. With that, the number of people with dementia is increasing. Unfortunately, there is no cure for dementia. The progression of symptoms with no hope of improvement is difficult to cope with, both for patients and their caregivers. New and evidence-based strategies are needed to support the well-being of both caregiver and patient. Mindfulness training is a body-mind intervention that has shown to improve psychological well-being in a variety of mental health conditions. Mindfulness, a non-judgmental attention to one’s experience in the present moment, is a skill that can be developed with a standard 8-week training. Research has shown preliminary but promising results for mindfulness-based interventions to benefit people with dementia and caregivers. The aim of this review is (a) to provide a rationale for the application of mindfulness in the context of dementia care by giving an overview of studies on mindfulness for people with dementia and/or their caregivers and (b) to provide suggestions for future projects on mindfulness in the context of dementia and to give recommendations for future research.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00982/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_686352_69_Psycho_20180626_arts_A

 

Improve Caregivers Emotion Regulation with Mindfulness

Improve Caregivers Emotion Regulation with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Caregivers have a habit of neglecting their own wellbeing for their patients’ sakes. Some caregivers even believe taking a few minutes out of the day to practice mindfulness is “selfish.” Nothing could be further from the truth. In fact, taking a few minutes to practice mindfulness everyday will improve the quality of care you can give to your patient. It should be mandatory that all caregivers practice some form of mindfulness today” – Caregiver Space

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is mentally or physically ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost to the caregiver. It exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Mindfulness training has been shown to be beneficial for both the caregiver and the patients. But, this is reactive, working with already stressed caregivers. It is important to be able to be proactive and better prepare caregivers to withstand the difficulties and stress of caregiving and provide better care for patients. In today’s Research News article “Developing professional caregivers’ empathy and emotional competencies through mindfulness-based stress reduction (MBSR): results of two proof-of-concept studies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5781061/ ), Lamothe and colleagues investigate the effects of mindfulness training on the emotion regulation ability of psychology students and professional caregivers.

 

They recruited psychology students in a university and professional caregivers in a pediatric hematology-oncology unit of a hospital. They were provided a Mindfulness-Based Stress Reduction (MBSR) program. The MBSR program was presented for 2 hours, once a week, for 8 weeks with 30-minute daily home practice. It consisted of discussion and meditation, body scan, and yoga practices. They were measured before and after the program and 3 months later for mindfulness, empathy, emotional competencies, recognition of emotions in others, emotional acceptance, and emotion regulation.

 

They found that in both groups there were large increases in mindfulness that were maintained 3 month later. In addition, they found that there were significant improvements after training in empathy, emotional competencies, recognition of emotions in others, identification of emotions in others, emotional acceptance, and emotion regulation, with the exception that the caregivers change in recognition of emotions in others was not statistically significant. At the 3-month follow-up they found that there were still significant improvements in identifying emotions and emotional acceptance.

 

These results are preliminary as there wasn’t a comparison, control, condition. As such, they are interpreted as a proof of concept. To reach firm conclusions a randomized controlled clinical trial with an active control condition is necessary. The results are interesting and powerful enough that such an extensive study is warranted. Nevertheless, the results provide preliminary evidence that mindfulness training improves the emotional competences of both students and professional caregivers. This suggests that mindfulness training can be used both for practicing caregivers and those in training. Hence, mindfulness training may be helpful both reactively and proactively to promote the emotional health of the caregivers and, in turn, provide better care.

 

So, improve caregivers emotion regulation with mindfulness.

 

“mindfulness practices can help both caregivers and their loved ones maintain their emotional well-being. This is important for two reasons. First, strong emotional well-being is a good defense against such stress-related problems as depression and anxiety. Second, emotional well-being supports the resiliency that makes a person’s life not just tolerable, but enjoyable and meaningful: restful sleep, invigorating exercise, healthful food and some form of spiritual or emotional nourishment.” – Adam Perlman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Lamothe, M., McDuff, P., Pastore, Y. D., Duval, M., & Sultan, S. (2018). Developing professional caregivers’ empathy and emotional competencies through mindfulness-based stress reduction (MBSR): results of two proof-of-concept studies. BMJ Open, 8(1), e018421. http://doi.org/10.1136/bmjopen-2017-018421

 

Abstract

Objectives

To assess the feasibility and acceptability of a mindfulness-based stress reduction (MBSR)-based intervention and determine if the intervention is associated with a significant signal on empathy and emotional competencies.

Design

Two pre–post proof-of-concept studies.

Setting

Participants were recruited at the University of Montreal’s Psychology Department (Study 1) and the CHU Sainte-Justine Department of Hematology-Oncology (Study 2).

Participants

Study 1: 12 students completed the 8-week programme (mean age 24, range 18–34). Study 2: 25 professionals completed the 8-week programme (mean age 48, range 27–63).

