Wednesday, June 21, 2017

Book Review: Finding Grace in the Face of Dementia

Finding Grace in the Face of Dementia. John Dunlop, MD. 2017. Crossway. 208 pages.  [Source: Review copy]

First sentence from introduction: Dementia, dignity, and honoring God—you must be kidding! Chances are you have never seen those three thoughts in the same sentence. How can such a tragedy as dementia be dignified, and how in the world can God be honored through it?

Premise/plot: Dunlop provides a Christian perspective of care on dementia in his new book. He writes in the introduction, "My purpose in writing this book is to provide a theological lens through which we can view dementia and then give a number of practical ways in which it can be applied. I trust it will be useful for those who are developing the disease as well as those who care for people at any stage of it. I also hope that many professional caregivers, whether doctors, nurses, chaplains, or social workers, will benefit from this read. In addition, I believe it will be useful for pastors, other church leaders, and members of ethics committees. I suspect that most readers will be followers of Jesus, but I truly hope that the book will be read by non-Christians as well. I am impressed by how many who do not embrace the Christian faith nevertheless hold the life and teachings of Jesus in high regard. My desire is that they will profit from a deeper consideration of how Jesus would respond to dementia."

Table of Contents:
Introduction
God and Dementia
What Should We Know About Dementia?
What about Diagnosis?
Can Dementia Be Prevented or Treated?
How Does It Feel to Have Dementia?
The Experience of Caregiving
Help for Caregivers
How Can We Honor God Through Dementia?
Respect the Dignity of Those with Dementia
Meet the Needs of Those With Dementia
What Should the Church Do?
Grow Through the Experience of Dementia
End-of-Life Issues

My thoughts: First and foremost the book is practical and packed with information. Some of this information is medical: what is dementia? what are the different types of dementia? what are the signs of dementia? when should you see a doctor if someone you love is showing signs of dementia? are there ways to slow down dementia? what kinds of help are available for caregivers? The book has plenty of tips.
There are number of practical ways in which we can respect dignity by entering the world of people with dementia. Here are a few examples: 1. Get to know their past history, if you are not already familiar with it. Talk to them about stories from their past to allow them to enjoy the memories they still have. It may help to compile a picture book and have them explain the pictures in it. 2. Share some funny stories. They may not understand them, but if you laugh, they may enjoy laughing along with you. 3. Learn what they prefer to be called and use that when speaking with them. It may be the nickname they had as a child. 4. Learn their likes and dislikes from earlier in their lives. You might take them to places they used to enjoy and serve them the comfort foods they once relished. Their forgetfulness may enable you to do this repeatedly. If they used to love mac and cheese, they may be fine eating it every day. 5. Play the music and sing the songs they used to love. 6. Slow down to get into their world. Life for those with dementia moves slowly. Anything you do together will take more time, as it may upset them or even lead to a meltdown if they feel rushed. 7. Respect the constrictions of dementia. As the disease progresses, patients will be less interested in the past and future and more focused on the present. They will be less interested in news of the world outside and may not want to leave the comfort of their home or room. What is going on in the lives of other people may not be important to them; eventually, however, they will care only about how they feel in the here and now. To respect their dignity, those around them must learn to enjoy the present moment with them. At times, being touched and held may be all they want. Recognize that caregivers’ need for activity may be far greater than theirs. 8. Respect their resistance to change. Establish routines they are comfortable with. Having meals at the same time and going to bed and getting up on a regular schedule are usually best. The world they live in does not require much variety. 9. If they perceive that you did something wrong and have become upset by it, accept that their understanding of what happened may be totally different from yours. Do not make excuses but apologize profusely. That will affirm them, avoid arguments, and allow them to feel better. 
But there are also theological aspects of this one. Dunlop examines the subjects of dignity and human worth. He asserts that it is not our intellect or memory that makes us have worth; our image-bearing does not stop with diagnosis. No matter how much the mind deteriorates, our worth and value does not diminish or lessen. Dunlop also focuses on God. God is good. God is faithful. God is sovereign. God is wise. God is ever present. God is the God of all comfort. He writes, "As we celebrate God’s goodness, we must recognize that part of his loving care for us is allowing difficulties to come into our lives—such as dementia. We cannot deny that dealing with dementia, whether from the perspective of the patient, the caregiver, or other observers, involves emotional, spiritual, and at times even physical suffering. To handle it well, Christians need to be taught early in their lives that God is in control, that he always does what is good, and that we can trust him through the hard times of life. If we are going to endure suffering in a way that honors God, we need a robust understanding of how God uses suffering. This must start with an understanding of who God is."

