Improve the Well-Being of Dementia Patients and Their Caregivers 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). Another trial indicates that MBSR was “more effective at improving overall mental health, reducing stress, and decreasing depression” than those who only participated in a caregiver education and support intervention.” – 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. 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.ncbi.nlm.nih.gov/pmc/articles/PMC6008507/ ), Berk and colleagues review and summarize the published research literature on the effectiveness of mindfulness training for both the patients with dementia and their caregivers.

They found that the literature reports that mindfulness training can help patients with mild cognitive decline by improving memory. They also report that mindfulness training improves the quality of life and depression in dementia patients and their caregivers when they are trained in mindfulness together. They further found that the research reports that mindfulness training helps the caregivers for the dementia patient by lowering perceived stress levels and depression and improving their quality of life. Hence, it appears that mindfulness training improves the well-being of both dementia patients and their caregivers.

These results fit with previous findings that mindfulness training in general improves the psychological and physiological responses to stress, depression, cognitive function, and quality of life in a wide variety of patients and healthy individuals of all ages. The results further suggests that training the dementia patient and their caregiver together is feasible and may have additional benefits for both.

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

“The disease is challenging for the affected person, family members, and caregivers. Although they know things will likely get worse, they can learn to focus on the present, deriving enjoyment in the moment with acceptance and without excessive worry about the future. This is what was taught in the mindfulness program.” – Ken Paller

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., & van Boxtel, M. (2018). Mindfulness Training for People With Dementia and Their Caregivers: Rationale, Current Research, and Future Directions. Frontiers in Psychology, 9, 982. http://doi.org/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.ncbi.nlm.nih.gov/pmc/articles/PMC6008507/

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/