Intervention

Standard MBSR programme including 8-week mindfulness programme consisting of 8 consecutive weekly 2-hour sessions and a full-day silent retreat.

Outcomes measures

Mindfulness as measured by the Mindful Attention Awareness Scale; empathy as measured by the Interpersonal Reactivity Index (IRI)’s Perspective Taking and Empathic Concern subscales; identification of one’s own emotions and those of others as measured by the Profile of Emotional Competence (PEC)’s Identify my Emotions and Identify Others’ Emotions subscales; emotional acceptance as measured by the Acceptance and Action Questionnaire-II (AAQ-II) and the Emotion Regulation Scale (ERQ)’s Expressive Suppression subscale; and recognition of emotions in others as measured by the Geneva Emotion Recognition Test (GERT).

Results

In both studies, retention rates (80%–81%) were acceptable. Participants who completed the programme improved on all measures except the PEC’s Identify Others’ Emotions and the IRI’s Empathic Concern (Cohen’s d median=0.92, range 45–1.72). In Study 2, favourable effects associated with the programme were maintained over 3 months on the PEC’s Identify my Emotions, the AAQ-II, the ERQ’s Expressive Suppression and the GERT.

Conclusions

The programme was feasible and acceptable. It was associated with a significant signal on the following outcomes: perspective taking, the identification of one’s own emotions and emotional acceptance, thus, justifying moving towards efficacy trials using these outcomes.

The programme was feasible and acceptable. It was associated with a significant signal on the following outcomes: perspective taking, the identification of one’s own emotions and emotional acceptance, thus, justifying moving towards efficacy trials using these outcomes.

 

Strengths and limitations of this study

Two feasibility studies of a mindfulness-based stress reduction (MBSR)-based intervention in students and professionals had high attendance rates and acceptability levels.

Results suggested a significant clinical signal on most measured outcomes in the domains of emotion regulation and empathy, with effects lasting at follow-up for identification of one’s own emotions and emotional acceptance.

The same pattern of results was obtained in two independent small-scale studies.

A limitation to theses studies is that samples were not randomly selected, had limited size, and no control groups were used.

Another limitation is that most outcomes were self-reported and could be subject to desirability bias.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5781061/

 

Improve the Social, Emotional, and Behavioral Functioning of Autistic Children and Their Parents with Mindfulness

Improve the Social, Emotional, and Behavioral Functioning of Autistic Children and Their Parents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A weekly mindfulness session for children with autism and a separate program for their parents showed promising results. After nine weekly sessions of mindfulness training, 21 adolescents with autism reported better quality of life and less time spent wandering in thought about topics like sadness, pain, and why they react to things the way they do. Parents reported that their children were more socially responsive. Parents also reported reduced stress and less frequent use of “dysfunctional parenting styles,” such as shouting.” – Sarah Hansen

 

Autism spectrum disorder (ASD) is a developmental disability that tends to appear during early childhood and affect the individual throughout their lifetime. It affects a person’s ability to communicate, and interact with others, delays learning of language, makes eye contact or holding a conversation difficult, impairs reasoning and planning, narrows and intensifies interests, produces poor motor skills and sensory sensitivities, and is frequently associated with sleep and gastrointestinal problems. ASD is a serious disorder that impairs the individual’s ability to lead independent lives including complete an education, enter into relationships or find and hold employment. It is also difficult and stressful for the caregivers.

 

The diagnosis of autism spectrum disorder (ASD) has been increasing markedly over the last couple of decades. It is currently estimated that over 1% of the world population has autism spectrum disorder (ASD). Its causes are unknown and there are no known cures. Treatment is generally directed at symptoms and can include behavioral therapies and drug treatments. Clearly, there is a need for effective alternative treatment options.

 

Mindfulness training has been shown to be helpful in treating ASD.  In today’s Research News article “Mindfulness-Based Program for Children with Autism Spectrum Disorder and Their Parents: Direct and Long-Term Improvements.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968048/ ), Ridderinkhof and colleagues examined the effectiveness of mindfulness training to improve the social and psychological health of children and their families.

 

They recruited children with autism spectrum disorder (ASD) and their parents and provided the child and one or both parents separately with a 9-week mindfulness training program. The sessions occurred once a week for 1.5 hours. For the children the sessions included breathing meditation, body scan, a 3-min breathing space, and yoga practices. For the parents the sessions also focused on mindful parenting. Home practice was encouraged. Before and after training and 2 months and one year later, the children were measured through self- and parental report for social communications, emotional and behavioral functioning, and mindfulness. Parents were assessed for their social communications, emotional and behavioral functioning, mindfulness, and parental stress.

 

They found that after treatment and 2 months and one year later the parents reported that the children showed significant improvement in social communications and attention and significant decreases in externalizing and internalizing symptoms, and rumination. The parents showed significant improvements in their social communications, attention mindfulness, and self-compassion and significant decreases in externalizing and internalizing symptoms, perceived stress, stress concerning parenting, and over-reactivity,. Hence, the mindfulness training appeared to produce significant improvements in both the children with autism spectrum disorder and their parents.

