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/

 

Care for Autism Caregivers with Mindfulness

Image may contain: 2 people, people sitting

Care for Autism Caregivers with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindful Parenting is a contemplative practice through which our connection to our child, and awareness of our child’s presence, helps us become better grounded in the present moment” – Mindful Parent

 

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 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 child with autism can be particularly challenging. About one out of every 68 children is considered autistic. These children’s behavior is characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. These make it difficult to relate to the child and receive the kind of positive feelings that often help to support caregiving. The challenges of caring for a child with autism require that the parent be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive to their child. 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.

 

The skills developed with mindfulness training become particularly important with caregiving for children with autism. All of the challenges of parenting become amplified. The application of mindfulness skills to the parents of children with autism is relatively new. So, it would seem reasonable to investigate this further. In today’s Research News article “Effectiveness of mindfulness-based interventions on quality of life and positive reappraisal coping among parents of children with autism spectrum disorder.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1422543424436246/?type=3&theater

or see summary below, Rayan and Ahmad recruited parents of children with autism and randomly assigned them to either receive 5 weeks of mindfulness training or a no-treatment control group. Mindfulness training was delivered in weekly 2.5 hour sessions with accompanying homework. The parents were measured prior to and after the training for quality of life, the ability to positively reappraise stress, and mindfulness.

 

They found that after mindfulness training the parents, not surprisingly, were significantly higher in mindfulness. Importantly, they also had significant improvements in quality of life including both psychological and social aspects and showed significant improvement in their ability to positively reappraise stress. Mindfulness training appear to have relatively powerful effects as all of the effects occurred with moderate to strong effect sizes. So, mindfulness training produced positive improvements in the parents in their ability to cope with the stresses of caring for an autistic child and improved their quality of life.

 

These results are important. Caring for a child with autism is difficult and takes a toll on the parents. They need help and support. The findings demonstrate that mindfulness training may be a powerful treatment to improve the parents’ quality of life and ability to cope with the stresses. Mindfulness training may do this by focusing attention on the present moment. Thinking about the past problems with the child and looking to future issues can result in deep worry, rumination, and catastrophic thinking. This amplifies the stresses of parenting a child with autism. By moving attention to just dealing with what is occurring in the present, these stresses can be coped with on their own basis alone, without amplification. This should markedly improve the quality of life for the parents.

 

So, care for autism caregivers with mindfulness.

 

“through mindfulness practice, we can come home to ourselves, getting on our own best side, attending to our own needs in a way that only we can do for ourselves. Parenting can be so hard, so the intention is to not make it worse. We learn to let go of unrealistic expectations, to love and accept ourselves more and more as we really are, finding more and more wholeness. Our children are in need of our unconditional love. But, we cannot give what we do not possess. Therefore, we must begin first with ourselves, experiencing more and more kindness, compassion and self-acceptance. As a result, this begins to naturally flow to our children, more and more.” – Lisa Kring

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Rayan A, Ahmad M. Effectiveness of mindfulness-based interventions on quality of life and positive reappraisal coping among parents of children with autism spectrum disorder. Res Dev Disabil. 2016 Aug;55:185-96. doi: 10.1016/j.ridd.2016.04.002.

 

Highlights

  • QOL is considered a critical outcome for measuring the effectiveness of intervention programs for parents of children with ASD.
  • To date, little is known about the effectiveness of MBI on QOL and coping in parents of children with ASD.
  • MBI can improve psychological and social domains of QOL and enhance coping in parents of children with ASD.
  • Parents who non-judgmentally respond to their children are expected to report better QOL and positive stress reappraisal coping.
  • The MBI should be considered as a supportive intervention to help parents of children with ASD.

 

Abstract

Background: Previous research has supported mindfulness-based interventions (MBIs) to enhance quality of life (QOL) in different populations, but no studies have been found to examine the effectiveness of MBIs on QOL among parents of children with ASD.

Aim: The purpose of the current study was to examine the effectiveness of brief MBI on perceived QOL and positive stress reappraisal (PSR) among parents of children with ASD.

Methods: A quasi-experimental, with nonequivalent control group design was used. One hundred and four parents of children with ASD were equally assigned to the intervention and control groups. The study groups were matched on measures of their gender and age, and level of severity of ASD in children. The intervention group participated in MBI program for 5 weeks, while the control group had not attended the program.

