Meditation and Healthy Aging

1. Meditation and Healthy Aging Elaine J. Yuen, PhD Thomas Jefferson University American Public Health Association November 8, 2004

2. Background • Meditation is one of the oldest and most widely practiced mind body therapies • Meditation practices support • An understanding of subjective experiences • An improved quality of life • An understanding of psychosocial factors that play a central role in health and healing • Research has examined relationships between meditation and clinical treatment for conditions such as cancer, depression and anxiety, and heart disease

3. Issues for Elders • Life stresses • decreasing physical and mental abilities • increased dependence within their living situations • changing family dynamics • Underlying view of meditation gives caregivers and elders perspectives that address impermanence, death and dying • Old age is a naturally contemplative time of life • Slowing down and attending to details that characterize old age are analogous to the practice of meditation • A contemplative view may be incorporated into hospice and palliative care where elders and caregivers face loss and change

4. Benefits of Meditation • “Relaxation response” different from that induced by physical exercise • Psychological balance that allows the experience of emotions while maintaining perspective on them • Integration of physical being, emotional impulses, and conscious thoughts • Can be practiced concurrently with existent religious beliefs

5. Practice of Meditation • “The practice of mindfulness is inherent in all human beings. In meditation we are continuously discovering who and what we are. We begin to discover our basic mind and heart. Often we think about meditation as some kind of unusual, holy spiritual activity. As we practice, that is one of the basic beliefs we try to overcome. The point is that meditation is completely normal; it is the mindful quality present in everything we do.” • Sakyong Mipham Rinpoche • Meditation practices • Breathing or a mantra as focal point • Nonjudgmental awareness to see repetitive patterns of behavior • Allowing thoughts and feelings to occur without invoking patterns of response so that insight is gained into involuntary habitual reactions

6. Mindfulness • Placing attention on the breath to stabilize the mind and rest awareness in the present moment • Cultivates a nonjudgmental state of openness and relaxation that can be maintained throughout daily activity • Transcendental Meditation (TM) • Sitting with eyes closed for 20 minutes and attending to a syllable or word (mantra) • Whenever thoughts or distractions arise, attention is directed back to the mantra • Herbert Benson used TM with other therapies to reduce heart rate, blood pressure, metabolic speed, and alleviate stress

7. Meditation in Medical Settings • Evidence that the mind has a meaningful role in health maintenance and disease recovery has fueled interest in meditation as a treatment in medical settings: • As a primary therapy to treat specific diseases • As an injunctive therapy in comprehensive treatment plans • As a way to improve quality of life for those with chronic illnesses • Meditation teaches patients how to cope with stresses of illness and treatment, as well as gives an increased sense of control and spiritual experience

8. Studies of Physiological Effects • Pain and Fibromyalgia • Reductions in present-moment pain, negative body image, inhibition of activity by pain, symptoms, mood disturbance, and psychological symptoms • Hypertension and Cardiovascular Disease • “Relaxation response” • Decrease in exercise-induced cardiac ischemia • Regression of coronary artery stenoses • Cancer • Addresses psychological disturbances and stress experienced during treatment

9. Psychology of Meditation • Dealing with a stressful medical condition may be subsumed into the larger goal of coping with the stresses of life • Meditation practices support coping with distress and disability in daily life, as well as addressing depression, anxiety and affective disorders • Meditation decreases stress through • Reducing overall psychological symptomatology • Increasing a sense of control in one’s life • Increasing one’s spiritual experiences

10. Loss and Change • Meditation practices may help to give perspective to life as elders’ physical and mental abilities operate at a slower pace • Elders often feel marginalized by the rapid pace of our society, and struggle to “keep up” producing chronic stressors • There may be fear and hesitation to directly face inevitability of impermanence, loss, and disorientation • Grieving process, dissolution of familiar patterns must be acknowledged

11. Resolving Hopes and Fears • Deeper goals of meditation include developing a sense of harmony within the universe and increased compassion • These values may be increasingly important to elders as they work to understand physical declines, impending death, and the loss of friends • Through the non-judgmental acknowledgement of thoughts, hopes and fears, meditation practice provides a context where anxieties about physical and mental functioning may be faced, felt, and understood

12. Memory and Mindfulness • Elders and their caregivers often face concerns of memory loss and inability to concentrate • Mindfulness practices aim to bring enhanced awareness to ordinary day-to-day events • For example, support development of mental strategies to address misplacing glasses • Langer (1989) • Through mindfulness exercises, a group of nursing home residents were able to improve memory and attention • Elders engaged in mindful learning were more active, alert, and happy

13. Working with Sterotypes about Aging • Even for those not acutely ill, there is often an unarticulated awareness of diminishing abilities • As ordinary as not being able to drive • Dependence on others for help in activities of daily living • Meditation practices may help elders free themselves from stereotypes our culture holds about the aged of being frail, infirm, and chronically ill • Elders often require support to be able to grieve these smaller functional losses, as well as to work through larger issues of sickness and death

14. Spiritual and Emotional Support for Elders“The challenge of old age is to allow the dissolution of form, to open to that. Elders cannot do it alone, our culture is so unsupportive, people go to pieces in despair” • Elders often struggle to articulate meaning and value as physical and mental abilities change • Meditation provides an environment which allows elders • To experience their physical and mental impermanence • To develop a larger view of their lives beyond the fear of loss of control or dying

15. Issues for Caregivers • Caregivers focused on addressing elders’ problems often neglect self-care issues • Meditation practices may address • Burnout and compassion fatigue • Working with death and dying • Establishing mindful home care or palliative care environments

16. Conclusions • Utility of meditation practice has been generally well established • Most current research in effects of meditation have not focused on elderly age groups • Anecdotal evidence shows that meditation practices are able to give elders insight into their losses and grieving by allowing conflicting emotions to surface • More formal research investigating the outcomes and mechanisms of how meditation works with elders and caregivers is needed

17. Buddha’s Teaching at the Time of His Death O bhikshus! Do not grieve! Even if I were to live in the world for as long as a kalpa, our coming together would have to end. You should know that all things in the world are impermanent; coming together inevitably means parting. Do not be troubled, for this is the nature of life. Diligently practicing right effort, you must seek liberation immediately. Within the light of wisdom, destroy the darkness of ignorance. Nothing is secure. Everything in this life is precarious. Always wholeheartedly seek the way of liberation. All things in the world, whether moving or non-moving, are characterized by disappearance and instability. Stop now! Do not speak! Time is passing. I am about to cross over. This is my final teaching.

18. Polonnaruwa, Sri Lanka

19. Shambhala Buddhist Meditation Center, Baltimore, Maryland