By Lucia McBee
Tom (not his real name) felt vacant when, at 65, his planned-for retirement and leisure was followed by a divorce and the loss of his traditional roles as father, husband and employee. A friend suggested an eight-week class called Mindfulness-Based Stress Reduction (MBSR) might help him cope with stress, anxiety and depression. Mindfulness includes the formal practices of meditation and yoga, and informally integrates awareness and self-compassion in all aspects of one’s daily life. The class not only taught Tom practical ways to cope, but also reconnected him with his youthful dreams of living a meaningful life.
While Tom was healthy and financially stable, many older adults are living with chronic illness or caring for someone who is. As we age, this likelihood in-creases. Mindfulness-based interventions (MBI) offer a mind-body approach toward health and healing that teaches coping skills for conditions disproportionately affecting older adults such as chronic illness, loss and pain. Mindfulness offers a shift from conventional medicine, from curing, to living with what cannot be changed.
Jane (not her real name) was a 70-year-old woman with arthritis who cared for both her institutionalized mother and her husband who had Parkinson’s disease. She found that a mindfulness course for caregivers taught her ways to take care of herself, and allowed her to worry less and enjoy the time left with her mother and husband. In a meta-analysis by Hurley, Patterson and Cooley, published in Aging & Mental Health (18:3, 2014), MBIs for family caregivers of those with dementia showed potential for improving caregiver mental health.
Studied Benefits of Mindfulness on Aging
Baby boomers may remember the seminal 1971 book on meditation, yoga and spirituality, Be Here Now (San Christobal, N.M.: The Lama Foundation), by Ram Dass (aka Dr. Richard Alpert), who dropped out, turned on and tuned in on LSD with fellow Harvard professor Timothy Leary. Ram Dass found he could experience similar bliss through the practices of meditation when he turned to the East for spiritual awakening. Baby boomers are now discovering that these same meditation and yoga practices provide benefits for their aging bodies and minds.
Meditation and yoga have been continuously practiced in the East for more than 2,500 years, providing a robust historical evidence of efficacy. Currently, the most widely used and researched program is MBSR. Created in 1979 by Jon Kabat-Zinn, MBSR is an intensive eight-week training that enables participants to connect with and cultivate their inner capacity to grow, heal, find balance and gain insight using daily assignments of secular, often deeply transformative, practices of “non-doing.” In Coming to Our Senses (New York: Hyperion, 2005), Kabat-Zinn describes mindfulness as “moment-to-moment, non-judgmental awareness cultivated by paying attention in a specific way, that is, in the present moment, as non-reactively, and as open-heartedly as possible.”
Western scientists now can observe and measure the benefits of MBIs. Following MBSR classes in 2003, Davidson and colleagues found in a study published in Psychosomatic Medicine (65:4, 2003) that participants had stronger immune responses compared to non-participants; and in 2011, Holtzel and colleagues observed in an article published in Psychiatry Research Neuroimaging (191:1, 2011) an increase in the gray matter in the brains of MBSR class participants. Epel and colleagues have even suggested in a story in the Annals of the New York Academy of Science (1172, 2009) that meditation might slow cellular aging. In 2013 alone, 549 scientific studies were published on the benefits of MBIs.
Basic Breathing Exercise
The following three-minute breathing exercise is from Mindfulness-Based Cognitive Therapy by Segal, Williams and Teasdale (New York: Guilford Press, 2002):
First minute: Awareness. Observe—bring the focus of awareness to your inner experience and notice what is happening in your thoughts, feelings and bodily sensations. Describe, acknowledge, identify—put experiences into words.
Second minute: Redirecting attention. Gently redirect your full attention to your breath. Follow your breath all the way in and all the way out.
Third minute: Expanding attention. Allow your attention to expand to the whole body—especially to any sense of discomfort, tension or resistance.
As best you can, bring this expanded awareness to the next moments of your day.
Mindfulness and Meditation for Elders
Studies on MBIs also have targeted elders. A 2014 meta-analysis by Marciniak and colleagues, published in Frontiers in Behavioral Neuroscience (8:17, 2014), found meditation led to improvements in attention and memory in older adults. MBIs also have shown positive benefits for older adults with anxiety and depression, according to Young and Baime in the Journal of Evidence-Based Complementary & Alternative Medicine (15:2, 2010), and in dealing with pain, according to Marone et al. in Pain (134:3, 2008).
Many cognitively intact and physically fit elders can participate in meditation, yoga and other mindfulness exercises. And MBIs can be adapted for frail elders to include shorter meditations; elimination of homework and all-day retreats; offerings such as chair yoga; and providing extra support via caregivers. For several years I ran groups in a nursing home for caregivers and elders with physical frailty, cognitive impairment and dementia. With adaptations for a frail population and the institutional environment, the groups and individual consultations offered a chance for residents and caregivers to find quiet, reconnect with their spiritual resources and each other, as well as to learn skills for coping with the challenges of loss, illness and pain. Or, as one 92-year-old participant said: “[The group] makes me feel at peace with the world. It helps my whole body and spirit. I forgot all my troubles.”
The extent of adaptations is clinically determined—MBIs are meant to be challenging, but with reasonable expectations for individual populations. The essential message of mindfulness for frail elders is that they learn ways to participate in their healing and focus on their abilities, not disabilities. The most important intervention may be reducing the stress of the family and professional caregivers who interact with them.
Despite the powerful historical and scientific evidence supporting the benefits of mindfulness and meditation, the final evidence is personal. Try the exercise described in the sidebar to the right throughout the day. Notice what you feel immediately following this practice, and after practicing for several days. There is no right or wrong answer—become the scientist of your own life! And be here now.
Lucia McBee, L.C.S.W., M.P.H., C.Y.I., is a geriatric social worker and certified yoga teacher who integrated mindfulness and complementary therapies with elders and their caregivers for more than 27 years. She is adjunct faculty at the Columbia School of Social Work, and a freelance speaker and consultant in New York City. She is the author of Mindfulness-Based Elder Care (New York: Springer Publishing Company, 2008).
Editor’s Note: This article appears in the July/August 2014 issue of Aging Today, ASA’s bi-monthly newspaper covering issues in aging research, practice and policy. ASA members receive Aging Today as a member benefit; non-members may purchase subscriptions at our online store or Join ASA.