Saturday, February 28, 2015

On God and Dementia

Happy (Almost) Spring!

Early in the year someone came up to me and asked whether I had any articles (or anything I’d written personally) on whether it’s any use to share the Gospel with those who have advanced dementia. This person had just put an aging mother in a nursing home in a nonresponsive state due to dementia, and was wondering whether (or perhaps had been told that) she was beyond hope.  This was not a new thought; others have in the past questioned the usefulness of a ministry to those with dementia or other debilitating mental conditions.  So let me share my answer, so you can see inside my world for a minute.

On God and Dementia.

Should we go and share the gospel with patients (even unbelievers) suffering from dementia Yes.

Even if they can’t reliably tell whether it’s day or night by looking out the window? Yes.

Even if they are completely insensible or comatose? Yes.


Because they are still alive, and where there is life there is hope.  It’s certainly not as rewarding as sharing the gospel with those who can respond to us verbally; but that is, at the bottom, a selfish goal. It’s human to want to be able to see the results of our work; to know we are being fruitful in what God has commanded us.  But many times we have to let that go, just do our bit faithfully and trust the results to God.  I think that’s the crux of the matter: questioning the benefit of sharing the gospel with those suffering from dementia evidences a misunderstanding both of the nature of the disability and of God.  I’ll deal with those one at a time.

The nature of the disability:

Dementia is not a disease. It’s a collection of symptoms. A disorder in memory, thinking, and reasoning that is severe enough to significantly impact the person’s ability to function independently.  It is insidious as it robs sufferers of both yesterday and tomorrow, and makes getting through today a challenge.  It isolates them by stealing away their memories and recognition of the people who, in normal conditions, would bring their greatest comfort.  The people to whom they belong. Eventually, the person with dementia is utterly alone in a land of strangers. Is it any wonder they react angrily and fearfully? Does this help explain why they push people away?

In their solitary state, they are aware that they are traveling - by what means they’re not exactly certain – to new unfamiliar places on a daily or even hourly basis. You can tell them all you want “This is your kitchen. You’ve lived here for 50 years! You had your breakfast here.” And it does no good. All they want is “to go home” – but  by that they don’t mean the same thing we mean.  They don’t recognize places in their house – but they remember that it is good to be “home.” That home they long for isn't a place: it's security, love and acceptance.  Even if they are physically in their own house, they are not at home because dementia has robbed them of their ability to recognize the familiar.  What they want is the feeling of security, love, and acceptance, and their condition robs them of even that.  Little by little, dementia takes them to a different place, though their bodies occupy the same bed or chair. Is it any wonder they’re disoriented? Do you understand why they prefer to sit in one chair for hours; why going outside for pleasant distractions completely unnerves them?

As the neurons in their brains die, they “slip away.”  And in our humanness we tend to write them off at the point at which they can no longer respond. “She’s beyond hope now,” we say. “It’s just a matter of time.”  And it’s true to a certain extent.  Dementia is, in the end, a terminal condition.  We visit out of a sense of duty for a while, but when there is no response we reason that there is no use in talking – they do not hear or recognize us – and we conclude that it doesn’t really matter whether we come and see them or not.  All we really need to do is ensure that they are adequately cared for and reasonably healthy.

And spiritually, once they can no longer respond we decide that “it’s no use” sharing the Gospel with them, because they can’t do anything about it anyway.

How do you know? You ask me.  Have you spoken with anyone who used to have dementia who doesn’t any more, and can tell us what it was like?

No, of course not.  But we don’t need that, really.  We need to rely on what we know about people, God and salvation.
One of the very most important things to understand about people is that “unable to respond” does not mean “absent.”  They can still hear. There are so many stories of people who were comatose but have recovered who can repeat what was said to them (or about then) when they were thought to be “out of it” that this is not seriously discounted any more.  Of all the senses, hearing is the last to be lost in the normal course of aging and disability.  Because hearing is totally passive.  Sight is an active sense, requiring one to exert effort and muscle coordination to open the eyelids, move the eyeballs, and focus on things/people.  Just seeing can be exhausting.  Our sense of touch (except for pain receptors) requires us to touch things.  Rest your finger lightly on something.  If you hold perfectly still, within a second you lose the ability to discriminate between soft, hard, smooth, rough, silky, furry…all you have is the sense of pressure. And after a couple seconds, even the sense of touching something fades away because we need to move the finger in order for the pressure sensors in the skin to fire.

But hearing is totally passive.  Even those who cannot respond can hear. And if they can hear, what do they need to hear more than the Gospel?  If they are believers, we can kind of understand that; they need to be reminded of the only security they have – even if they forget it again by lunch time.  But what if they are not believers? Is there any reason to share with them if they can’t respond? Just think about that for a minute. What does the Bible say about that?  Here’s a very clear encouragement from Romans 10:17. Faith comes through hearing, and hearing through the Word of God.