Results: After the intervention program, results of paired samples t-test indicated that parents in the intervention group demonstrated significant improvements in measures of psychological health domain of QOL, social health domain of QOL, mindfulness, and positive stress reappraisal with medium to large effect size (P < 0.01). The control group demonstrated improvement in measures of the dependent variables with small effect size.

Conclusion: MBI is culturally adaptable, acceptable, and effective method to improve QOL and PSR in parents of children with ASD.

 

Improve Caregiving for People with Intellectual Disabilities with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness – or intentionally paying attention to the present moment with nonjudgment – turns out to be equally as beneficial for those of us who are caregivers as it is for those of us who need caregiving. A mindfulness practice can improve not only our experiences of caregiving, but also the ways in which we (re)act as caregivers.” – Jennie Crooks

 

Caring for children and adults with intellectual and developmental disabilities can be difficult. Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime. Recent estimates in the United States show that about one in six, or about 15%, of children aged 3 through 17 years have one or more developmental disabilities.

 

Today, most people with intellectual and developmental disabilities live with their families. This places many stresses on the caregivers and their families and stretches their financial resources. Due to these issues, people with severe cases of intellectual and developmental disabilities are often cared for in community and group homes. The staff of these homes, like family caregivers are under high levels of stress for many reasons including that many individuals with intellectual and developmental disabilities are highly aggressive and at time combative.  They sometimes require physical restraint and can cause injuries to the caregiver and to other patients. In addition, the high levels of stress and injury results in many staff leaving.

 

It should be clear that there is a need for methods to reduce the stress, injuries, and burnout of caregivers in community and group homes. Mindfulness training has been found to be helpful for caregivers in the home setting. So, it would be reasonable to expect that mindfulness training may also be helpful for caregivers in community and group homes. In today’s Research News article “Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) vs. Training-as-Usual (TAU): A Randomized Controlled Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1405689346121654/?type=3&theater

or see summary below or view the full text of the study at:

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.01549/full?utm_source=newsletter&utm_medium=email&utm_campaign=Psychology-w43-2016

Singh and colleagues recruited caregivers of individuals with intellectual and developmental disabilities in a large institutional setting. They were randomly assigned to receive either a Mindfulness-Based Positive Behavior Support (MBPBS) program or the usual training program offered in the facility (Training as Usual; TAU). “The standard 7-day MBPBS protocol was presented in three parts, spread over a 10-week period.” Before and after training they measured patients’ aggressive events, such as hitting, biting, scratching, punching, kicking, slapping, or destroying property, and emergency medications dispensed, the staff’s stress and turnover, and the institutional costs.

 

They found that the staff receiving MBPBS had a significantly greater reduction in stress levels (36%) and had fewer resignations than those receiving TAU (9%). The mindfulness training also produced a significant reduction in the number of aggressive events, emergency medications dispensed, and the need for physical restraints. For the institution, MBPBS training reduced the need for staff, the number of days lost due to injury, and medical and physical rehabilitation therapy services for injured staff and thus saved the facility significant funds.

 

These are exciting findings. Mindfulness training improved the environment and staff stress and reduced costs. That’s quite remarkable given that this is one of the most costly and difficult caregiving challenges there is. It is unclear how improving the mindfulness of the caregivers produced such a marked improvement in the behaviors of the individuals with intellectual and developmental disabilities. Perhaps, being more mindful facilitates the quality of the interactions, calming the patients. As the authors state “We suspect that disciplined meditation practice enables the caregivers to gradually change their relationship to their perceived mental and emotional experiences that arise when providing care to the individuals. . . this mindset enables them to avoid reacting to the challenging behaviors of the individuals based on their premature cognitive commitment to control aggressive behavior through physical restraints and stat medications.”

 

So, improve caregiving for people with intellectual disabilities with mindfulness

 

“Learning to quell distress and anxiety is especially important for parents of children with development disabilities because it’s often a lifetime caregiving commitment.” – Elisabeth M. Dykens

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Singh NN, Lancioni GE, Karazsia BT, Chan J and Winton ASW (2016) Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) vs. Training-as-Usual (TAU): A Randomized Controlled Trial. Front. Psychol. 7:1549. doi: 10.3389/fpsyg.2016.01549

 

