Improve Caregiving for Developmental Disabilities with Mindfulness

By John M. de Castro, Ph.D.

 

“mindfulness practices could be helpful for . . . caregivers because they encourage a nonjudgmental interpretation of their child’s situation, and increased acceptance of their reality. 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

 

Four in ten adults in the U.S. are caring for an adult or child with significant health issues, up from 30% in 2010. Caring for a loved one is an activity that cuts across most demographic groups, but is especially prevalent among adults ages 30 to 64, a group traditionally still in the workforce. Caring for children and adults with intellectual and developmental disabilities can be particularly 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 a 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, 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 “Caregiver Training in Mindfulness-Based Positive Behavior Supports (MBPBS): Effects on Caregivers and Adults with Intellectual and Developmental Disabilities”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1202660149757909/?type=3&theater

or see below, or for a full text see:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746712/

Singh and colleagues implemented a 10-week Mindfulness-Based Positive Behavior Support (MBPBS) training for caregivers of individuals with intellectual and developmental disabilities in community and group homes. The training added practice with meditation to a standard Positive Behavior Support (PBS) program. The PBS program “is designed to decrease an individual’s problem behaviors by teaching new skills, modifying the environment where the problem behaviors occur, and enhancing quality of life.” It was hypothesized that the addition of mindfulness training would magnify and supplement the effectiveness of the PBS program.

 

Singh and colleagues found that the MBPBS training resulted in a significant decrease in the use of physical restraint and significant decreases in injuries to staff and other patients. There were also significant reductions in the staff’s perceived stress levels and turnover rate. The reduced stress and injuries resulted in a highly significant reduction in institutional costs. These results clearly demonstrate that the MBPBS training is effective for caregivers. It is not clear, however, whether the meditation training was responsible, the Positive Behavior Support training or both. It remains for future research to identify which components are necessary and sufficient for improvement of caregivers well-being.

 

Regardless, it is clear that the combination of meditation to Positive Behavior Support (PBS) training produces important improvements for the staff, patients, and institution in caregiving for individuals with intellectual and developmental disabilities in community and group homes.

 

“caregivers and patients found that the mindfulness training actually helped improve their relationships with each other. Mindfulness places both people in the present and in positive emotion; the two sides share this experience with a bit of freedom from the baggage of their history. . . . such gentle, positive interaction helped defuse the ongoing stress of a caregiver dynamic, and it helped build a stronger relationship in the present.”Adam Perlman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

Study Summary

Singh, N. N., Lancioni, G. E., Karazsia, B. T., & Myers, R. E. (2016). Caregiver Training in Mindfulness-Based Positive Behavior Supports (MBPBS): Effects on Caregivers and Adults with Intellectual and Developmental Disabilities. Frontiers in Psychology, 7, 98. http://doi.org/10.3389/fpsyg.2016.00098

 

Abstract

Caregivers often manage the aggressive behavior of individuals with intellectual and developmental disabilities that reside in community group homes. Sometimes this results in adverse outcomes for both the caregivers and the care recipients. We provided a 7-day intensive Mindfulness-Based Positive Behavior Support (MBPBS) training to caregivers from community group homes and assessed the outcomes in terms of caregiver variables, individuals’ behaviors, and an administrative outcome. When compared to pre-MBPBS training, the MBPBS training resulted in the caregivers using significantly less physical restraints, and staff stress and staff turnover were considerably reduced. The frequency of injury to caregivers and peers caused by the individuals was significantly reduced. A benefit-cost analysis showed substantial financial savings due to staff participation in the MBPBS program. This study provides further proof-of-concept for the effectiveness of MBPBS training for caregivers, and strengthens the call for training staff in mindfulness meditation.