 

The results, however, have to be interpreted very cautiously. This study ran for over a year and there was no comparison condition. During that time the children mature, learn in school, and have additional experiences and the parents continue to learn how to cope with their child’s ASD. So, the observed improvements may have occurred anyway, even without the mindfulness training. The results, though are encouraging and suggest that a randomized controlled trial is justified. ASD is such a difficult issue for the child and the parents that the investment in further study is needed.

 

So, improve the social, emotional, and behavioral functioning of autistic children and their parents with mindfulness.

 

mindfulness practices may be a viable technique in not only improving behavioral and cognitive responses in those with ASD, but also the overall well-being of their caregivers.” – Krupa Patel

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ridderinkhof, A., de Bruin, E. I., Blom, R., & Bögels, S. M. (2018). Mindfulness-Based Program for Children with Autism Spectrum Disorder and Their Parents: Direct and Long-Term Improvements. Mindfulness, 9(3), 773–791. http://doi.org/10.1007/s12671-017-0815-x

 

A combined mindfulness-based program for children and their parents (MYmind) was beneficial for adolescents with autism spectrum disorder (ASD). In this study, we investigated whether this program is also beneficial for younger children with ASD, whether effects last on the long-term, and whether it reduces common comorbid problems. Forty-five children referred with ASD aged 8 until 19 years old, and their parents participated. Repeated measures of children’s and parents’ social communication problems, emotional and behavioral functioning, mindful awareness, and of parenting were conducted pre-intervention, post intervention, 2-month follow-up, and 1-year follow-up. While children did not report significant changes in mindful awareness, their social communication problems decreased, and their emotional and behavioral functioning improved. Results were not consistent at each occasion; improvements reported by children were most substantial at a 2-month follow-up and only partly remained at a 1-year follow-up, while all children’s improvements as reported by parents were present on all occasions. Parents themselves reported improved emotional and behavioral functioning, improved parenting, and increased mindful awareness on all occasions. Parents’ social communication problems reduced only directly after the intervention. Most improvements were supported by the qualitative investigation of children’s and parents’ experienced change as reported on open-ended questions. This study suggests that children, including adolescents, with ASD and their parents can benefit from a mindfulness-based program with parallel sessions for children and parents.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968048/

 

Improve Dementia Caregiver Psychological Health and Stress with Mindfulness

Improve Dementia Caregiver Psychological Health and Stress with Mindfulness

 

By John M. de Castro, Ph.D.

 

“people who care for family members with Alzheimer’s disease and other dementias in the home experienced a decrease in perceived stress and mood disturbance when practicing Mindfulness-based Stress Reduction (MBSR).” – Heather Stang

 

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. For Alzheimer’s disease, 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 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 caregivers report relief when their loved one passes away. Obviously, there is a need to care for the caregivers of dementia patients. 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 “A Pilot Randomized Controlled Trial of Mindfulness-Based Stress Reduction for Caregivers of Family Members with Dementia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070659/ ), Brown and colleagues recruited adult family members providing caregiving for patients with Alzheimer’s Disease. They were randomly assigned to receive either an 8-week, once a week for 2 hours, Mindfulness-Based Stress Reduction (MBSR) program or a Social Support program. Participants were measured before and after the programs and 3 months later for perceived stress, experiential avoidance, mood states, physical and mental health, caregiver burden, and quality of relationship between the caregiver and care recipient. They also provided saliva samples to measure cortisol levels.

 

They found that both MBSR and Social Support produced significant improvements in experiential avoidance, depression, vitality, fatigue, confusion, and physical and mental health. They also found that MBSR also produced significant improvements in perceived stress, tension, and anger while Social Support produced significant improvement in caregiver burden. Unfortunately, these effects were not sustained at the 3-month follow-up.

 

Hence, it appears that both MBSR and Social Support are effective in improving caregivers’ psychological well-being, but only temporarily. MBSR appears to be superior to Social Support in providing these benefits. The stress of caring for patients with Alzheimer’s Disease is immense and the importance of the relief provided by these programs cannot be overemphasized. But, the study clearly demonstrates a need for future research to investigate means to prolong the effectiveness of these programs.

 

So, improve dementia caregiver psychological health and stress with mindfulness.