Caregivers of individuals with intellectual and developmental disabilities (IDD) often end up having their medical and psychological well-being compromised due to the stressful nature of caregiving, especially when those in their care engage in aggressive behavior. In this study, we provided caregivers with mindfulness-based training to enable them to better manage their psychological well-being and, through this, to also enhance specific indices of quality of life of the individuals in their care. Thus, the aim of the present study was to evaluate in a randomized controlled trial (RCT) the comparative effectiveness of Mindfulness-Based Positive Behavior Support (MBPBS) and Training-as-Usual (TAU) for caregivers in a congregate care facility for individuals with severe and profound IDD. The comparative effects of the two training conditions were assessed in terms of caregiver variables care recipient variable (number of aggressive events), and agency variables Results showed that MBPBS was significantly more effective than TAU in enabling the caregivers to manage their perceived psychological stress, and to reduce the use of physical restraints and stat medications for aggressive behavior of the individuals in their care. In addition, there were significant reductions in aggressive events by the individuals in their care, 1:1 staffing of individuals with aggressive behavior, and staff turnover. Furthermore, the MBPBS training was significantly more cost-effective than the TAU training. If replicated in future RCT studies, MBPBS may provide an effective means of enhancing socially acceptable bidirectional engagement of caregivers and care recipients within a person-centered context.

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.01549/full?utm_source=newsletter&utm_medium=email&utm_campaign=Psychology-w43-2016

 

Reduce Depression and PTSD Symptoms in Caregivers for Dying Children with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness Self-Compassion turns the usual self-critical paradigm around and asks the care partner, in the midst of a difficult caregiving moment; become aware of the emotions that arise in the moment and where they reside in your body (Mindfulness), recognize that there are others who suffer in this way (Common Humanity), and then offer yourself what you need in the moment (Self-Kindness). Again, this is not to change the moment of suffering for the person you are caring for or for yourself, but because you are suffering too! In the end this supports both of you in a softer way and provides the circumstances, not necessarily for ‘cure’ but for healing.” – Sarel Rowe

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. This is the fatigue, cynicism, and professional inefficacy that comes with work-related stress. Burnout is associated with depression-like symptoms and often post-traumatic stress disorder (PTSD)-like symptoms. Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout.

 

Providing care for the dying 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. Indeed, 62% of physicians involved with end of life care report symptoms of burnout. This is magnified many times when the patient is a child. This is supposed to be the beginning of life, not its end. It is often the case that caregivers for the dying become personally attached to their patient. With a child, that attachment becomes deep and profoundly emotional. This level of emotional stress is difficult to repeatedly endure. So, there is a need to find ways to help the healthcare professionals who provide care in general, but particularly for those working with children to cope with the stress and emotional drain.

 

It has recently been demonstrated that mindfulness training can help caregivers cope with the stress. It has also been shown to help to prevent burnout in multiple occupations and particularly in healthcare workers. So, it would make sense to investigate the effectiveness of mindfulness training in preventing burnout in healthcare workers providing end of life care to children. In today’s Research News article “Multimodal Mindfulness Training to Address Mental Health Symptoms in Providers Who Care for and Interact with Children in Relation to End-of-Life Care.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1308949565795633/?type=3&theater

or see summary below. O’Mahoney and colleagues recruited palliative care and other health-care professionals who were involved in caring for terminally ill children. They received a 9-week mindfulness training program meeting once a week for 2 hours in the evening. They were measured before and after training for experiential avoidance, cognitive fusion (taking thoughts as true and upsetting), depression, burnout, and PTSD symptoms.

 

They found that the mindfulness training resulted in significant decreases in depression and post-traumatic stress disorder (PTSD) symptoms. These are interesting preliminary results. But, there is a need to follow this up with a randomized controlled trial to determine unequivocally if the training was responsible for the improvements. The effects do seem reasonable as mindfulness training has been shown in different contexts to reduce depression and improve PTSD symptoms. These findings simply extend these general understandings of the effects of mindfulness training to end of life care for children. But, again demonstrate the usefulness of mindfulness training to relieve the psychological effects of caregiving.

