Abstract
Objectives
Mindfulness training (MT) may enhance the well-being of family caregivers of persons with neurodegenerative disease. However, long-term benefits are unclear. The current mixed-methods study examined whether benefits associated with MT are maintained 1 year following program completion.
Methods
Family caregivers who participated in a randomized trial examining the benefits of MT relative to psychoeducation were re-contacted 12 months post program completion. Of the original 57 participants, 35 consented to participate in the telephone interview and 23 completed questionnaires that tapped into perceived distress, depression, caregiver burden, and quality of life.
Results
Univariate analyses failed to detect a significant between-groups difference at 12 months post program. Paired sample t-tests revealed maintenance of within-group benefits for distress and depressive symptoms in the MT group such that mean scores at 12 months did not differ from post-intervention scores but did differ from pre-intervention scores. Additional within-group gains were found for the MT group such that caregiver burden at 12 months significantly differed from pre- and post-intervention burden score. Thematic analysis of transcripts revealed four themes: do what works and what fits; moving beyond the program; ability to return; and continued struggle and need for support. Qualitative analyses suggest that continued practice of mindfulness maps onto perceptions of wellness 12 months later.
Conclusions
While MT has potential to support caregivers’ mental health and well-being 12 months following program completion, continued supports are required to facilitate continued practice.
Similar content being viewed by others
Data Availability
Data are available at Mendeley Data: Fiocco, Alexandra (2022), “Preliminary Evidence for Lasting Benefits One Year Following Mindfulness Training Among Older Family Caregivers of Persons with Neurodegenerative Disease,” Mendeley Data, V1, https://doi.org/10.17632/y538gmbp9x.1
References
Braun, V., & Clarke, V. (2012). Thematic analysis. In H. Cooper (Ed.), APA handbook of research methods in psychology (vol. 2. pp. 57–71). American Psychological Association.
Brown, K. W., Coogle, C. L., & Wegelin, J. (2016). A pilot randomized controlled trial of mindfulness-based stress reduction for caregivers of family members with dementia. Aging and Mental Health, 20(11), 1157–1166. https://doi.org/10.1080/13607863.2015.1065790
Bushlack, T. J., & Bockm, T. (2018). Validating the “Centering for Wisdom Assessment”: Assessing the role of contemplative practices in the cultivation of practical wisdom. Journal of Psychology and Theology, 46(3), 143–167. https://doi.org/10.1177/0091647118764956
Canadian Institute for Health Information (2010). Supporting informal caregivers – The heart of home care. https://secure.cihi.ca/free_products/Caregiver_Distress_AIB_2010_EN.pdf
Capistrant, B. D., Moon, J. R., Berkman, L. F., & Glymour, M. M. (2012). Current and long-term spousal caregiving and onset of cardiovascular disease. Journal of Epidemiology and Community Health, 66(10), 951–956. https://doi.org/10.1136/jech-2011-200040
Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31(1), 23–33. https://doi.org/10.1007/s10865-007-9130-7
Centers for Disease Control and Prevention (2019, October 30). Caregiving for person with alzheimer's disease or a related dementia. https://www.cdc.gov/aging/caregiving/alzheimer.htm
Cheung, D., Kor, P., Jones, C., Davies, N., Moyle, W., Chien, W. T., Yip, A., Chambers, S., Yu, C., & Lai, C. (2020). The use of modified mindfulness-based stress reduction and mindfulness-based cognitive therapy program for family caregivers of people living with dementia: A feasibility study. Asian Nursing Research, 14(4), 221–230. https://doi.org/10.1016/j.anr.2020.08.009
Cohen, S., Kamarch, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. https://doi.org/10.2307/2136404
Collins, R., & Kishita, N. (2020). Prevalence of depression and burden among informal care-givers of people with dementia: A meta-analysis. Ageing and Society, 40(11), 2355–2392. https://doi.org/10.1017/S0144686X19000527
Family Caregiver Alliance (2016). Caregiver statistics: Demographics. https://www.caregiver.org/resource/caregiver-statistics-demographics/#
Flanagan, J. C. (1978). A research approach to improving our quality of life. American Psychologist, 33(2), 138–147. https://doi.org/10.1037/0003-066X.33.2.138
Franco, C., Sola, M. M., & Justo, E. (2010). Reducing psychological discomfort and overload in Alzheimer’s family caregivers through a mindfulness meditation program. Revista Espanola De Geriatria Y Gerontologia, 45, 252–258. https://doi.org/10.1016/j.regg.2010.03.006
Gao, C., Chapagain, N. Y., & Scullin, M. K. (2019). Sleep duration and sleep quality in caregivers of patients with dementia: A systematic review and meta-analysis. JAMA Network Open, 2(8), e199891. https://doi.org/10.1001/jamanetworkopen.2019.9891
Harmell, A. L., Chattillion, E. A., Roepke, S. K., & Mausbach, B. T. (2011). A review of the psychobiology of dementia caregiving: A focus on resilience factors. Current Psychiatry Reports, 13(3), 219–224. https://doi.org/10.1007/s11920-011-0187-1
Kabat-Zinn J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Random House Inc.
