Today, an increasing number of holistic or complementary practices are being integrated with traditional medical modalities. For example, mind-body and energy therapies that were more common in Eastern practices are gaining momentum in Western medicine. Mindfulness meditation, a well-known mind-body practice, is being utilized in many healthcare institutions, even those without established holistic management centers. Why this rising acceptance? Current trends in technology, genomics, pharmaceutical developments and other innovations are largely responsible for people living longer with chronic and life-threatening diseases such as diabetes-related complications, heart failure, Amyotrophic Lateral Sclerosis (ALS), Parkinson’s disease and cancer. Patients with chronic disease and multimorbidity often struggle with chronic pain, anxiety and depression, altered functional status, poor sleep quality and other factors that can have a negative effect on quality of life and well being. Thus, patients often seek on their own complementary and integrative therapies such as meditation, acupuncture, and phytotherapy. Complementary and integrative therapies (CIT) mindfulness are holistic practices that can be particularly useful for patients receiving cancer and palliative care as well as their caregivers^[1,2]. Palliative care offers a holistic and multidisciplinary approach to patients across the lifespan including their families/caregivers and encompasses the mind, body and spirit with the goal of symptom management and alleviating suffering^[3].

Mindfulness meditation
  Mindfulness meditation is a regular practice in Buddhism and Zen, a spiritual practice to attain enlightenment and as a means to end suffering. However, this practice has been studied and found also to have benefits in secular populations. Dr. Kabat-Zinn, founder of the Mindfulness Based Stress Reduction (MBSR) program, published several studies on the positive effects of mindfulness meditation on physical and emotional health in chronic pain patients^[4,5]. The MBSR program is a formal 8-week course that combines mindfulness meditation, Hatha yoga, and relaxation techniques along with didactics in a small group format. Moreover, MBSR continues to be widely studied and found to have a positive effect on symptom improvement in patients with chronic pain, sleep quality, and stress and anxiety^[6-8]. Since the inception of MBSR thousands of patients, laypersons, and professionals have participated in the program with many testimonies to it benefits as well as several professionals being trained in mindfulness tools.

  The concept of mindfulness in simplest terms means paying attention in any given moment. The breath is used as the focal point to help redirect ones attention back to the present. Mindfulness meditation can be practiced in the traditional sitting position (zazen posture) or alternate methods such as sitting in a chair, walking or the body scan. Thus, anyone who is willing, including those with functional limitations, can learn to meditate. The body scan, practiced while lying down in a quiet place, is an exercise that directs ones focus to the individual body parts starting at the feet and moving upward finishing at the face and head. This practice can increase awareness of one’s current feelings and sensations of the body with the goal of acceptance.

  Mindfulness and mindfulness meditation can become a way of life. It requires a willingness to try something new and openness to what may transpire as well as regular daily practice. There are many self directed videos and books as well as formal classes. Mindfulness meditation alone or in combination with MBSR or other holistic therapies such as Tai Chi, yoga, and acupuncture may offer additional benefits to patients. More research studies to examine the positive effects are important for a wider acceptance and utilization of these therapies in clinical practice, especially in palliative and hospice care.

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