Mindfulness Training for Older Adults: Adding Life not Just Years
Before there was cryonics, there were Egyptian mummification. Before there was mindfulness, there was unconscious living. Before the significant advances in medicine in the 21st century, the average life expectancy in the world was 48 years. Today the average life expectancy in the United States is 78.6 years according to the Centers for Disease Control and Prevention. While this is great news, the National Council on Aging highlights a possible downside. An aging population associated with physical and cognitive decline can mean a population of increased pain and suffering. However, mindfulness training for older adults can add life not just years to their living and thus help to ameliorate the physical and psychological distress that can follow aging.
Mindfulness-Based Stress Reduction (MBSR) was designed by Jon Kabat-Zinn, a scientist. He was the key figure involved in bringing mindfulness into the mainstream of medicine and society. Kabat-Zinn defined mindfulness as paying attention to our lives, moment by moment, on purpose, in a certain way, and without judgment.
In general, mindfulness training can help in calming the individual and reducing stress and anxiety in the body. If practiced regularly it can increase your ability to respond to challenges and changes rather than react. It also has the potential to increase resiliency and bring about physical, emotional and mental changes.
Key studies in mindfulness training for older adults are:
- Improvements in immune system and brain post MBSR group by Davidson et al., 2003.
- Increase in brain’s “grey matter” following 8-week MBSR class by Holzel et al, 2011.
- Decrease in cellular aging and disease protection: Increase in telomeres by Epel et al., 2009.
But how can mindfulness and meditation help older adults live with less pain and psychological distress?
Mindfulness training helps to reduce pain
Mindfulness training involves paying attention to your emotions and feelings without judging them as bad or good. From the perspective of pain, you accept the pain. This behavior contradicts how you normally react to pain. When pain arises, “the mind becomes preoccupied with how to get relief, how to move away from it, as from other unpleasant events,” explains W. Jack Rejeski, PhD, in the article “Mindfulness: Reconnecting the Body and Mind in Geriatric Medicine and Gerontology”. But a study suggests that an acceptance rather than avoidance of pain results in lower physical and psychological disability and reduces pain intensity.
Mindfulness training and the role of acceptance
Acceptance, therefore, plays a role in reducing suffering. Acceptance in this context is not the same as resignation. It is accepting the emotions as is—nothing more, nothing less. The acceptance contains no judgment. It is in accepting that less resistance, which induces suffering in the body, occurs. The body is able to relax and let go.
Mindfulness involves the practice of acceptance for the sake of letting go the tension. According to Meditations in Plain English, you “accept everything that arises: Accept your feelings, even the ones you wish you did not have. Accept your experiences, even the ones you hate.”
Mindfulness training as a way of life
A common complaint in geriatric medicine and gerontology is negative emotions and physical symptoms. Because mindfulness training can also be a way of life, older adults can also gain wisdom from their bodies. In a review for mindful-based interventions for older adults, it noted that as “older adults begin to tune in to the sensations of movement, they can be encouraged to notice how negative thoughts, emotions, and physical symptoms express themselves in the body. Identifying the physical reality of an experience, such as anxiety, and feeling the body resist pain are first steps in being able to let go or to relax the body and, concurrently, to let go and to relax the mind.”
Mindfulness can be integrated in the physical activities of daily living. My 85-year-old mother suffers from back pain. One day, I went with her to one of her doctor’s visit. The doctor, who was a pain management specialist and knew my mother well, told her to relax her face when she saw her. My mother not realizing her face was distorted quickly relaxed her face and smiled. The doctor then remarked, doesn’t that feel better. Though my mother’s pain was still there, it was reduced as she smiled.
In the Art and Science of Mindfulness, authors Shapiro et al share a 2008 research study by Morone, Greco and Weiner involving 37 participants with an average age of 75. The participants were either placed in a mindfulness intervention program or a waiting list. The participants who took part in the mindfulness program showed significantly greater improvements on measures of chronic pain acceptance, engagement in activities, and overall physical functioning.”
Mindfulness training brings more appreciation of life
Because mindfulness is a focus on the present; the tendency to cling to the past or go into the future is reduced. Appreciation of life is augmented and becomes conducive for older adults who are prone to take a closer look at the meaning of life.
Mindfulness meditation is not simply an event, for example, taking ten minutes to quietly sit. It is a way of being. Mindfulness in plain English puts it in this way:
You learn new ways to receive and understand sensation. You develop new methods of dealing with conscious thought, and new modes of attending to the incessant rush of your own emotions. These new mental behaviors must be made to carry over into the rest of your life. Otherwise, meditation remains dry and fruitless, a theoretical segment of your existence that is unconnected to all the rest.
One way to look at mindfulness meditation is to think of it as a rehearsal for the actual performance of life. But, of course, life is not a performance. It is to be—present—to be in the moment capturing every emotion. For to live FULLY is to experience every human emotion.
Example of walking meditation from Mindfulness in Plain English:
To do the walking meditation, you need a private place with enough space for at least five to ten paces in a straight line. You are going to be walking back and forth very slowly, and to the eyes of most Westerners, you’ll look curious and disconnected from everyday life. This is not the sort of exercise you want to perform on the front lawn where you’ll attract unnecessary attention. Choose a private place.
The physical directions are simple. Select an unobstructed area and start at one end. Stand for a minute in an attentive position. Your arms can be held in any way that is comfortable, in front, in back, or at your sides. Then while breathing in, lift the heel of one foot. While breathing out, rest that foot on its toes. Again while breathing in, lift that foot, carry it forward and while breathing out, bring the foot down and touch the floor. Repeat this for the other foot. Walk very slowly to the opposite end, stand for one minute, then turn around very slowly, and stand there for another minute before you walk back. Then repeat the process. Keep your head up and you neck relaxed. Keep your eyes open to maintain balance, but don’t look at anything in particular. Walk naturally. Maintain the slowest pace that is comfortable, and pay no attention to your surroundings. Watch out for tensions building up in the body, and release them as soon as you spot them. Don’t make any particular attempt to be graceful. Don’t try to look pretty. This is not an athletic exercise, or a dance. It is an exercise in awareness. Your objective is to attain total alertness, heightened sensitivity and a full, unblocked experience of the motion of walking. Put all of your attention on the sensations coming from the feet and legs. Try to register as much information as possible about each foot as it moves. Dive into the pure sensation of walking, and notice every subtle nuance of the movement. Feel each individual muscle as it moves. Experience every tiny change in tactile sensation as the feet press against the floor and then lift again.
Example of seated meditation
In seated meditation, our primary focus is the breath. Total concentration on the ever-changing breath brings us squarely into the present moment.
Older adults have unique needs as they progress through life. They are more prone to pain and psychological distress. However, learning to be mindful can give renewed purpose and vigor to life. Paying attention and staying present can help older adults live with less pain and find more fulfillment in life; for, in the words of President Abraham Lincoln, “[I]n the end it’s not the years in your life that count; it’s the life in your years.”