 

So, reduce depression and PTSD symptoms in caregivers for dying children with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

We are set up for short-term stress, but caregiving is long-term stress. Mindfulness works to inhibit the stress response. Most of us run around listening to our thoughts, and this is particularly true of caregivers, who are driven by the To-Do list. They are never at rest.” – Griffiths Vega

 

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

 

Study Summary

O’Mahony S, Gerhart J, Abrams I, Greene M, McFadden R, Tamizuddin S, Levy MM. A Multimodal Mindfulness Training to Address Mental Health Symptoms in Providers Who Care for and Interact With Children in Relation to End-of-Life Care. Am J Hosp Palliat Care. 2016 Jul 21. pii: 1049909116660688. [Epub ahead of print]

 

Abstract

AIM: Medical providers may face unique emotional challenges when confronted with the suffering of chronically ill, dying, and bereaved children. This study assessed the preliminary outcomes of participation in a group-based multimodal mindfulness training pilot designed to reduce symptoms of burnout and mental health symptoms in providers who interact with children in the context of end-of-life care.

METHODS: A total of 13 medical providers who care for children facing life-threatening illness or bereaved children participated in a 9-session multimodal mindfulness session. Mental health symptoms and burnout were assessed prior to the program, at the program midpoint, and at the conclusion of the program.

RESULTS: Participation in the pilot was associated with significant reductions in depressive and posttraumatic stress disorder (PTSD) symptoms among providers (P < .05).

CONCLUSION: Mindfulness-based programs may help providers recognize and address symptoms of depression and PTSD. Additional research is needed to enhance access and uptake of programming among larger groups of participan

Improve Dementia Patients and Their Caregivers with Mindfulness

Mindfulness dementia2 Paler

By John M. de Castro, Ph.D.

 

“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

 

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 caregivers report 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 addition, mindfulness training has been found to help protect aging individuals from physical and cognitive declines. So, it would make sense to combine mindfulness training of the patients and caregivers as a pair.

 

In today’s Research News article “Benefits of Mindfulness Training for Patients with Progressive Cognitive Decline and their Caregivers.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1247548971935693/?type=3&theater

or below or view the full text of the study at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363074/

Paler and colleagues provided an 8-week mindfulness training program for Alzheimer’s Disease patients and their caregivers. They were also given homework exercises on CDs to be practiced for 30-60 minutes daily. They found that the training produced an increase in quality of life, improvement in cognitive executive function, and a decrease in depression and sleep problems for both the patients and caregivers. The vast majority of the participants were pleased with the program and felt that they were less stressed and better able to cope with stressful circumstances and their relationships had improved.

 

These results are outstanding and suggest that combined mindfulness training for both patients and caregivers is a safe and effective method to improve the emotional state, cognitive ability, quality of life, sleep, and stress management for both. The efficiency of training both at the same time is important as the feasibility of implementing the program increases as the demands on time decrease. Mindfulness training is known to improve emotion regulation and depression, cognitive processes, improve sleep, decrease the psychological and physical responses to stress, and improve relationships in normal people. It is important that this study established that this is also true for dementia patients and their caregivers.

 

It should be noted that there was no control or comparison condition. So, it is impossible to make a strong conclusion that the mindfulness program itself produced the improvements. A randomized Controlled Trial (RCT) is needed to confirm these results. Nevertheless, the results are exceptionally promising and provide the rationale to implement an RCT. The authors do note, however, that recruitment of patients and caregivers for a control group would likely be extremely difficult.

 

So, improve dementia patients and their caregivers with mindfulness.

 

“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.” – Ken Paler

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Paller, K. A., Creery, J. D., Florczak, S. M., Weintraub, S., Mesulam, M.-M., Reber, P. J., … Maslar, M. (2015). Benefits of Mindfulness Training for Patients with Progressive Cognitive Decline and their Caregivers. American Journal of Alzheimer’s Disease and Other Dementias, 30(3), 257–267. http://doi.org/10.1177/1533317514545377

 

Abstract

New strategies are needed to help people cope with the repercussions of neurodegenerative disorders such as Alzheimer’s disease. Patients and caregivers face different challenges, but here we investigated an intervention tailored for this combined population. The program focused on training skills such as attending to the present moment nonjudgmentally, which may help reduce maladaptive emotional responses. Patients participated together with caregivers in weekly group sessions over 8 weeks. An assessment battery was individually administered before and after the program. Pre-post analyses revealed several benefits, including increased quality-of-life ratings, fewer depressive symptoms, and better subjective sleep quality. In addition, participants indicated that they were grateful for the opportunity to learn to apply mindfulness skills and that they would recommend the program to others. In conclusion, mindfulness training can be beneficial for patients and their caregivers, it can be delivered at low-cost to combined groups, and it is worthy of further investigation.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363074/