 

“One of the major difficulties that individuals with dementia and their family members encounter is that there is a need for new ways of communicating due to the memory loss and other changes in thinking and abilities. The practice of mindfulness places both participants in the present and focuses on positive features of the interaction, allowing for a type of connection that may substitute for the more complex ways of communicating in the past. It is a good way to address stress.” – Marla Paul

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Brown, K. W., Coogle, C. L., & Wegelin, J. (2016). A Pilot Randomized Controlled Trial of Mindfulness-Based Stress Reduction for Caregivers of Family Members with Dementia. Aging & Mental Health, 20(11), 1157–1166. http://doi.org/10.1080/13607863.2015.1065790

 

Abstract

Objectives

The majority of care for those with Alzheimer’s Disease and other age-related dementias is provided in the home by family members. To date there is no consistently effective intervention for reducing the significant stress burden of many family caregivers. The present pilot randomized controlled trial tested the efficacy of an adapted, 8-week Mindfulness-based Stress Reduction (MBSR) program, relative to a near structurally equivalent, standard Social Support (SS) control condition for reducing caregiver stress and enhancing the care giver-recipient relationship.

Method

Thirty-eight family caregivers were randomized to MBSR or SS, with measures of diurnal salivary cortisol, and perceived stress, mental health, experiential avoidance, caregiver burden, and relationship quality collected pre- and post-intervention and at 3-month follow-up.

Results

MBSR participants reported significantly lower levels of perceived stress and mood disturbance at post-intervention relative to SS participants. At 3-month follow-up, participants in both treatments conditions reported improvements on several psychosocial outcomes. At follow-up there were no condition differences on these outcomes, nor did MBSR and SS participants differ in diurnal cortisol response change over the course of the study.

Conclusion

Both MBSR and SS showed stress reduction effects, and MBSR showed no sustained neuroendocrine and psychosocial advantages over SS. The lack of treatment condition differences could be attributable to active ingredients in both interventions, and to population-specific and design factors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070659/

 

Improve Dementia Patient Caregiver Mental Health and Reduce Stress with Mindfulness

Improve Dementia Patient Caregiver Mental Health and Reduce Stress with Mindfulness

 

By John M. de Castro, Ph.D.

 

“To my mother, I owe the experience of being with her since the beginning of her dementia, and the ability to notice what a difference mindfulness practice made in our relationship. From feeling only grief, to a growing acceptance of her in the moment, even appreciating new aspects of her personality that became freed as a result of her condition.” – 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 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 caregivers report relief when their loved one passes away.

 

Obviously, there is a need to care for the caregivers of dementia patients. 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 “Mindfulness training for psychological stress in family caregivers of persons with dementia: a systematic review and meta-analysis of randomized controlled trials.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626236/, Liu and colleagues review and summarize the published Randomized Controlled Trials (RCTs) on the effectiveness of mindfulness training on the psychological state of caregivers for dementia patients.

 

They identified 7 published Randomized Controlled Trials (RCTs). The studies employed a variety of different mindfulness training techniques; including Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT), and meditation practice. They report that the published studies find that mindfulness training produces a significant decrease in depression and perceived stress, a trend toward decreased anxiety, and significant improvement in mental health quality of life. The importance of these findings is underscored by the fact that these were all well controlled scientific studies of high quality. Hence, mindfulness training appears to be of significant help to caregivers of dementia patients improving their mental health and quality of life.

 

It has been demonstrated that mindfulness training improves anxiety, depression, and quality of life, and reduces stress in a wide variety of populations. So, it is not surprising that it has similar effectiveness for these caregivers. The magnitude of the burden on these caregivers, however, is such that the improvements produced by mindfulness training are a blessing. Hence, mindfulness training should be incorporated into routing support and treatment programs for caregivers of dementia patients.

 

So, improve dementia patient caregiver mental health and reduce stress with mindfulness.

 

“One of the major difficulties that individuals with dementia and their family members encounter is that there is a need for new ways of communicating due to the memory loss and other changes in thinking and abilities. The practice of mindfulness places both participants in the present and focuses on positive features of the interaction, allowing for a type of connection that may substitute for the more complex ways of communicating in the past.” – Sandra Weintraub

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Liu, Z., Chen, Q., & Sun, Y. (2017). Mindfulness training for psychological stress in family caregivers of persons with dementia: a systematic review and meta-analysis of randomized controlled trials. Clinical Interventions in Aging, 12, 1521–1529. http://doi.org/10.2147/CIA.S146213

 

Abstract

Caring for a relative with dementia is extremely challenging; conventional interventions may not be highly effective or easily available on some occasions. This study aimed to explore the efficacy of mindfulness training in improving stress-related outcomes in family caregivers of people with dementia using a meta-analytic review. We searched randomized controlled trials (RCT) through April 2017 from five electronic databases, and assessed the risk of bias using the Cochrane Collaboration tool. Seven RCTs were included in our review. Mindfulness interventions showed significant effects of improvement in depression (standardized mean difference: −0.58, [95% CI: −0.79 to −0.37]), perceived stress (−0.33, [−0.57 to −0.10]), and mental health-related quality of life (0.38 [0.14 to 0.63]) at 8 weeks post-treatment. Pooled evidence did not show a significant advantage of mindfulness training compared with control conditions in the alleviation of caregiver burden or anxiety. Future large-scale and rigorously designed trials are needed to confirm our findings. Clinicians may consider the mindfulness program as a promising alternative to conventional interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626236/

