Evaluating a Contemplative Care Approach for Nursing Homes

The LeadingAge LTSS Center @UMass Boston has been engaged by the New York Zen Center for Contemplative Care (NYZCCC) to evaluate the impact of the center’s Contemplative Care approach on nursing home residents. The evaluation will also assess the impact of NYZCCC’s Resiliency Training on nursing home staff.

Both the Contemplative Care intervention and the Resiliency Training will take place at Isabella Geriatric Center  in New York City.

NYZCCC’s mission is to “transform the culture of care through contemplative practice, meeting illness, aging, and death with compassion and wisdom.”


NYZCCC’s 2-pronged intervention at Isabella will involve both residents and staff.

Working with residents: Trained contemplative caregivers from NYZCCC will work individually with Isabella residents to carry out a healing modality centered around the recognition and alleviation of suffering. The ZenCare team working at Isabella will use the “Four Noble Truths”—foundational tenets shared by Buddhist practitioners—to “identify the nature of the resident’s suffering, the cause of their suffering, the means to the end of their suffering, creating a way forward.” While Contemplative Care as taught at NYZCCC is presented through the lens of Zen Buddhism, this is not a religious or faith-based intervention.

The intervention with residents will focus on 3 key themes:

  • Meaning: This involves creating ways for residents to engage, giving dignity to the process of aging, encouraging personal expression, exploring spiritual expression, communicating with residents in a way that lets them know they are seen and valued, identifying the loss of rituals and activities that were meaningful to residents, exploring new ways of engaging that could be meaningful to them, supporting and educating residents to distinguish pain from suffering, exploring grief and loss, and exploring existential concerns and distress about death.
  • Community: This intervention involves enhancing social engagement and the resident’s sense of belonging, supporting development of communication and friendship among residents, exploring residents’ feelings of isolation and loneliness, acknowledging the impact of ongoing change in the community, and fostering resilience through relationship building.
  • Agency: This involves encouraging residents to express their thoughts and feelings, a range of emotions and oppositional opinions; perceive and express their needs; participate in their care plan; and learn to ask others for help.

Training staff: NYZCCC will also conduct Resilience Training for Isabella staff. That training is based on NYZCCC’s premise that “one can only be as intimate with others as one is with one’s self,” according to the center. Lectures, experiential learning, meditative practice, role play, and group exercises will be used to help Isabella staff cultivate greater resilience in the work place. The training is designed to reduce burnout and feelings of isolation, and increase staff members’ confidence in providing care, capacity to deal with grief and loss, job satisfaction, cohesiveness, communication, and support.


The LTSS Center’s evaluation will focus on 2 basic research questions:

  • What are the impacts of implementing a comprehensive contemplative care approach to care on nursing home residents’ perceptions and experience of community, meaning, well-being, satisfaction, and agency?
  • How does the Resiliency Training affect the caregiving staff’s sense of community, team effectiveness, job satisfaction, overall resiliency, and agency?

Working in conjunction with Isabella staff, the research team will identify residents to participate in the intervention and recruit residents for the control group. Staff members serving these residents will also be assigned to an intervention and control group.

Researchers will use surveys, key-informant interviews, and focus groups to understand the experiences of individual residents, staff, and leadership participating in the intervention. The collected data will be used to measure changes in key outcome variables over time.

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