INTEGRATING BHAVANA 4 AND ACCEPTANCE AND COMMITMENT THERAPY TO ENHANCE QUALITY OF LIFE FOR DEMENTIA PATIENTS

Abstract

Dementia is a global public health challenge that severely impacts the quality of life of both patients and caregivers across physical, psychological, and social dimensions. The number of patients worldwide has increased from 55 million in 2020 and is projected to reach 139 million by 2050, while Thailand has approximately 770,000 patients, with projections indicating a rise to 2.4 million by 2050. Patients commonly experience progressive cognitive decline, depression, and loss of independence in daily living, while caregivers bear substantial physical and emotional burdens, placing them at risk of burnout. Although no definitive cure exists, holistic care encompassing physical, psychological, social, and spiritual dimensions represents a crucial pathway to enhancing quality of life for all involved. This article aims to explore the integration of Buddhist Bhavana 4 principles - comprising physical development (Kayabhavana), moral development (Silabhavana), mental development (Cittabhavana), and wisdom development (Pannabhavana) - with Acceptance and Commitment Therapy (ACT), which enhances psychological flexibility through six core processes: Acceptance, Cognitive Defusion, Being Present, Self-as-Context, Values, and Committed Action, to improve the quality of life for dementia patients and their caregivers. The study revealed that both frameworks share commonalities in promoting mindfulness, accepting reality, and values-guided living. Their integration yields complementary applications: Kayabhavana combined with Committed Action promotes consistent physical self-care; Silabhavana combined with Values fosters ethical and appropriate behaviors; Cittabhavana combined with Acceptance, Defusion, and Being Present facilitates effective management of negative emotions and thoughts; and Pannabhavana combined with Self-as-Context builds understanding of the disease and preserves self-worth. This integrative approach enables patients and caregivers to face the challenges of dementia with greater psychological flexibility, sustainably reduce suffering, maintain human dignity, and enhance quality of life. This holistic framework, synthesizing Eastern and Western wisdom, represents a promising model for aging societies at both national and international levels.