Improve Caregiver and Cirrhosis Patient Psychological Health with Mindfulness

Improve Caregiver and Cirrhosis Patient Psychological Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness practices also help people observe their thoughts and behaviors with less reactivity and judgment, which could enable caregivers to better respond to the emotional and physical difficulties they encounter.” – Emily Nauman

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is mentally or physically ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost to the caregiver. It exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Liver disease affects about 3.9 million people and Cirrhosis kills nearly 40,000 people each year. Providing care for an individual with end stage liver disease has not been seriously studied. The challenges of caring for an individual with cirrhosis require that the individual be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. And it improves the ability to maintain attention and focus in the face of high levels of distraction. So, it is not surprising that mindfulness improves caregiving and assists the caregiver in coping with the stress.

 

In today’s Research News article “Mindfulness-Based Stress Reduction Therapy Improves Patient and Caregiver-Reported Outcomes in Cirrhosis.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539344/, Bajaj and colleagues recruited patients with cirrhosis and their caregivers. The majority of the caregivers were women and spouses. They measured the patients before and after treatment for depression, anxiety, sleep quality, sleepiness, health related quality of life, and sickness impact. Caregivers were also measured for depression, anxiety, sleep quality, caregiving burden and perceived caregiver burden. Both patients and their caregivers received a 4-week program of modified structured Mindfulness-Based Stress Reduction (MBSR) along with discussions of barriers and strategies to deal with stress. The program included training in Qigong (gentle movements), body scan, progressive relaxation, and loving kindness meditation. Patients and caregivers were encouraged to practice these skills at home.

 

They found that following treatment the patients showed significant improvements in depression, sleep quality, and health related quality of life. In addition, they found that after treatment the caregivers had significant improvements in depression, sleep quality, caregiving burden and perceived caregiver burden. Mindfulness training has been shown to reduce depression, improve sleep and health related quality of life, and caregiving in a wide variety of healthy and ill individuals. So, it is not surprising that the modified MBSR program produced similar significant benefits for both the cirrhosis patients and their caregivers. It is encouraging that a relatively brief (4 week) program can have such positive benefits.

 

The study did not have a control condition. So, unequivocal conclusions cannot be reached. But, the results are sufficiently encouraging to justify the implementation of a large scale randomized controlled clinical trial including an active control condition of the effectiveness of MBSR training for cirrhosis patients and their caregivers.

 

So, improve caregiver and cirrhosis patient psychological health with mindfulness.

 

“When it comes to embracing mindfulness as a caregiver, start with asking yourself questions. How can you look at ways to reduce stress so you don’t take on the entire thing as your job and you have to do everything? When you’re more intentional, you can look at what is truly needed in this picture to help the care recipient and ask who might be supportive besides yourself and how can you involve other resources?” – Nancy Kriseman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Bajaj, J. S., Ellwood, M., Ainger, T., Burroughs, T., Fagan, A., Gavis, E. A., … Wade, J. B. (2017). Mindfulness-Based Stress Reduction Therapy Improves Patient and Caregiver-Reported Outcomes in Cirrhosis. Clinical and Translational Gastroenterology, 8(7), e108–. http://doi.org/10.1038/ctg.2017.38

 

Abstract

Objectives:

Patient-reported outcomes such as health-related quality of life (HRQOL) are impaired in cirrhosis due to under-treated mood and sleep disorders, which can adversely impact their caregivers. Mindfulness-based stress reduction (MBSR) can improve patient-reported outcomes (PRO) in non-cirrhotic patients but their impact in cirrhosis is unclear. To evaluate the effect of MBSR and supportive group therapy on mood, sleep and HRQOL in cirrhotic patients and their caregivers.

Methods:

Cirrhotic outpatients with mild depression (Beck Depression Inventory (BDI)>14) on screening with an adult caregiver were enrolled. At baseline, BDI, sleep (Pittsburgh sleep quality index PSQI, Epworth Sleepiness Scale, ESS), anxiety (Beck Anxiety inventory) and HRQOL (Sickness Impact Profile, SIP) for both patients/caregivers and caregiver burden (Zarit Burden Interview Short-form, ZBI-SF and perceived caregiver burden, PCB) and patient covert HE(CHE) status were measured. Patients who had BDI>14 at baseline, along with their caregivers then underwent a structured MBSR program with four weekly hour-long group sessions interspersed with home practice using CDs. After the last group, all questionnaires were repeated.

