Prayer Helps Enhance Quality of Life in Dementia

Praying significantly improves quality of life in nursing home residents with dementia and agitation, findings from a controlled study of 28 nursing home residents suggest.

Residents assigned to the intervention group participated with the researcher in a prayer exercise that included about 5 minutes of prayer on 5 out of 7 days for 4 consecutive weeks; the control group did not participate in the program. For the intervention, residents picked a prayer or the researcher provided one of two nondenominational prayers.

Both quantitative and qualitative analyses indicated that the residents in the prayer group had more improvement in quality of life, said Lena G. Smith, Ph.D., of the University of New Mexico, Albuquerque. She completed the study as part of a dissertation and has presented the findings at conferences including the Alzheimer's Association Dementia Care Conference in Garden Grove, Calif.

Quantitative measures included the Quality of Life in Late-Stage Dementia (QUALID) scale and the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH). Using multivariate analysis of covariance, Dr. Smith found a significant difference between the two groups (P = .003), and subsequent univariate analysis showed it was the QUALID scale that contributed to the significance seen on multivariate analysis (P = .002). “This indicates that the difference between the two groups was in quality of life,” Dr. Smith said in an interview.

She applied qualitative analysis to data derived from information logged during the study period, such as verbal comments, gestures, and facial expressions observed during prayer time. Four major themes of behavior and responses emerged as attributable to the impact of the prayer exercise emerged. Supporting the quantitative findings, the themes were gratitude, reverence, satisfaction, and familiarity.

For example, more than 70% of residents in the intervention group expressed direct verbal gratitude, and many showed reverence by bowing their heads, crossing themselves, or placing their hands in a prayer position.

The nursing home residents who participated in the study had moderate to late-stage dementia (Mini-Mental State Exam scores averaged 8 out of 30).

Dementia affects at least 15% of people over age 65 years, and behavior disturbances can occur in up to 80% of nursing home patients with Alzheimer's disease. The findings are important because they provide an intervention for agitation and quality of life other than medication, Dr. Smith said.

Furthermore, surveys show that prayer is important for many Americans, with 75% reporting that they pray for wellness and up to 96% expressing a belief in God. In addition, most Americans say they believe in the healing power of prayer, and at least one study reported religion as “very important” to 75% of people aged 75 years and older, Dr. Smith noted.

Positive Change IsSeen in Behaviors

Gratitude, reverence, satisfaction, and familiarity were four themes that emerged from qualitative analysis in Dr. Smith's study.

Gratitude was expressed verbally by a number of residents in the intervention group. Examples of some of their responses included, “Thank you for that,” “That was so pretty,” “God bless you, darling,” and “That was sweet.”

Nonverbal expressions of gratitude included hugs, hand squeezes, smiles, and tears.

Reverence was shown by participants in the intervention group by closed eyes, bowed heads, head nodding during the prayer, and by holding of hands in a traditional prayer position.

Overall, 63% of participants had a positive change in behaviors and demeanor during prayer, she noted. Familiarity was demonstrated by increased conversation and recognition. Residents often would say, “See you tomorrow” or “I'm glad you came back.”