Providing care for a family member with dementia exerts a great deal of strain on a caregiver, and caregiving has been linked to a number of health problems associated with chronic stress, such as depression and anxiety. These negative aspects of caring for individuals with dementia suggest a need for effective interventions for caregivers that help them manage the stress and emotional challenges associated with their duties. To address this issue, a study in the Gerontologist compares the effectiveness of a mindfulness-based stress reduction program with the effectiveness of a community caregiver education and support program, in order to determine the effectiveness of each program in improving caregivers’ overall mental health.
While both programs improved caregiver mental health and proved effective at improving anxiety, social support, and burden, the mindfulness program proved more effective at improving overall mental health, reducing stress, and decreasing depression.
Mindfulness focuses the practitioner on observing the present moment in a nonjudgmental manner and involves observing thoughts and emotions without getting caught up in them. This focus on the present has been shown to reduce worry and rumination on past and future events, which can lead to higher levels of depression, anxiety, and negative mood. Mindfulness has also been shown to lead to improvements in how stressful events are appraised.
The participants in this study were 78 primary caregivers of community-dwelling family members who had memory loss consistent with dementia. Of these caregivers, 38 took part in a mindfulness-based stress reduction (MBSR) program and 40 took part in a community caregiver education and support program. Both programs consisted of eight weekly two-and-a-half-hour in-person group sessions and a more intensive five-hour retreat.
Participants in the MBSR program received instruction about the practice of mindfulness, and also practiced meditation and gentle yoga exercises each week. They were taught techniques of sitting, walking, and body scan meditation, and asked to document their daily mindfulness activities in a health behaviors calendar.
The community caregiver education program participants were educated about issues affecting family caregivers and about group social and emotional support. Each week, they received information about dementia, legal and financial matters, community resources, communication, self-care, grief, and loss. Group discussions on these topics were also held.
The largest and most long-lasting benefit of the mindfulness program was seen in the mental health scale employed in the study (the MCS-10). On this scale, mindfulness participants showed immediate improvement that was still evident six months after beginning the program. By contrast, the community program group did not show any improvement on this scale at any time point. Immediately after the two programs ended, the mindfulness group also showed a greater improvement in perceived stress and depression, but by six months after the study began, both groups showed similar levels of improvement.
There were no differences between the two groups on the other outcomes measured in this study. Immediately after each program, participants in both groups showed improvement in their levels of anxiety. For both groups, social support, objective burden, subjective stress, and subjective demand showed a steady improvement that was still evident four months after the programs had ended.
Mindfulness programs offer exciting potential as a resource for helping caregivers manage the strains of caring for individuals with dementia. In addition to the benefits of mindfulness on mental health shown here, mindfulness programs also have the advantage of being relatively low cost and offering easy-to-learn exercises and techniques that can be easily practiced daily. Both of the programs studied offered some improvements for caregivers, but, compared to the community caregiver support and education program, the mindfulness program offered a broader range of improvements and in some cases brought about improvements more immediately.