Results:

20 patient/caregiver dyads were included. All patients were men (60±8 years MELD 12.9±5.7, 14 prior hepatic encephalopathy (HE)) while most caregivers (n=15) were women (55±12 years, 23±14 years of relationship, 65% spouses). There was no change in patient BDI between screening and baseline (20.1±11.2 vs. 19.0±10.6, P=0.81). All dyads were able to complete the four MBSR+supportive group therapy sessions. There was a significant improvement in BDI (19.0±10.6 vs.15.6±8.2 P=0.01), PSQI (7.2±3.7 vs. 5.5±3.7, P<0.001) and overall HRQOL (25.0±13.2 vs. 17.7±14.0,P=0.01) but not in anxiety or CHE rates in patients. Similarly caregiver burden (ZBI-SF13.0±9.0 vs. 9.8±6.9,P=0.04, Perceived burden 72.1±29.9 vs. 63.0±14.5,P=0.05) and depression reduced (BDI 9.1±7.8 vs. 5.9±6.0,P=0.03) while caregiver sleep quality (7.2±3.7 vs. 5.5±3.7,P<0.001) improved. Prior HE did not affect PRO change after MBSR+supportive groups but the ZBI-SF of caregivers taking care of HE patients improved to a greater extent (delta −1.1±6.5 vs. 7.4±5.3 HE, P=0.04).

Conclusion:

A short program of mindfulness and supportive group therapy significantly improves PRO and caregiver burden in cirrhotic patients with depression. This non-pharmacological method could be a promising approach to alleviate psychosocial stress in patients with end-stage liver disease and their caregivers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539344/

Improve Caregiving for Family Members with Mental Illness with On-Line Mindfulness Training

Improve Caregiving for Family Members with Mental Illness with On-Line Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“When specifically used with family caregivers, MBSR improves overall mental health, reduces stress and decreases depression. “ – Jane Hamilton

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is mentally or physically ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost to the caregiver. It exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Providing care for a relative with mental illness can be particularly challenging. Mental illnesses can make it difficult to relate to the individual and receive the kind of positive feelings that can support caregiving. The challenges of caring for a relative with mental illness require that the individual be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. And it improves the ability to maintain attention and focus in the face of high levels of distraction. So, it is not surprising that mindfulness improves caregiving and assists the caregiver in coping with the stress.

 

The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This produces costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules. This is particularly true for caregivers where the demands on the individual are substantial. As a result, there has been attempts to develop on-line mindfulness training programs. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts.

 

In today’s Research News article “Effectiveness and Usability of a Web-Based Mindfulness Intervention for Families Living with Mental Illness.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408047/, Stjernswärd and Hansson recruited adult participants who have a family member with a diagnosed mental illness. They were randomized into a mindfulness training and a wait-list control group. Mindfulness training occurred on-line and consisted of audio/video files, descriptive text files, and instructions for daily mindfulness exercises, and self-compassion exercises. It was recommended that participants engage in the training twice a day for 10 minutes, six days per week for 8 weeks. recommended training was set to 2 × 10 min/day, 6 days/week for 8 consecutive weeks.

 

Participants were measured before and after training and 3-months later for mindfulness, caregiver quality of life, self-compassion, and perceived stress. They found that mindfulness training produced significant increases in mindfulness, self-compassion, and caregiver quality of life, including relational problems, mental health, and problems with daily activities and significant reductions in perceived stress.

 

These are interesting results but must be tempered with the knowledge that the control condition was a no-treatment, wait-list control. So, the results could be due to confounding factors such as placebo effects, experimenter bias, attention effects, etc. But, they suggest that mindfulness training for caregivers with family members with mental illnesses can be successfully delivered on-line. If the results are supported by better controlled trials, they could be important in that improvements in the mental health and quality of life can be offered to caregivers in a convenient and inexpensive format. This could be very helpful in relieving a difficult situation for the caregivers and result in improved caregiving.

 

So, improve caregiving for family members with mental illness with on-line mindfulness training.

 

5 Steps to Avoid Caregiver Burnout

  1. Develop a mindfulness practice, whether it’s yoga, meditation, or Qigong.
  2. Incorporate mini-mindfulness moments. Set aside time several times a day to ground yourself and to be in the present moment.
  3. Learn to accept your emotions, both pleasant and unpleasant, rather than wishing them away.
  4. Recognize the need for self-care in caregiving. Taking time for yourself may be an old piece of advice but it’s essential.
  5. Find a support network that can help you build a mindfulness practice, whether it is your friend, the YMCA, or a meditation group.” – Jason Drwal

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Stjernswärd, S., & Hansson, L. (2017). Effectiveness and Usability of a Web-Based Mindfulness Intervention for Families Living with Mental Illness. Mindfulness, 8(3), 751–764. http://doi.org/10.1007/s12671-016-0653-2

 

Abstract

Families living with mental illness express needs of support and experiences of burden that may affect their own health detrimentally and hence also their ability to support the patient. Mindfulness-based interventions have shown beneficial health effects in both clinical and healthy populations. The aim of the current study was to explore the effectiveness and usability of a web-based mindfulness program for families living with mental illness, which was first tested in a feasibility study. The study was designed as a randomized controlled trial with an experiment group and a wait-list control group with assessments on primary and secondary outcomes at baseline, post-intervention, and at a 3-month follow-up. Significant positive improvements in mindfulness and self-compassion, and significant decreases in perceived stress and in certain dimensions of caregiver burden were found, with good program usability. Easily accessible mindfulness-based interventions may be useful in addressing caregivers’ needs of support and in preventing further ill health in caregivers. Further studies are needed, among others, to further customize interventions and to investigate the cost-effectiveness of such programs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408047/

Mindfully be a Better Parent

Mindfully be a Better Parent

 

By John M. de Castro, Ph.D.