Kaddour, L., & Kishita, N. (2020). Anxiety in informal dementia carers: A meta-analysis of prevalence. Journal of Geriatric Psychiatry and Neurology, 33(3), 161–172. https://doi.org/10.1177/0891988719868313
Karimirad, M. R., Seyedfatemi, N., Mirsepassi, Z., Noughani, F., & Cheraghi, M. A. (2022). Barriers to self-care planning for family caregivers of patients with severe mental illness. Journal of Patient Experience. https://doi.org/10.1177/23743735221092630
Liu, Z., Chen, Q. L., & Sun, Y. 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.
Liu, Z., Sun, Y. Y., & Zhong, B. L. (2018). Mindfulness‐based stress reduction for family carers of people with dementia. Cochrane Database of Systematic Reviews, 8(8), CD012791. https://doi.org/10.1002/14651858.CD012791.pub2
Mallya, S., & Fiocco, A. J. (2018). Impact of informal caregiving on cognitive function and wellbeing in Canada. International Psychogeriatrics, 1049–1055. https://doi.org/10.1017/S1041610217002605
Mallya, S., & Fiocco, A. J. (2019). The effects of mindfulness training on cognitive and psychosocial wellbeing among older family caregivers of persons with neurodegenerative disease. Mindfulness. https://doi.org/10.1007/s12671-019-01155-1
Maxwell, J. A. (2010). Using numbers in qualitative research. Qualitative Inquiry, 16(6), 475–482. https://doi.org/10.1177/1077800410364740
Molero Jurado, M. D. M, Pérez-Fuentes, M., Barragán Martín, A. B., Soriano Sánchez, J. G., Oropesa Ruiz, N. F., Sisto, M., & Gázquez Linares, J. J. (2020). Mindfulness in family caregivers of persons with dementia: Systematic review and meta-analysis. Healthcare (Basel, Switzerland), 8(3), 193. https://doi.org/10.3390/healthcare8030193
Morgan, L. P., Graham, J. R., Hayes-Skelton, S. A., Orsillo, S. M., & Roemer, L. (2014). Relationships between amount of post-intervention of mindfulness practice and follow-up outcome variables in an acceptance-based behavior therapy for generalized anxiety disorder: The importance of informal practice. Journal of Contextual Behavioral Science, 3(3), 173–176. https://doi.org/10.1016/j.jcbs.2014.05.001
Morse, J. M., Barrett, M., Mayan, M., Olson, K., & Spiers, J. (2002). Verification strategies for establishing reliability and validity in qualitative research. International Journal of Qualitative Methods, 1(2), 13–22. https://doi.org/10.1177/160940690200100202
Ong, J. C., Shapiro, S. L., & Manber, R. (2009). Mindfulness meditation and cognitive behavioral therapy for insomnia: a naturalistic 12-month follow-up. Explore, 5(1), 30–36. https://doi.org/10.1016/j.explore.2008.10.004
Plaza, I., Demarzo, M. M. P., Herrera-Mercadal, P., & García-Campayo, J. (2013). Mindfulness-based mobile applications: Literature review and analysis of current features. JMIR mHealth and uhHealth, 1(2), e24. https://doi.org/10.2196/mhealth.2733
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Journal of Applied Psychological Measurement, 1, 385–401.
