Mindfulness-based cognitive therapy for depression in people with dementia: A qualitative study on participant, carer and facilitator experiences

People with dementia and depression, their carers, and course facilitators reported that mindfulness-based cognitive therapy had several beneficial effects, including a sense of shared suffering, greater present-moment awareness, positive emotional changes such as increased self-compassion, and reduced anxiety for carers. Specific aspects like facilitator characteristics and certain mindfulness practices were especially useful, while carer involvement, cognitive difficulties, and barriers to home practice affected engagement. Facilitators noted adaptations they made and suggested further modifications. The findings suggest mindfulness-based cognitive therapy is potentially useful for depression in dementia but requires additional adaptation.

Study at a glance

Abstract

Background Depression in dementia is common and associated with negative health outcomes. Mindfulness-based cognitive therapy is a recommended treatment of choice for recurrent depression, but its use for depression in dementia is yet to be assessed. Objective This study aimed to investigate the experiences of people with depression and dementia who participated in the mindfulness-based cognitive therapy intervention and those of their carers and facilitators. Methods This qualitative study was nested within a randomised controlled feasibility study. Semi-structured interviews were conducted with 18 people (eight people with dementia and depression, six carers and four course facilitators). Thematic analysis was used to analyse the data. Findings Several beneficial effects of mindfulness-based cognitive therapy were described. These were a sense of shared suffering among the group, greater present moment focus and awareness, various positive emotional changes, including greater self-compassion, and benefits for carers, such as the reduction of anxiety. Specific aspects of the programme were identified as particularly useful, including facilitator characteristics and certain mindfulness practices. Carer involvement, cognitive difficulties and barriers to home practice influenced engagement with the course. Facilitators described adaptations made to mindfulness-based cognitive therapy and suggested additional modifications for future groups. Conclusion Results of this process evaluation suggest that mindfulness-based cognitive therapy is a potentially useful intervention for people with depression in dementia, but that further adaptation of the intervention is required to make the programme suitable for this clinical population.