 

“As parents, perhaps the most precious thing we can give our children is the gift of our full presence, in the moment. This is the deep intention and invitation for parents as they make space for mindfulness practice in their lives. Mindful parenting takes to heart the deep truth that we can only give to our children what we have given first and fundamentally to ourselves.” – Lisa Kring

 

Raising children, parenting, is very rewarding. But, it can also be challenging. Children test parents frequently. They test the boundaries of their freedom and the depth of parental love. They demand attention and seem to especially when parental attention is needed elsewhere. They don’t always conform to parental dictates or aspirations for their behavior. They are often affected more by peers, for good or evil, than by parents. It is the parents challenge to control themselves, not overreact, and act appropriately in the face of strong emotions. Meeting these challenges becomes more and more important with adolescents, as here are the greatest struggles for independence and the potential for damaging behaviors, particularly, alcohol, drugs, and sexual behavior.

 

The challenges of parenting require that the parents be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive to each  other and their child. In addition, both parents working cooperatively, coparenting, is needed. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. It improves relationships, And it improves the ability to maintain attention and focus in the face of high levels of distraction. Mindful parenting and coparenting involve having emotional awareness of themselves and their partner and also having emotional awareness of and compassion for the child and having the skills to pay full attention to the child in the present moment, to accept parenting non-judgmentally and be emotionally non-reactive to the child.

 

In today’s Research News article “Mindfulness in Parenting and Coparenting.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830503/

Parent and colleagues investigate the relationship between mindfulness and parenting and coparenting in being effective parents. They recruited parents of children in three age ranges; young childhood (3 to 7 years old), middle childhood (8 to 12 years old), and adolescence (13 to 17 years old). They completed measures of mindfulness, mindful parenting (careful listening and attention, low reactivity, non-judgmental responses, emotional awareness, and compassion for the self and the child), mindful coparenting (negotiation of a shared caregiving role between two adults), positive parenting (expressions of warmth and affection, facilitating supportive parent-child communication) and negative parenting (reactive parenting, ineffective discipline), and coparenting relationship quality (increased coparenting agreement, closeness, and support and decreased coparenting conflict and undermining).

 

They found that high levels of parental mindfulness were significantly associated with high levels of mindful parenting and mindful coparenting and low levels of negative parenting. In turn, high levels of mindful parenting were associated with high levels of positive parenting and low levels of negative parenting. High levels of mindful coparenting were associated with high levels of coparenting relationship quality. There were no differences in these effects between parents young, middle or adolescent children. Hence, being mindful makes for better parents directly and indirectly by affecting mindful parenting and coparenting skills.

 

It should be kept in mind that this study was correlational and there were no active manipulations. So, causation cannot be concluded. But previous studies that included mindfulness training have demonstrated that improving mindfulness improved parenting. So, it is reasonable to suggest that the relationships are causally connected. Hence, it appears that mindfulness produces better parenting.

 

So, mindfully be a better parent.

 

“According to new research, children who experience mindful parenting are less likely to use drugs or get depression or anxiety.” – Jill Suttie

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Parent, J., McKee, L. G., Anton, M., Gonzalez, M., Jones, D. J., & Forehand, R. (2016). Mindfulness in Parenting and Coparenting. Mindfulness, 7(2), 504–513. http://doi.org/10.1007/s12671-015-0485-5

 

Abstract

Mindfulness has been established as a critical psychosocial variable for the well-being of individuals; however, less is understood regarding the role of mindfulness within the family context of parents, coparents, and children. This study tested a model examining the process by which parent dispositional mindfulness relates to parenting and coparenting relationship quality through mindful parenting and coparenting. Participants were 485 parents (59.2% mothers) from three community samples of families with youth across three developmental stages: young childhood (3 – 7 yrs.; n = 164), middle childhood (8 – 12 yrs.; n = 161), and adolescence (13 – 17 yrs.; n = 160). Path analysis using maximum likelihood estimation was employed to test primary hypotheses. The proposed model demonstrated excellent fit. Findings across all three youth development stages indicated both direct effects or parent dispositional mindfulness, as well as indirect effects through mindful parenting and mindful coparenting, with parenting and coparenting relationship quality. Implications for intervention and prevention efforts are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830503/

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:

http://onlinelibrary.wiley.com.ezproxy.shsu.edu/doi/10.1002/jclp.22470/full

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

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

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

 

Abstract

Objective

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.