Reinhard, S. C., Feinberg, L. F., Choula, R., & Houser, A. (2019). Valuing the invaluable. Insight on the Issues, 104, 89–98. https://www.aarp.org/content/dam/aarp/ppi/2015/valuing-the-invaluable-2015-update-new.pdf
Ribeiro, L., Atchley, R. M., & Oken, B. S. (2018). Adherence to practice of mindfulness in novice meditators: practices chosen, amount of time practiced, and long-term effects following a mindfulness-based intervention. Mindfulness, 9(2), 401–411. https://doi.org/10.1007/s12671-017-0781-3
Schulz, R., & Beach, S. R. (1999). Caregiving as a risk factor for mortality: The Caregiver Health Effects Study. JAMA: Journal of the American Medical Association, 282(23), 2215–2219. https://doi.org/10.1001/jama.282.23.2215
Sephton, S. E., Salmon, P., Weissbecker, I., Ulmer, C., Floyd, A., Hoover, K., & Studts, J. L. (2007). Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: Results of a randomized clinical trial. Arthritis and Rheumatism, 57(1), 77–85. https://doi.org/10.1002/art.22478
Sharma, N., Chakrabarti, S., & Grover, S. (2016). Gender differences in caregiving among family - Caregivers of people with mental illnesses. World Journal of Psychiatry, 6(1), 7–17. https://doi.org/10.5498/wjp.v6.i1.7
Solhaug, I., de Vibe, M., Friborg, O., Sørlie, T., Tyssen, R., Bjørndal, A., & Rosenvinge, J. H. (2019). Long-term mental health effects of mindfulness training: A 4-year follow-up study. Mindfulness, 10(8), 1661–1672. https://doi.org/10.1007/s12671-019-01100-2
Teague, S., Youssef, G. J., Macdonald, J. A., Sciberras, E., Shatte, A., Fuller-Tyszkiewicz, M., Greenwood, C., McIntosh, J., Olsson, C. A., Hutchinson, D., & the SEED LifeCourse Sciences Theme (2018). Retention strategies in longitudinal cohort studies: A systematic review and meta-analysis. BMC Medical Research Methodology, 18, 151. https://doi.org/10.1186/s12874-018-0586-7
Waldron, E. M., Hong, S., Moskowitz, J. T., & Burnett-Zeigler, I. (2018). A systematic review of the demographic characteristics of participants in US-based randomized controlled trials of mindfulness-based interventions. Mindfulness, 9(6), 1671–1692. https://doi.org/10.1007/s12671-018-0920-5
Whitebird, R. R., Kreitzer, M. J., Lewis, B. A., Hanson, L. R., Crain, A. L., Enstad, C. J., & Mehta, A. (2011). Recruiting and retaining family caregivers to a randomized controlled trial on mindfulness-based stress reduction. Contemporary Clinical Trials, 32(5), 654–661. https://doi.org/10.1016/j.cct.2011.05.002
Whitebird, R. R., Kreitzer, M., Crain, A. L., Lewis, B. A., Hanson, L. R., & Enstad, C. J. (2013). Mindfulness-based stress reduction for family caregivers: A randomized controlled trial. The Gerontologist, 53, 676–686. https://doi.org/10.1093/geront/gns126
Whitlatch, C. J., & Orsulic-Jeras, S. (2018). Meeting the informational, educational, and psychosocial support needs of persons living with dementia and their family caregivers. The Gerontologist, 58(Suppl. 1), S58–S73. https://doi.org/10.1093/geront/gnx162
World Health Organization (2021, September 2). Dementia. https://www.who.int/news-room/fact-sheets/detail/dementia.
Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 20(6), 649–655. https://doi.org/10.1093/geront/20.6.649
Acknowledgements
We would like to thank the family caregivers who took time from their demanding schedule to participate in this research. We would also like thank the research assistants who contributed to this project.
Funding
This research was supported by the Mind and Life Institute 1440 Award (A.J.F). L.H. is supported by a Social Sciences and Humanities Research Council Master’s Award.
Author information
Authors and Affiliations
Contributions
AJF: designed and executed the study, conducted data analyses, and co-wrote the paper. LH: collaborated in the analysis, co-writing, and editing of the final manuscript.
Corresponding author
Ethics declarations
Ethics Approval
This study was approved by the Toronto Metropolitan University (formerly Ryerson University) Research Ethics Board (REB#2014–118-2).
Consent to Participate
Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Fiocco, A.J., Hytman, L. Preliminary Evidence for Lasting Benefits One Year Following Mindfulness Training Among Older Family Caregivers of Persons with Neurodegenerative Disease. Mindfulness 13, 2968–2978 (2022). https://doi.org/10.1007/s12671-022-02005-3
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12671-022-02005-3