While some stress is normal and natural for us, and provides for a level of motivation and involvement in our lives, too much can be cause for serious problems. These may include feelings of being overwhelmed and anxious, chronic insomnia, an inability to relate effectively with others, and a host of physical ailments and disorders, ranging from stomach upset to heart disease. The many demands on us – those expectations we place on ourselves, as well as external pressures and deadlines – can make finding a healthy balance in life seem elusive.
The stress of caring for someone with a progressive life limiting illness adds another challenge to everyday life. Those of us who work in palliative hospice care are acutely aware of the necessity of finding balance in our personal and professional lives. Being as present as we can be with our clients is essential so that we may be able to meet their needs as well as those of the family and other members of the team.
Mindfulness based stress reduction (MBSR) has emerged in the past two decades as a systematic method of training, usually in a group setting, in meditation techniques designed to teach participants ways to be more conscious and aware of their reactions to stressful life events. This intervention has been used among patients with a wide variety of chronic ailments, as well as among groups of relatively healthy individuals who have attempted to improve their abilities to cope with the normal stresses of everyday life. Research has indicated substantial benefits for individuals suffering from chronic pain, fibromyalgia, cancer, anxiety disorders, depression and the stresses of medical school and prison life. More recent research has suggested that a short term program in mindfulness meditation produces demonstrable effects on brain and immune function.
Mindfulness has been defined as a state in which one is highly aware and focused on the reality of the present moment, accepting and acknowledging thoughts and feelings. Unlike other meditation techniques, mindfulness is not a way of distracting oneself away from an unpleasant situation or “blissing out.” Rather, this approach teaches participants to stay in the present moment, training the mind to come back from thoughts of the future or past, thus approaching stressful situations in an enhanced state of awareness, responding to a situation instead of automatically reacting to it. Based on a centuries old Buddhist tradition, mindfulness has been brought to North America largely by Dr. Jon Kabat-Zinn, author of several books including “Full Catastrophe Living” and “Wherever You Go, There You Are.”
The traditional approach consists of an eight week group meeting, once a week that involves participants learning about and practicing various ways of being “present” or in the moment. Homework assignments are given as well as a full day meditation “retreat” at the end of the eight week period. Emphasis is placed on practice while engaged in the daily activities of living, such as eating, walking, listening or working. In this way, meditation becomes a way of life, as opposed to something to do once a day for twenty minutes in a cross legged position. Practicing mindful awareness with difficult or challenging emotions such as anger and grief can prove to be a way to heal from past and present traumas. A few moments a day spent in mindful awareness of your breath or the sensations when picking up a cup of hot coffee, can bring us back home to the present moment, and ultimately, to ourselves.
Recently, a drop in mindfulness group has begun at Hospice Niagara for staff who wish to practice moving more deeply into the present moment. For those who work in the residence, daily routines are unpredictable and it is not always possible to participate in a lengthy group. To this end, staff are invited to attend each week if their schedule permits. A small group practices in a quiet room together, with some instruction about using the natural rhythm of the breath as a way to anchor to the present moment. We meet for approximately fifteen minutes and may discuss a book of interest or a hand out about meditation.
The practice of mindfulness in a hospice setting provides a framework for professional caregivers to manage the stress of their daily roles. It is a “time out” to connect with the essential or inner self, to connect with colleagues in an intentional way, thus fostering team resiliency. Most importantly, it allows us to make deeper connections with those we care for at end of life.
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