Method

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).

Results

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.

Conclusion

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.

http://onlinelibrary.wiley.com.ezproxy.shsu.edu/doi/10.1002/jclp.22470/full

 

Improve Cancer Patient and Caregiver Well-Being with Spiritual Care

Improve Cancer Patient and Caregiver Well-Being with Spiritual Care

 

By John M. de Castro, Ph.D.

 

“Serious illnesses like cancer may cause patients or family caregivers to have doubts about their beliefs or religious values and cause much spiritual distress. Some studies show that patients with cancer may feel that they are being punished by God or may have a loss of faith after being diagnosed. Other patients may have mild feelings of spiritual distress when coping with cancer.” – National Cancer Institute

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Not only the patient but also the caregivers have difficult issues to cope with. Providing care for cancer patients can be can be a very satisfying, rewarding, and even joyful experience. But, over time, caregiving can wear the caregiver out and can lead to burnout. Caregiving comes at a cost to the caregiver. It exacts an economic toll in lost work hours, income, and even the opportunity to take a promotion or relocate for a better position. But, more significantly, it exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Obviously, there is a need to both care for the cancer patients and also for the caregivers. Religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer and also for their caregivers. It is thought that people take comfort in the spiritual when facing mortality. But, spiritual concerns, such as feelings of being abandoned by god or needing forgiveness for actions in their lives might lead to anxiety and worry rather than comfort and can exacerbate the psychological burdens of cancer or on the quality of life of cancer patients and their caregivers. Hence, there is a need to study the effects of spiritual care on the cancer patient and their caregivers.

 

In today’s Research News article “Spiritual Care Therapy on Quality of Life in Cancer Patients and Their Caregivers: A Prospective Non-randomized Single-Cohort Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320005/

Sankhe and colleagues recruited adult cancer patients undergoing surgery whose life expectancy exceeded 6 months and one of their caregivers. This was a pilot study without a control group in which all patients and caregivers were provided with spiritual care consisting of 90 minutes daily counseling, reading and chanting. They were measured at the baseline, discharge and 2, 4, and 6 months following the surgery, for spiritual well-being and quality of life, including physical well-being, social/family well-being, emotional well-being and functional well-being.

 

They found that both the cancer patients and their caregivers had large and significant improvements in spiritual well-being and in all quality of life domains. These improvements were maintained 6 months after discharge. These are impressive effects of spiritual care but, because of the lack of a control condition, any conclusions must be tempered with the understanding that there are a myriad of possible confounding factors. The results do though provide strong evidence for the conduct of a randomized controlled clinical trial of providing spiritual care for cancer patients and their caregivers.

 

So, improve cancer patient and caregiver well-being with spiritual care.

 

“Spirituality and religion can be important to the well-being of people who have cancer, enabling them to better cope with the disease. Spirituality and religion may help patients and families find deeper meaning and experience a sense of personal growth during cancer treatment, while living with cancer, and as a cancer survivor.” – National Comprehensive Cancer Network

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Sankhe, A., Dalal, K., Agarwal, V., & Sarve, P. (2017). Spiritual Care Therapy on Quality of Life in Cancer Patients and Their Caregivers: A Prospective Non-randomized Single-Cohort Study. Journal of Religion and Health, 56(2), 725–731. http://doi.org/10.1007/s10943-016-0324-6

 

Abstract

Spiritual care is still in infancy stage all over the globe including India. The present study was an original study evaluating the role of spiritual care in cancer patients and their primary caregivers regarding their spiritual and general well-being. The study was a prospective, non-randomized single-group study involving cancer patients undergoing surgery and their primary caregivers. Functional assessment of cancer therapy—general and functional assessment of chronic illness therapy-spiritual care was evaluated during the admission and at the time of discharge, two, four  and 6 months following discharge from the hospital. Descriptive statistics was used for demographic details and repeated measure ANOVA with Dunn’s test was used for analysis of changes in the scores. A total of 107 (63 males and 44 females) patients with a mean (SD) of age 51 (13) years were recruited in the study. Similarly, for each patient one of their primary caregivers was recruited with their mean (SD) age of 39.4 (12.7) years. A total of 11/107 (10.3%) patients died and nine out of 107 (8.4%) were lost to follow-up eventually during the study period. There was a statistically significant (P < 0.0001) increase in the scores at all the follow-up periods in both the patient and their relative groups. To conclude, we found out that spiritual care on the basis of MATCH guideline improved the level of not only spiritual well-being but general well-being also in both the patients and their primary caregivers. Control group could have improved scientific validity of study in accessing effect of spiritual care. Authors believe that more robust comparative study on each principle against all five MATCH principles in future will add scientific validity and clear the various ambiguities in spiritual care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320005/