Our pastoral calling often creates a palpable connection with those we serve. We bring our gifts and receive signs that our words and actions comforted or supported. We show up faithfully and respond to cues that our presence mattered.
When a pastor calls on someone living with dementia, what can we do to share the love of God and offer a caring touch? What symbols or rituals will connect spiritually? How do we know?
This question was first posed on the RevGalBlogPals Facebook group. Let’s continue that important conversation started by this pastor’s struggle:
Dear Matriarchs:
I’m wondering how other pastors connect with people who are overcome by dementia. I have a couple of people who don’t recognize the Lord’s Prayer, words of institution or what the sacrament of Holy Communion is anymore. I find myself stalling to go visit, because it is so sad, especially when I remember how vibrant they used to be. How does one connect gently to these dear children of God? Oh, and I am NOT a singer!
Caring Pastor
Thank you, Caring Pastor, for your openness to new ways to provide care in a challenging situation. Let’s see what our Matriarchs have to say:
Dear CP,
One of the beliefs of my tradition is that God loves us even before we are aware of it or when we don’t realize it. This seems to align with loving someone with dementia. Being present with someone who cannot connect at all is frustrating, but consider both the cosmic/mysterious reasons to do this as well as the way you are modeling love to the staff and family of your parishioner. We never know who might be watching how we love those who cannot respond.
I love that you are indeed trying to reach out to this child of God whether she knows it or not. Thank you.
Jan
A Church for Starving Artists
Dear Caring Pastor-
I have not had a lot of experience working with dementia patients. When I was in parish ministry I served those rare younger suburban start-ups. However, your question struck a chord for me and as I sit here I am remembering my grandfather who in his dementia went on adventures without ever leaving his chair and would get frustrated with the nursing staff that they hadn’t noticed he’d been gone all morning.
I lived too far away to visit regularly and so I don’t have memories of the time when the window of connection got narrower and tighter. So I’ve been thinking, if I were the patient, what would I hope for?
- Touch, but on my terms. Don’t hold my hand if I’m not in the mood.
- Make an attempt at eye contact. Pull up a chair and sit next to me.
- Use your adult voice. Talk to me with the respect I deserve as an adult.
- Ask me questions that require more than a “yes” or “no” answer if I am able to engage in conversation.
- Tell me a story if I’m willing to listen.
- Most of all remind me that I am loved. Loved by God and loved by a caring pastor.
God’s blessings to you and those you care for!
Heidi Rodrick-Schnaath aka RevHRod
Dear Caring Pastor,
You are not alone in your sadness and struggling in knowing how to be in ministry with members of our faith community who are living with dementia. It is a cruel disease. My best and only advice is that your presence, and thus God’s presence, is enough. It IS wonderful to sing hymns or read scripture or pray prayers but in the end your presence with them is the best gift you can give. Be with your people. Hold their hand. Pray in silence over them. Sit with them. There is nothing you are called to do to fix or change the situation other than your presence.
And you will find, as I am sure you already have, that just being with them is not only a gift for them but a gift for you.
Sending prayers for peace and presence,
Rev. Kelley Wehmeyer Shin
Memorial Presbyterian Church
Xenia, Ohio
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How have you ministered to people with dementia?
Please share your stories and strategies and resources in the comments.
Send us your question! Whatever your pastoral dilemma or ministry challenge, we would love to weigh in with some ideas for you. Write to us at AskTheMatriarch (at) gmail (dot) com.
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RevGalBlogPals 
I visited fairly routinely a member of my congregation who first became a communicative shut-in but who gradually became more and more affected by Alzheimer’s. I was particular to take the elements of communion with me on my last two visits as it seemed that he might be nearing his time to go home. CP, I am no singer myself, but I sang his favorite hymns (soft and very low), which seemed to relax him a little. While I did not hold his hand, I would occasionally rest my hand on his in the hope that he would realize someone was in the room with him. He was doubly blessed to be able to remain at home until the end of his life, and my most precious memory of him was in the sharing of The Lord’s Supper. He could no longer chew and swallow, so I would invoke the Words of Institution, touch the bread to his lips, and say, “The body of Christ broken for you, —-“. Touch the juice to his lips and say, “The blood of Christ shed for you, —–.” The first time, he moved his lips as if he were a little aware; the second time, not at all. I may have received far more comfort than my congregant did, but it remains a standout moment in my ministry to date. Just as we do in gift giving, give your member that which you would wish to receive under the same circumstances. Blessings as you serve those whom no one else frequently wants to.
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Your story reminded me of a teaching I’m trying really hard to get folks to step away from, having to do with keeping children away from Communion “until they can understand it.” If you carry that out to its logical end, you also have to deny the sacrament to those who used to be able to understand, but who now cannot because their cognitive abilities have been taken from them by illness or injury. “I’m not prepared to do that; are you?” I asked in a sermon awhile back. Just one more reason why we have to think through carefully what we’re teaching.
