The Interplay Among Mindfulness, Caregiver Burden, and Mental Health in Family Members of Individuals With Dementia

Caring for a person with dementia often results in high levels of perceived burden, poorer overall mental health, and a reduced quality of life (QoL). Using a sample of 106 dementia caregivers, we examined associations among caregiver objective and subjective burden (from the Burden Assessment Scale), mindfulness (from The Five Facet Mindfulness Questionnaire) and a mental health latent variable (with the Beck Depression Inventory, the Beck Anxiety Inventory, the Depression and Anxiety Stress Scale, and the Quality of Life Inventory as indicators). As expected, we found that lower levels of burden and greater mindfulness were associated with better mental health. Also in line with study hypotheses and with the stress-appraisal-coping model developed by Lazarus and Folkman (1984), we found that subjective burden partially mediates the relationship between objective burden and mental health outcomes. Specifically, subjective appraisals of caregiving appeared to indirectly affect the association between the concrete costs of caregiving and psychological outcomes in dementia caregivers. This finding suggests the potential for negative psychological outcomes to be improved by addressing caregivers' appraisals of the caregiving experience. Finally, we hypothesized that mindfulness would moderate the association between burden (objective and subjective) and mental health outcomes such that in people who are more mindful, burden has less of an impact on mental health. This hypothesis was not supported. Thus, while greater mindfulness does appear to be associated with better mental health, being more mindful does not appear to dampen the effect of burden on mental health. Research and clinical implications are discussed.