Pastoring Dementia Patients

I was with some local pastors recently, thinking through dementia and dementia care in our churches. The following points came out of our discussion. I hope they help.

1. Don’t be scared by dementia.

Like all illnesses, dementia is well within God’s sovereign purposes. Dementia is an illness, a disordering of the mind, just as other illnesses attack the body. Scrambled thoughts and words, as well as behaviour, can be very scary when we see them in a dementia patient. God isn’t scared by it, though, and we need to learn not to be, either.

2. Dementia doesn’t defeat the gospel.

“If you believe in your heart that God raised Jesus from the dead, you will be saved” (Ro. 10.9). Dementia patients have a heart belief, given and guarded by the Holy Spirit, during their illness. Dementia cannot take that, and grace is able to work within even the prison of dementia.

3. Christian dementia patients are members of the Body of Christ.

So we must treat them accordingly. They need love, prayer, fellowship, the Word, and as they’re able to receive it, the Lord’s Supper.

4. Visiting dementia patients is essential.

Church members and attenders who are struggling with this illness need no less care and effort from pastors and other members, and they obviously now need far more. Whether they’re at home or in residential care, they need to be visited.

5. Be realistic about visits.

They might not remember you. They might be agitated, or totally blank. A dementia visit is unlike any other. But don’t ever feel you have a reason not to visit, for however short a length your visit might be.

6. Be practical and flexible.

A visit might just be five minutes, and five minutes with a person who has ceased remembering you is fine. Who says they need to know who you are for your visit to count, or that it doesn’t count if you’re not spending 40 minutes with them?

7. Have a purpose for each visit.

What do you want to achieve? Have you planned how you can support or encourage the patient? Think it through beforehand.

8. Be human.

You are a person, serving another person. So be human. This sufferer needs to hear a tender voice, and feel the physical touch of warmth. Chat, share news, and do the normal things that normal people do together. Remember birthdays and happy anniversaries.

9. Absurd is OK.

Some of the best preparation I had for pastoral work was reading the works of Samuel Beckett. On countless visits with all sorts of people, it’s felt at times like the Theatre of the Absurd! And it often will be with dementia sufferers. That’s fine. Learn to laugh, where you can. All sorts of bizarre and crazy things will be said and happen as you serve dementia patients. You are allowed to laugh, as appropriate.

10. Remember that when the mind is going, the memory is often working in some form.

So try to tap into what you know are helpful memories. When patients cannot think or talk lucidly, they can always remember. Sing a hymn, speak of happy shared times of grace. Bring up what the Lord might use to press his goodness home into this heart.

11. Always read the Scriptures.

It may be one verse, or it may be a short passage. Try to find out which Scriptures are meaningful to the sufferer, and read them, and comment on them together, if possible.

12. Pray.

 Pray with confidence, believing that God hears you when you’re with and apart from the patient. Pray familiar prayers, including the Lord’s Prayer. Ask the patient if they would like to pray, however advanced the disease is. That might be their trigger to pray, even out loud—to your massive surprise and encouragement!

13. Remember the family.

Even if the patient isn’t distressed, friends, family and church family probably are. Remember them, in your prayers, and in how you talk about the individual. Be sensitive to their aching hearts and worries.

14. Celebrate the grace and be honest about the difficulties with the church family.

Talk about the patient with them. Don’t allow them to forget the patient, or think that you have. Don’t allow them to think that dementia is God’s mistake. Celebrate God’s faithfulness so far. Encourage their faith with the fact that God really does supply grace, and really does do all things well.

15. Tell everyone that heaven is best.

Frightened people—both patients and and their families—need to hear that the truth of heaven is the reward of faith. Talk a lot about heaven.

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Editor’s note: This article originally appeared on Lewis’ personal blog.