Being a limited licensed psychologist, although it is not my
primary focus as of late, I have been trying to keep up on the
latest effective psychotherapy techniques. One method that
has truly captured my attention and interest is the increased
focus of “mindfulness” and the use of other Buddhist
concepts in psychotherapy. A basic definition of “mindfulness”
in psychotherapy is “awareness of the present experience
with acceptance.” Or in other words, undivided attention to
the present moment without judgment. Moreover, therapists
are not only encouraged to teach their clients about
mindfulness to assist with coping with a myriad of symptoms,
including pain, stress and other difficult emotional states, but
therapists are requested to also use mindfulness techniques
when interacting with their clients to make the experience
more enjoyable for the therapist, with the emphasis on
empathy and the therapeutic relationship.

It occurred to me that this would be a fantastic model of
delivering care to individuals with dementia. Typically, our
goals when caring for individuals with dementia is to
maximize the person’s dignity functioning and independence,

and to recognize the person’s individuality, life history, as a social being. To preserve humanity
in light of a disease that seems to be strip it completely away. These are incredibly worthwhile
goals. How to effectively achieve these goals is yet to be fully explored and identified;
a playground of possibilities and creativity ensues.

The individual with dementia’s experience, largely due to the symptoms and the progression
of the disease, seems to consist of a sequence of moments with little or no reference to the
future, and in seemingly complete isolation and void of understanding from others from their
perspective. I could only wager an educated guess that meaningful connections or moments
with another human being and without judgment must be incredibly precious for individuals
with dementia, when so much of their time is spent being anxious, uncertain, and painfully
aware of their limitations.

So, can it be said that caregivers (either family, paraprofessional or professional) of individual’s
with dementia can maximize the individual’s quality of life through being “mindful?” Or, helping
the individual experience meaningful moments? This requires the recognition of the equivalent
significance of the caregiver’s relationship with the individual, and his or her ability to be fully
present when interacting with the individual, and complete acceptance of the individual as they
are at that very moment. By doing so, both shall benefit from the use of mindfulness.

By having the caregiver’s complete undivided attention to the individual with dementia, the
caregiver is then permitted to have increased awareness at that present moment of the states
the individual is experiencing which may be affecting him/her positively or negatively, including
environmental, cognitive, physical and psychosocial states of the individual. This in turn allows
the caregiver to react or respond accordingly to enhance his or her ability to have a meaningful
relationship with that person at that given moment in time (e.g., making modifications in the
environment, addressing psychosocial needs). In addition, accepting the individual as they are
at that moment, and/or accepting the situation, provides the caregiver with the ability to relate
to the individual. This allows the caregiver to respond with empathy and equanimity, by avoiding
being caught up in his or own emotional reactions to the individual’s pain, illness, weaknesses,
inabilities, or their behaviors, which can be a significant source of caregiver stress, as well as
stressors in the own everyday life.

In essence, by using concepts of mindfulness, the benefit is two-fold: creating meaningful
connections with the individual which improves quality of life, and providing respite to the
caregiver from losses and weaknesses of the individual, personality conflicts, and other extraneous day-to-day stressors that the caregiver may face. In other words, recognition
that the individual with dementia and the caregiver are one in the same: human beings.

For more information on using mindfulness-based strategies for caregivers:

Bruce, A., & Davies, Betty (2005). Mindfulness in Hospice Care: Practicing Meditation-in-Action.
Qualitative Health Research, 15(10), 1329-1344

McBee, Lucia. (2003). Mindfulness Practice with the Frail Elderly and Their Caregivers:
Changing the Practitioner-Patient Relationship. Topics in Geriatric Rehabilitation, 19(4), 257-264.

Minor, H., Carlson, L., Mackenzie, M., Zernicke, K., & Jones, L. (2006). Evaluation of a
Mindfulness-Based Stress Reduction (MBSR) Program for Caregivers of Children with
Chronic Conditions. Social Work in Health Care, Vol 43(1), 91-109.

Shapiro, S., Astin, J., Bishop, S., & Cordova, M. (2005). Mindfulness-Based Stress Reduction
for Health Care Professionals Results from a Randomized Trial. International Journal of Stress
Management, 12(2), 164-176.

Shigaki, C., Glass, B., & Schopp, L. (2006). Mindfulness-Based Stress Reduction in Medical
Settings. Journal of Clinical Psychology in Medical Settings, Vol 13(3), 209-216.

Germer C., Siegel R Fulton, PR. (Ed) (2005) Mindfulness & Psychotherapy. New York:
The Guilford Press.

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