Pioneering Mindfulness-Based Dementia Care Program Launched at UC San Francisco

Marguerite Manteau-Rao is a mindfulness colleague and friend, editor of the Mind Deep blog, psychotherapist and now a pioneer in bringing much-needed mindfulness training to people caring for those with dementia. 

By Marguerite Manteau-Rao

‘Mindfulness’ and ‘dementia’, two words to do with mind:
dementia, from Latin word demens, which means ‘without mind 

Mindfulness and dementia are not just connected in words. Mindfulness also happens to be a key element of successful dementia care, working on two fronts: 1) to reduce caregiver’s stress, 2) to help the caregiver be present for the person in their care. Facts gathered by the Alzheimer’s Association show the extraordinary stress suffered by most family caregivers:

• 61 percent of dementia caregivers suffer from high emotional stress.
• 33 percent report symptoms of depression.
• 43 percent experience high physical stress.
• 75 percent are concerned about maintaining their health.
• Dementia caregivers are more likely to have adverse physiological changes such as high levels of stress hormones, reduced immune function, increased hypertension, coronary heart disease.
• In the last year of their loved one’s life, 59 percent feel they are on duty 24 hours a day.

This goes on for an average of 4 to 8 years post-diagnosis. It is no wonder 72 percent of caregivers express relief after their loved ones die. For professional caregivers and health care providers, the stress is also intense and can lead to burnout.

Until recently, most mindfulness-based approach to dementia care referred to Mindfulness-Based Stress Reduction for dementia caregivers. Having observed numerous times the unique challenges as well as mindfulness practice opportunities in dementia care, I realized the need for a mindfulness-based program specially tailored to dementia caregiving. Hence began the Presence Care Project, a non-profit initiative aimed at promoting a new form of dementia care training. In the Presence Care approach,  mindfulness, informed by experiential understanding of the person with dementia, becomes the foundation upon which a caregiver can rest, moment-to-moment, day after day, during the long journey of dementia. UCSF OSHER Center for Integrative Medicine has now taken on this new approach and recently launched its new Mindfulness-Based Dementia Care (MBDC) program.

MBDC builds upon the now very well proven model of Mindfulness-Based Stress Reduction (MBSR),  and combines solo mindfulness practices, interactive mindful care practices, lectures, and group sharing. Throughout, aspects of mindfulness practice and dementia care are interwoven. The emphasis is on practice during and between classes. The end goal is for participants to experience a radical shift in attitude from mostly doing and reacting, to being skillfully present for themselves and the person in their care. MBDC is appropriate for the whole range of persons involved in dementia care: family and friend caregivers, professional caregivers, elder care professionals, nurses, doctors, and other health care providers.

MBDC rests on this central premise: mindfulness, that which helps dementia caregivers reduce their stress, is also what can help them provide the best care for the person with dementia.

The first series of 8-week classes has started and is taught by Marguerite and Dr. Kevin Barrows, physician and director of mindfulness programs at the Osher Center.

3 responses to “Pioneering Mindfulness-Based Dementia Care Program Launched at UC San Francisco

  1. I work in Holland as a spiritual caregiver in a homefor people who suffer from dementia. And I am a mindfulness trainer. Those two things I bring together in my work. Recently I spoke with the manager about training professional caregivers in mindfulness and what will be the result of that in their work. He opened the door a little bit, I have hope. Your writing is a stimulation for me to go on. I feld the strenght of mindful working in the setting of dementia, and now I am confirmed. Thank you.

  2. How fabulous to hear of the launching of the MBDC program!

    A dedicated mindfulness practitioner and scholar in Canada, I am involved in mindfulness development for professional caregivers in extended care facility settings. I also work as a coach to families who want to keep their family member with dementia at home.

    For me there is no doubt about the benefit mindfulness development can have for a caregiver. I see how caregiver burnout and stress in our Canadian healthcare system is a huge problem contributing to lack of quality care and the ever increasing costs of healthcare. I have observed time and time again, both in myself and others, how calmness and focused attention is far more likely to illicit a calm response from the person with dementia. I see a real need for the caregiver to be able to pay attention in the moment non-judgmentally to effectively support and stay healthy in working with those with dementia (all qualities that mindfulness practices develop).

    While I am not aware of any studies that are being conducted in this regard specifically (and I hope this will soon change), the neuroscience seems to suggest that in mindful presence with a person with dementia, caregivers actually could be contributing to the healing, or at least the slowing down of their brain damage and supporting new neuron connections (???) In fact, given there are no other imminent cures I am aware of, mindfulness-based caregiving could perhaps be the ONLY hope there is.

    What I did not expect when I began working in this field is how much working with individuals with dementia would be a gift in supporting my own mindfulness development. With verbal communication often not possible, a certain kind of presence to understand their needs is required. Everything I do with a person with dementia requires that I REALLY slow down – sometimes hours to companion through one meal! If I rush or try to impose my agenda, I will most likely be met with resistance. If I become attached to what that person might have been able to do yesterday, I create suffering for myself (and for them I believe as well). It can be painful for me to watch how a family member can become so attached with a person’s “identity” prior to their dementia that they simply cannot seem to see beyond and connect with the person in the here and now. Mindful eating, mindful breathing, mindful walking mindful speech are being cultivated moment by moment in the presence of someone with dementia…. if I allow myself to remain open to this.

    With the prediction that the diagnosis of dementia will increase to epidemic proportions, I see a gift for all of us to harness.

  3. Pingback: Mindfulness and Dementia | Mindfulness & Wellbeing

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