There can be no doubt that in the past few decades, great strides have been made in increasing the overall public awareness of mental health issues such as dementia. This is in no small measure due to the efforts of governments, non-government organisations and advocacy groups.
However, old prejudicial, stigmatising and patronising attitudes still linger and have proven difficult to shake off. Thus on occasion, we continue to hear of demeaning terms—such as “senile”, “demented”, or even “mad”—being used to describe people with the illness. Such misrepresentations of people with dementia must be gently corrected and should never be left unchecked.
Dementia is a disease that, depending on its severity, can strip a person of their autonomy and intellectual prowess. But there is a sense in which Christians find it a challenge to understand the condition and respond faithfully.
One reason why Christians sometimes flounder in discerning what might be an appropriate response is because a good deal of our theology and worship is based on the premise that the believer is a cognitively able and independent being. Such a Christian would be able to understand what the Bible teaches, what they are doing when they partake of the bread and wine, and know who it is they are worshipping.
What do we do, then, with someone who can no longer read, much less understand, the Bible? What do we do with someone who no longer knows what is happening at a worship service, or who can no longer even remember who Jesus is?
This person may have been our Sunday school teacher, a respected church leader or pastor. And our response should not only be to reach out to them in compassionate ministry, but should also involve an honest interrogation of current perspectives pertaining the Christian life and a radical change in understanding on our part.
Perhaps our understanding of worship, the reception of spiritual truth, and the Christian life itself has been governed by an outlook that privileges reason and the intellect. Perhaps our understanding of the Christian existence is therefore woefully reductionistic. And perhaps it is precisely the presence of our brothers and sisters suffering from dementia that challenges our limited vision.
Perhaps our understanding of worship, the reception of spiritual truth, and the Christian life itself has been governed by an outlook that privileges reason and the intellect. Perhaps our understanding of the Christian existence is therefore woefully reductionistic. And perhaps it is precisely the presence of our brothers and sisters suffering from dementia that challenges our limited vision.
Take Christian discipleship, for example. In many of our churches, discipleship has to do with activities such as Bible study, listening to sermons and attending seminars on a variety of Christian topics. While these activities are indeed important, Christian discipleship and its nurture involve much more than just an intellectual assent to the Christian faith.
Although many Christians may not realise it, much of their reception and internalising of spiritual truths and spiritual formation occur before cognition. They take place as believers indwell the ethos of the Church—the Body of Christ and community of the Holy Spirit—through participation in its life, worship and ministry.
The same can be said about the most important activity of the Church: worship.
Worship services of many evangelical churches appeal to the intellect because they lack the non-verbal liturgical gestures, liturgical movements and sacred signs found in other Christian traditions. However, even in these churches, worship is always a participation in the corporate devotion of the congregation that involves the entire person, not just their intellect.
Because the spiritual life and worship involve the entire person, not just their minds, persons suffering from dementia should never be regarded as being incapable of them. The Holy Spirit does not depart from a child of God simply because their brain is diseased.
Persons with dementia can therefore still express their love, devotion and worship to God—perhaps not always in ways perceptible or known to us, but certainly known to God.
Persons with dementia can therefore still express their love, devotion and worship to God—perhaps not always in ways perceptible or known to us, but certainly known to God.
But can they really relate to God if they no longer remember him? How can they worship their Saviour if they no longer recognise the name of Jesus?
Again, we must broaden our understanding of memory and knowledge and how they relate to the whole person, not simply their mental faculties.
We often think of memory as a recollection of faces, persons and incidents—which involves some form of mental activity. However, a more holistic and full-bodied concept of memory is what some writers have called “habit memory”.
Many have noticed how a person with dementia who is mostly oblivious to their surroundings suddenly lights up and becomes animated when they hear their favourite song or hymn. Or how they become responsive when certain rituals are performed in church.
This is habit memory at work. It is a way of recalling the past by reliving it in the present. Here, memory is not some faint vision or representation of the past. In habit memory, the past becomes immanent and active in the person who remembers.
Habit memory suggests that memory is not simply a list of things we can consciously bring to mind. It is not a file stored away in the brain, waiting to be pulled out on demand. Memory runs deeper than that—it lives in the body, in routine, in the familiar rhythms of daily life. It is less something we retrieve and more something we inhabit.
Habit memory shows that there is a profound sense in which we are our memories. This means that although at one level (the cognitive), we might have forgotten many things, they are still a part of us and shape who we have become.
Furthermore, the Christian with dementia is part of the fellowship of believers—a community that knows them and cares for them, a community that remembers. Most significantly, the Christian with dementia is remembered by God—who loves them, has redeemed them through Jesus Christ, and is transforming them by his Spirit into the image and likeness of his Son.
Dr Roland Chia is Chew Hock Hin Professor of Christian Doctrine at Trinity Theological College and Theological and Research Advisor at the Ethos Institute for Public Christianity.