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Blessings on all those who minister to those with dementia! It was one of the hardest parts of my mnistry (I am now retired). More often than not, I didn’t know the person before they had dementia, so they wouldn’t know me at all. I might as well be one of the nurses or a social worker. I always tried to visit when a family member was present so they could tell their loved one “it’s the minister.” In each parish I served, my predecessor was male, so the person with dementia probably would not have recognized a woman as a minister. Maybe with the family member telling them this, it clicked. Often not, I think. And yes, I had people who spit the bread out or let the cup dribble down their chin. I do think presence was the important part of the visit, not the elements: the presence of the Lord first, then the presence of other believers witnessing to the grace of God in Jesus Christ. Yes, they are children of God. God knows every fiber of their being, even when they no longer know others around them. It’s hard to visit, I know, but keep going. You never know when you may make a connection.
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One member of my church who was already sliding into dementia when I arrived here used to refer to me as “the minister’s wife.” I’m sure that was why her family was upset with me for not visiting her; when they’d ask if the pastor had been to see her, she would say no, but I don’t think she ever volunteered, “But the minister’s wife has been here.” Her family would have known that was me.
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I serve as a pastor to a congregation, and have many members who are somewhere on the journey with dementia/alzheimer’s. I also do worship at local care facilities a couple times a year (the local clergy group rotates this duty). I always wear my clerical collar for those visits/services, as even if the people don’t know me or remember me, they are of a generation that the collar signifies something, and it helps as an anchor for our conversation. many of the conversations are loopy/repetitive–that’s ok. The people are expressing and connecting in the way that they can. Some are able to join in prayers/singing/ritual, others are not. Many people, in my experience, have welcomed a caring touch, and a blessing (with touch/sign of the cross on the forehead) even if they cannot understand the words. Sometimes the people I visit are far enough down the road that they realize they should know me, and don’t, and that distresses them or makes them anxious- in that case, I let staff and family members know. (and probably don’t make as frequent visits). One of the most powerful things we do, I think, is to treat these people as what we know them to be: fully human, fully loved by God. We can model that for staff and family–that they are not diminished on God’s sight, that God loves them now, as they are. In some ways, it is helpful NOT to have known them earlier in their life–we do not bring the grief of what was lost, but rather rejoice in what we encounter- a beloved child of God.
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Dear CP,
First of all your comments reminded me of when I was first in the seminary and having to do field ed. I was in an assisted living place and on my first day there I am being “shown the ropes” by the chaplain who is taking me on a tour of the entire building. This tour includes the “special care unit” which is the locked/code place where the folks with dementia are living. We go into the unit and as we are talking about their rooms and how they respond to pictures of themselves from long ago – I turn and find myself face to face with the woman who was my kindergarten teacher!! As strange as that was – it was also helpful in me getting over my fears of dealing with older people; I began to realize that everyone is someone’s parent, spouse, teacher, etc., and deserves my pastoral care – even if they don’t realize that I’m there giving it to them. You are also doing more for family than you will ever fully realize. I have a firm belief that when someone passes away – we are ministering fully to the family left behind more than the deceased and that is also true of dealing with families whose loved ones are in the midst of dementia. It is sad true – but I also have amazing stories of humor and grace in there as well.
Also your local Alzheimer Association will have a wealth of material – and an amazing group of professionals and volunteers – ready to help you! The St. Louis, MO chapter has started a group called “faith ambassadors” which is made up of clergy and laity from the area churches who work closely with the association on how to minister and be of help to those with dementia. Reach out to other clergy also – they are probably going through this very thing!
Prayers are with you, caring Pastor!
Peace,
Pastor Been There, Doing That
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This is such a good topic. I have visited many patients with dementia as a congregational minister. Here are two practical suggestions:
(1) Research shows the area of the brain where music is stored often is still intact when people have dementia. So the old hymns are a huge gift to the elderly with dementia. This music will ‘wake up’ the brain and calm the spirit too. … I am not a singer either. So this is how I bring music with me. I keep a basket packed with communion serving items–and an old cassette-tape Walkman and a portable speaker. During my little Communion service at the nursing home, I play a cassette tape with very old hymns into a speaker I set on a table near us. The person with dementia and I simply listen to the hymns together before we have Communion. (What a wonderful moment of respite for me too in a busy day)! Loading the music onto an iPod or iPhone would work also if you can download some old hymns the patient will recognize. Portable speakers are fairly inexpensive. Some work with Bluetooth. Mine has a cable that hooks into the earphones port of the old battery-powered Walkman.
(2) I always find it extraordinary what prayer does to people with dementia. They feel it. Even if they are in the presence of silent prayer in my experience they feel that so well. It’s like their spirits are open in some vast way to soaking up prayer. So pray, pray, pray in the presence of the person with dementia. He or she will take in every bit and find sustenance for the difficult journey.
Music and prayer. These are the hallmarks of worship at every stage of life and especially toward the end.
Blessings on your ministry,
Vicki
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