God’s care throughout life
So many people I speak with have close family members or friends who are living with dementia.
Their stories are often urgent, sad and filled with questions.
Can a Christian lose his/her faith because of the cognitive changes that come with dementia? Can someone with dementia come to know and trust Jesus? How can we best care for people with dementia? Any many, many more.
My answers to the first three questions are simple.
No, a Christian cannot lose their faith through dementia. Yes someone can, and many do, come to faith in Jesus while living with dementia. And good pastoral care starts, as always, with good theology: knowing how God sees us, knowing what faith is, knowing how God brings us to faith and sustains our faith, and knowing that dementia is no obstacle to our God of all power and goodness.
Dementia is a medical term that covers about 100 forms of brain impairment. The best known is Alzheimer’s disease. In different ways, the various forms of dementia can a ect short- and long-term memory, behaviour and moods, and all bodily functions. Currently there is no cure, although progress has been made in slowing some symptoms.
Alzheimer’s Australia (which has a very helpful website) reports that there are more than 342,800 Australians living with dementia. This number is expected to increase to 400,000 in less than 10 years. Without a medical breakthrough the number of people with dementia in this country is expected to be almost 900,000 by 2050.
Many people with dementia are cared for in their homes. This will only increase given the significant cost of residential care and the efforts of various governments to keep people in their homes longer. It is also worth mentioning that specialised aged care is almost non-existent in developing (and many developed) countries where Australian Christians serve as missionaries. Dementia is not only a “Western” condition.
When dementia is mentioned, many people fear losing their dignity, identities, independence, relationships and faith. There is a great deal we can do to help with these concerns but our pastors and people working with the aged need training, resources and encouragement with this essential ministry.
Our care starts with knowing how God sees us. God tells us he has made us in his image (Genesis 1:27). Each one of us is of in nite value to God, because he gave his Son for us. Our personhood and value are not based on our capacities or how we or other people see us, but on how God sees us. This God-given status is irrevocable. Paul tells us in Romans 8:38 that death cannot separate us from the love of God in Christ Jesus. If death does not destroy us, then dementia certainly cannot. No matter what happens to us in this life, we never cease to bear the image of God and be each other’s neighbour.
One fear that some Christians have when they contemplate “losing their memories” is that they will forget God or their trust in him. There is a great deal that could be said here about the promises of Jesus to protect his sheep (for example, John 10:1-18) and his help in perseverance (1 John 2:1).
Our theology of death also helps. We expect to be “us” when we rise a er death. When Jesus turned to the criminal who was crucified with him and said, “today you will be with me in paradise”, we take it that he meant both he and the criminal would be themselves in paradise (Luke 23:43). God protects us through death so he can resurrect us, with whatever access to our memories that implies. Our memories ultimately are with God and are not contingent on our brains.
There is much more that could be said on this. But I hope you can already see why we can be confident that a Christian will not lose their faith in dementia.
Turning to the question of whether someone can come to faith in dementia, the major obstacle we face is not theological, but the way we put more emphasis on assenting to abstract ideas and the ability to articulate knowledge over a simple love for, and dependence on, God.
We know before we speak that our parents love us and we are dependent on them. Likewise, people with dementia come to love and depend on the God who saves.
Christians who are used to caring for people with dementia will always emphasise the need for patience and kindness, but they have also developed a number of other ways to convey the love of God to the people in their care. Evangelicals rightly emphasise the word in how we know God, and how he reveals himself to us. This applies also to people with dementia. The word of God is explicit in Bible readings and implicit in hymns, songs, liturgy (especially the Lord’s Supper) and prayer, all of which work well at different stages of dementia. Some supplement the word with dramatisation, pictures and music, but the word still lies at the heart of how God speaks. Words can trigger and shape beliefs and, in God’s hands, bring to faith someone with dementia.
God’s ability and willingness to save is not limited by our ability to show that we remember things, or by a temporary loss of access to our memories. Compared to being held in the memory of God, our immediate access to our memories and the ability to articulate our knowledge seems quite fragile.
A couple of years ago I interviewed more than 20 Christians who cared for people with dementia in aged care facilities. Each one could tell me stories of people with dementia who had come to trust in Jesus. There is nothing in our theology that precludes us from believing that the Holy Spirit can bring people to Christ while they live with dementia, and much that suggests we should expect it.
We can work with the biblical truth that faith is relational and a gift from God that is not dependent on our capacities or effort. In some respects dementia may even make people more responsive to God’s saving work, as “the lie of independence” is stripped away and replaced with the truth of dependence on God.
With the increase in dementia, a heavy load will fall on aged care facilities. But an increasingly heavy load will also fall on our churches, pastors and Christians caring for the aged. While recognising the vulnerability of these people, there is much we can do to help. Knowing that someone is always a person in the eyes of God, and God saves until the end of this life, should encourage us to persevere in our love of people in our care.
I have barely touched the surface here, but there are excellent resources to help. At a theological level the work of Professor John Swinton (author of Dementia: Living in the Memories of God) and, at a pastoral level, the books of Professor Elizabeth MacKinlay, stand out.
Anglican Retirement Villages and the Centre for Ministry Development are running a full-day symposium called Faith and Dementia on February 15, 2016 in Epping, at which both these people are speaking. In addition, Mary Andrews College runs a course titled Ministry with Seniors that looks at both the theological and practical aspects of care for people with dementia. I also hope to publish a book next year entitled Coming to Christ in Dementia.
To conclude, if you ever have the opportunity to care for someone with dementia, please take it. Our powerful, loving God helps and saves to the end. So care for your family and friends who have dementia. Talk with them. Sing to them. Pray for them. Take them to church services. Hold them. Let God’s love for them flow through you.