How to Reduce Stress and Burnout by Caregiving with Mindfulness

How to Reduce Stress and Burnout by Caregiving with Mindfulness

By Kara Seibel RN BSHP

Family caregiving has many challenges; emotional overload, time constraints, anxiety, missed work, conflicts with siblings and spouses not to mention burnout. Caregivers are so overwhelmed with day-to-day tasks; they may miss the opportunity for personal and spiritual growth that caregiving for a loved one may give.

Mindfulness is a way of paying attention and being present in the moment, it is possible to awaken ones being to the mysteries, challenges, and miracles of this existence. Buddhists have been using mindfulness for over 2500 years and it is well suited for these times of hectic lifestyles and uncertainty; it’s also the perfect antidote to the chronic stress-reaction cycle. The practice of mindfulness gives us the opportunity to sit quietly and breath, letting go of thoughts that arise without judgement while bringing our attention back to the breath. This practice can help us harness our natural insight, wisdom, and compassion, and therefore transform our life and benefit those around you.

Mindfulness is a practice because it is something we should do daily to reap the benefits of stress reduction and physical and emotional wellbeing. To begin your practice, start with as little as 5 minutes of sitting quietly and observing the breath (just as it is), working up to 30 minutes daily. Thoughts will arise, we are problem solvers, and our minds are always busy, studies show that people are less happy when their minds wander than when they don’t. Mindful awareness is attained through both “formal” and “informal” mindfulness practices.

 A formal practice is more structured, you set aside time (usually the same time and space daily) for practice. These practices could include a sitting meditation, breathing, body scan or visualization practices in which we practice moment to moment awareness without judgment leading to better understanding and clarity of mind as well as open heartedness.

Informal mindfulness practice incorporates mindfulness into day-to-day activities such as walking, dishwashing, housekeeping, eating, and talking to others. It is turning off the “autopilot mode of living” and training your attention to return to the present while you are doing an activity. Being “in the moment” teaches us to be more focused and attentive to whatever activity we are involved with. An Informal Mindfulness Practice allows us to practice our mindfulness throughout the day and allows our hearts to be open while being less reactive and judgmental.

Creating a new habit while already feeling like you have too much on you plate may seem like adding to the to do list but using the “tiny habit” approach created by BJ Fogg a Social Scientist from Stanford University “these are things we can do at least once a day for 30 seconds and we attach them to and anchor habit like brushing your teeth, washing your hands or getting a drink of water.” Also, the “STOP Practice” just taking a moment throughout the day finding the breath and following it into the body observing the situation and atmosphere around you no change is necessary, just awareness.

Mindful Based Stress Reduction (MBSR) training is an evidence-based program developed by Jon Kabat-Zinn at the University of Massachusetts Medical School. The MBSR program is a practical approach that trains attention, allowing people to cultivate awareness and to have more choices. MBSR training uses a combination of mindfulness meditation, body awareness, yoga and exploration of behaviors, thinking, feeling and action.www.mindful.org

Mindfulness can help you not just with daily stress reduction but also with providing the best care possible.  Mindfulness is helpful for caregivers because it helps bring our full attention to something, even though difficult or painful and we can see it clearly, know it and relate skillfully with it. Mindfulness based dementia care (MBDC) is well suited for dementia care because that is where the person living with dementia dwells, in the present moment. In her book “Caring for a Loved one with Dementia” A Mindfulness-Based Guide for Reducing Stress and Making the Best of Your Journey Together, Marguerite Manteau-Rao combines mindfulness-based stress reduction with dementia care. www.presencecareproject.com

These are the ways in which a mindfulness practice equips you for positive care interactions with the person living with dementia:

• Calm and centered presence – calmness is one of the greatest gifts a caregiver can give to the receiver of care.
• Not being limited by expectations or wishes – Mindfulness keeps us present and, in the moment, it opens us up to what each moment may bring. We are more powerful when we are in the moment.
• “Being” vs Busy – many challenges arise when we rush to perform tasks with a person living with dementia without first checking where the person is now in the moment.
• Responding not reacting – with difficult interactions, instead of reacting to a situation which can make matters worse. Mindfulness teaches us to take the time to pause before making the appropriate response, which may reduce tension and stress.
• Awareness of the person and the environment – when we are task driven, we may miss cues about the persons physical and mental state of being, as well as environmental stressors.
• Attunement – with our daily mindfulness practice we learn other ways of connecting and signaling with the persons state of being in that moment, which is critical when the person loses the ability to communicate.

A Mindfulness practice is centered around eight attitudes:

• Nonjudgement
• Patience
• Beginners Mind
• Trust
• Non striving
• Acceptance
• Effort
• Self-compassion

MBDC also teaches us that being with grief is an omnipresent part of the journey for both caregiver and the person living with dementia. We may also mourn the loss of a relationship that brought companionship as well as sense of self and identity. The daily grind of caregiving may also cause loss of friendships, income, privacy, space, and time.

The Types of grief

• Ambiguous loss and disenfranchised grief are what happens when the person living with dementia is physically present and at the same time psychologically absent, either cognitively or emotionally. The person with dementia may make perfect sense one moment and not the next, the effects on the caregiver can be unsettling, emotions are fluctuating between hope and hopelessness and over a prolonged period it can deaden feelings and make it impossible to move on. What also makes ambiguous loss so difficult is the lack of validation from the outside world. Just having one friend or family member to share feeling and emotions with is important, according to Pauline Boss, in her book Ambiguous loss: Learning to live with unresolved grief.
• Anticipatory Grief describes the set of complex feelings experienced while anticipating the inevitable losses ahead. What will my life be without this person? You may mourn the loss of memory, awareness, personality before each loss happens. Mindfulness can help bring you back to the present moment, what is happening now.

Awareness of the losses you have experienced because of your loved one’s dementia is an important process. Grief Milestone are significant turning points in your dementia journey with your loved one like getting lost for the first time. Making a list of your losses acknowledging them while being gentle and loving with yourself then using your mindfulness practice to recognize, become aware and accept how this new loss is affecting you. People grieve differently intuitively and instrumentally or the combination of the two.

Intuitive grief is more emotional, and the feelings of grief are intensely related to loss. Feelings of anger, depression and guilt may be present but with a mindfulness practice we can avoid identifying with these powerful emotions, by using the breath to make room for them and let them pass.

Instrumental grief is experienced physically and intellectually. The process of becoming hyperactive and immersing oneself in tasks and projects related to caregiving, not excepting help, and helping the person living with dementia more than they need. This type of grieving leads to burnout but by practicing mindfulness you become aware of your state and the way your actions and attitudes are negatively affecting your health and your loved one’s well-being.

The grief process affects families differently. Family members with strong family ties may support each other while families with strained family bonds, dementia may contribute to conflicts. Keep in mind that the person living with dementia is dealing with their own grief process. This process is most apparent when the person is conscious of the decent into dementia and during lucid moments. If we make a list of the person living with dementias losses it is truly staggering and it will help us empathize with their grief. We will be a more loving care partner. When we are at ease with our own grief, we can be there for the person living with dementia’s grief to decrease the need to act out and decrease the distress of disenfranchised grief.

“Sitting with” practice is a simple yet powerful practice that allow you to accomplish many things at once. Starting with the “power to choose” you ask the other person may I sit with you? While waiting for a response you put the control in their hands. While “sitting with” you sit, breath and observe, you create a spatial and emotional connection between yourself and the person you are caring for. And this creates a Care partnership.

A care partnership is a mutual and more balanced way of being with our loved ones. This type of partnership allows the person living with dementia to take an active role in their care to the best of their abilities. This causes less stress and a better relationship with your loved one.