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Literature Review

Dhanakrit Mann

Nightingale College

BSN 485-05

Dr. Tara Race

February 9, 2025

Literature Review

Introduction

Long-term care (LTC) residents often undergo significant psychological distress, including anxiety and cognitive decline. Nowadays across America, many residents of long-term settings are usually diagnosed with mental illnesses in addition to their chronic diagnosis. Typically, healthcare staffs look to pharmacological treatments, which has now been commonly used to treat these residents; however, these present other challenges such as side effects of said drugs and diminishing efficacy over time. Mindfulness-Based Interventions (MBIs) have gained attraction as an alternative approach that encourages emotional regulation and cognitive resilience. Research by Hofmann and Gómez (2017) suggests that MBIs improve mental health outcomes by reducing anxiety and enhancing cognitive function reducing overall incidents of agitation. The aim of this literature review is to examine the effectiveness of MBIs in LTC residents with mental diagnosis, describe methods used to search for relevant studies, analyze key findings, and highlight the gaps in knowledge that require further investigation.

Methods of Searching

To find pertinent studies on MBIs for LTC residents, the study team employed a combination of personal interviews and online databases. The primary databases used for research included Google Scholar, PubMed, PsycINFO, and CINAHL, ensuring a comprehensive search of peer-reviewed articles published between 2019 and 2024 To obtain pertinent results, keywords like "mindfulness-based interventions," "long-term care residents," "anxiety," and "cognitive function" were utilized. Strict criteria were applied while selecting articles for this review, and studies with small sample sizes or those unrelated to the target groups were disqualified. This process ensures that only pertinent information was used to support the research.

Review of the Literature

Research shows clearly that MBIs effectively reduce anxiety and episodes of agitation among residents in LTC. A study by Sulosaari et al. (2022) found that guided mindfulness sessions led to significant reductions in generalized anxiety and agitation, improving residents' overall mental well-being. Similarly, Hsiung et al. (2023) conducted a randomized controlled trial which also showed improved emotional regulation and decreased symptoms of depression and anxiety in elderly residents in LTC homes which practiced mindfulness-based interventions.

The mental benefits that MBIs have on these residents have also been thoroughly studied. Hofmann and Gómez (2019) reported that mindfulness practices promote brain plasticity; involves adaptive structural and functional changes to the brain which enhanced memory and attention in geriatric patients with mental illnesses. Hsiung et al. (2023) further supported this finding, indicating that mindfulness exercises stimulate brain regions responsible for cognitive processing, thereby preventing cognitive decline among LTC residents.

To utilize MBIs for residents with mental illnesses, researchers have recommended slightly adjusting the already established traditional practices to accommodate physical and cognitive limitations. Terry et al. (2021) suggested reducing the number of sessions, simplifying mindfulness exercises, and incorporating individualized coaching. These adjustments make MBIs more accessible to geriatric patients with chronic illnesses.

Social integration is another key benefit of MBIs in LTC settings. Pérez et al. (2022) found that mindfulness programs improved interpersonal relationships, empathy, and overall community engagement. These findings emphasize the role of MBIs in encouraging togetherness and reduced feelings of isolation among these residents.

Despite all the thoroughly researched benefits, challenges still do exist in the implementation of these MBIs. MBI’s are not a magical solution and require proper implementation. Some challenges include variability in intervention delivery and noncompliance among residents. Terry et al. (2021) and Hsiung et al. (2023) highlighted the need for standardized protocols to ensure consistency and effectiveness across LTC facilities.

Findings

The research shows the effectiveness of MBIs in reducing anxiety, agitation and enhances mental function among geriatric residents. Studies also indicate that mindfulness practices help decrease stress levels, improve emotional regulation, and helps brain plasticity (Hofmann & Gómez, 2017; Hsiung et al., 2023). Additionally, MBIs promote social interaction with peers and enhance the overall quality of life in LTC settings (Pérez et al., 2022).

However, gaps remain in understanding the long-term effects of MBIs, particularly for residents with severe cognitive impairments such as advanced dementia. Future research should most definitely be explored in figuring out whether MBIs can be adapted to benefit geriatric patients with severe chronic illnesses and also examine the sustainability of mindfulness practices over extended periods (Lu et al., 2023).

Conclusion

Mindfulness-Based Interventions provide great hope and paints a a promising picture of a non-pharmacological approach to reducing episodes of agitation, anxiety and enhancing cognitive function in these residents. Current research supports the effectiveness of MBIs in improving mental well-being, fostering social integration, and enhancing cognitive resilience (Hofmann & Gómez, 2017; Hsiung et al., 2023). However, challenges such as standardizing intervention protocols and addressing severe cognitive impairments remain. Future studies should focus on developing structured MBI programs tailored for a diverse LTC populations to ensure broader accessibility and effectiveness (Lu et al., 2023). Addressing these gaps will enhance the standards of implementation of MBIs, ultimately improving the quality of life for LTC residents.

References

Sulosaari, V., Unal, E., & Cinar, F. I. (2022). The effectiveness of mindfulness-based interventions on the psychological well-being of nurses: A systematic review. Applied Nursing Research, 64, 151565. https://doi.org/10.1016/j.apnr.2022.151565

Terry, C., Penland, M., Garland, D., Wang, W., Burton, T., & Dark-Freudeman, A. (2021). Adapting mindfulness-based interventions for residents of long-term care facilities. Gerontology & Geriatric Medicine, 7, 1–10. https://doi.org/10.1177/23337214211057703

Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-based interventions for anxiety and depression. Psychiatric Clinics of North America, 40(4), 739–749. https://doi.org/10.1016/j.psc.2017.08.008

Pérez, V., Menéndez-Crispín, E. J., Sarabia-Cobo, C., de Lorena, P., Fernández-Rodríguez, A., & González-Vaca, J. (2022). Mindfulness-based intervention for the reduction of compassion fatigue and burnout in nurse caregivers of institutionalized older persons with dementia: A randomized controlled trial. International Journal of Environmental Research and Public Health, 19(18), 11441. https://doi.org/10.3390/ijerph191811441

Hsiung, Y., Chen, Y.-H., Lin, L.-C., & Wang, Y.-H. (2023). Effects of mindfulness-based elder care (MBEC) on symptoms of depression, anxiety, and spiritual well-being of institutionalized seniors with disabilities: A randomized controlled trial. BMC Geriatrics, 23, 497. https://doi.org/10.1186/s12877-023-04220-6

Lu, C. P., Dijk, S. W., Pandit, A., Kranenburg, L., Luik, A. I., & Hunink, M. G. M. (2023). The effect of mindfulness-based interventions on reducing stress in future health professionals: A systematic review and meta-analysis of randomized controlled trials. Applied Psychology: Health and Well-Being, 16(2), 765–792.