We were all dead in our sin. God had to quicken in us the faith to believe the gospel.  In a way, we were worse than those with dementia because we exercised our will to consciously refuse to respond to the Word. But their volition is significantly impaired. Their heart is softened; in their fear and disorientation they are like people being tossed about by a raging river; they are ready to cling to any rock.  It must be THE ROCK.

 We tend to put “boxes” around people’s Christianity.  To gauge the eternal state of someone’s soul by applying modern evangelical constructs as our meter stick.  Modern evangelicalism says the evidence of saving faith is a prayer (the Sinner’s prayer) or “asking Jesus to come into our heart” or showing a changed life. It’s something we have to DO.  That’s slippery ground to stand on. I’m not 100% in agreement with Calvinism, but it is pretty clear in Scripture that God is the agent, and the author, and the perfector of our faith. We are sheep. Clay.  Dead.  Hmmm. What a travesty it is to devalue someone’s life (or faith) because they can no longer move or smile or speak. 

The Nature of God

Saying it’s useless to share with those who have dementia is putting ourselves in the place of God.  We think it’s up to us.

Here’s the truth: IT’S NOT.

God talks about Himself in His word and shows us glimpses of what He is doing.  If you’re dealing with someone with dementia, I highly recommend reading Isaiah 55:10-11 daily until you have it memorized. Here it is:

ISAIAH 55:10-11

10 For as the rain comes down, and the snow from heaven,
And do not return there,
But water the earth,
And make it bring forth and bud,
That it may give seed to the sower
And bread to the eater,
11 So shall My word be that goes forth from My mouth;
It shall not return to Me void,
But it shall accomplish what I please,
And it shall prosper in the thing for which I sent it.”

See how important this is?  What food for the soul is here! The rain and snow come down to the earth and seem to disappear. But they don’t really.  They sink in and are hard at work watering the earth and making it productive and spreading the blessing far and wide.  The dirt may not look any different, but the water is working down deep and in due time the fruit is seen. Just because we don’t see the water on the surface doesn’t mean we can conclude that it’s not necessary.  To withhold the water on the basis that it’s just wasted pouring it into dirt like that will starve the ground and make it impossible for fruit to be produced.

Now, this is not a promise – it’s a principle. A general statement of the way things usually work. We know that the rain and snow do not guarantee  fruit.  Even if the water is sufficient, the fruit may fail due to environmental conditions or disease or human intervention. But without the water none of those other things matter. Even in the perfect, disease-free environment, with patient nurturing; if there is no water fruit is impossible.

The Word is the water.

Just because we don’t see it having an effect doesn’t mean it’s not working.  It may sound harsh to say it this way, but withholding the Word starves the soul, making fruit impossible. With the Word, fruit is possible. Without the Word, there will be no fruit – guaranteed.  No chance. No hope. No fruit – no seed – no future.

But, you say, in this case the life can’t bring forth fruit anyway – the person is comatose. 

Wrong again. The ultimate fruit is eternal life. Which we will not see until heaven.

The second half of the verse is familiar, but I don’t think we think much about it. But there it is in black and white. His word will not return void.  Like the water and the snow.  It’s not possible for it to return void.  And further, it accomplishes what He pleases.  This should make us laugh with joyful relief.  It isn’t only not about what THEY can do in response, it’s not about what we do either!  It’s not about phrasing the gospel just right to break through their defenses or out-logic them. It’s not about us at all! It is God who does all the work through His word. HA!

God has spoken through a bush…and thunderclouds, and a donkey…and still His word accomplished its purpose every time.  His words through His prophets have produced amazing results: like animating dead bones. His word through His Son and His servants have brought the dead back to life! How can we say God’s word can no longer work in this person just because they’re not able to respond?

And how will they hear the Word unless we proclaim it?  We should continue to pray for them, certainly.  But while they are alive, we should be diligent to speak the Word to them. If we cannot, we can definitely pray that someone else (like a chaplain perhaps) will. 

In conclusion, as long as what we’re saying is God’s word, it is never wasted effort. We may not see any result in their lifetime, but we must not stop speaking the Words of life to those who are suffering from dementia.  There is nothing to fear: no reason to hesitate. This life has nothing left to offer them – but eternity is within their grasp.

Here’s a parting song:

1.      Sing them over again to me,

                   wonderful words of life;

                   let me more of their beauty see,

                   wonderful words of life;

                   words of life and beauty

                   teach me faith and duty.


                   Beautiful words, wonderful words,

                   wonderful words of life.

                   Beautiful words, wonderful words,

                   wonderful words of life.


2.                Christ, the blessed one, gives to all

                   wonderful words of life;

                   sinner, list’n to the Gospel call,

                   wonderful words of life;

                   all so freely given,

                   wooing us to heaven.



3.                Sweetly echo the gospel call,

                   wonderful words of life;

                   offer pardon and peace to all,

                   wonderful words of life;

                   Jesus, only Savior,

                   sanctify forever.

                   Beautiful words, wonderful words,

                   wonderful words of life.

                   Beautiful words, wonderful words,

                   wonderful words of life.





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