He concludes, "If we are going to honor God in and even through dementia, we first need to know God in an intimate way. We need to think the way he thinks, respond to life’s situations the way he responds, love the things he loves, and value the things he values. When we know God in this way, we are able to respond to dementia the way God himself would respond."

Favorite quotes:

  • Compassion is not only showing love and kindness, but it is also understanding how others feel and then allowing ourselves to feel that same way. It is taking the time and effort to get into their lives to see the world as they see it. If they are frustrated, for example, we must allow ourselves to feel that frustration. This is crucial when relating to those with dementia.
  • Caregiving is a distinct call from God. It is not something we randomly fall into. Unfortunately, it may seem like this responsibility is foisted upon us, but that is not true. We often think of God’s calling as something that comes to us through a great, supernatural experience, but often the call comes to us by the circumstances he puts in our path.
  • Caregiving may be a trial, but it is carefully orchestrated by a loving God to transform the life of the caregiver. Furthermore, the caregiver will recognize that the sacrifice of Jesus on the cross was, in part, to be an example of sacrificial giving to others.
  • We basically have three options for how we spend our time: we may choose to invest time well, doing things with eternal value; we may spend most or part of our lives in sin; or, third, we may spend time doing things that, though not bad in themselves, are frankly a waste of time. There will come a day when we will stand before God to have our works judged. Thankfully, we will not be judged for our sinful deeds, for when we trusted Christ, they were forgiven. What will be judged is the amount of time we invested in doing good for eternity in comparison to the time we wasted.
  • Since memory is so important and God values it so highly, we must do whatever we can to preserve the memories of those who have dementia. We can do this by repeatedly telling them the stories of their lives. We should emphasize how God graciously brought them to himself and worked in and through them. And they may never tire of hearing the Bible stories they knew from Sunday school. We need to keep repeating that God loves them and that Jesus died for them. We need to use hymns, either singing or listening, as they will touch their emotional memories. We should also continually remind them of our love for them. 
  • We must never allow their cognitive impairment to blind us to their emotional needs. They may feel much more than they know, and how they feel may be far more important to them then what they know.
  • Music is a wonderful way to reach the spirit of people with dementia. Our church used to offer a worship service in the assisted-living facility next door. One dear friend was there every weekend playing his guitar and singing the old hymns. We were amazed how many of the residents, even with dementia, would either sing along or sit smiling in quiet reverie. I would on occasion be asked to present a brief devotional. In spite of my best efforts, many slept or did not follow even the simplest of thoughts. It was not the preaching that reached their souls; it was the music.
  • The best thing that a local church can do to prepare victims and caregivers for the spiritual challenges of dementia is to instill in them a deep and joyful experience with Jesus. If Christians memorize Scripture and sing hymns often enough to ingrain them in their brains, they may become part of their emotional and procedural memories, thereby being more likely to recall them once faced with dementia. For the caregiver, Scripture and hymns may sustain them through days of challenge and difficulty when they have so little time to nurture their own spiritual lives.
  • There is no guarantee that prayer, reading the Scriptures, and other disciplines of the Christian life established prior to the onset of dementia will continue through the course of the disease, but it is fairly certain that if they were not practiced before the onset of dementia, they will not be practiced afterward. 
  • God’s people must understand that suffering is not a tragic mistake that comes into our lives. Scripture assures us that it is the norm for a Christian. In the book of Acts the apostles taught that “through many tribulations we must enter the kingdom of God” (Acts 14:22). Peter writes, “Let those who suffer according to God’s will entrust their souls to a faithful Creator” (1 Pet. 4:19). Yes, times of suffering are not a tragic mistake in God’s universe; he ordains them according to his will.


© Becky Laney of Operation Actually Read Bible

No comments: