Dementia: Dementia is not a specific disease but is rather a general term for the impaired ability to remember, think, or make decisions that interferes with doing everyday activities. Alzheimer’s disease is the most common type of dementia. Though dementia mostly affects older adults, it is not a part of normal aging. (CDC)

Last Friday (28th October 2022) I was privileged to be part of a seminar on dementia and spirituality organised by St Luke’s ElderCare. The invitation came rather late, but I said yes without much hesitation because I had seen first-hand my mother’s journey down that tough road and welcomed any opportunity to help others know about dementia and indeed to continue to learn more about this condition. There is a pressing need for the church, indeed for all of us, to be more knowledgeable about dementia because here are the Singapore statistics:

In Singapore, 1 in 10 people above the age of 60 suffers from dementia. This corresponds to approximately 82,000 people in 2018 and this number is projected to increase to 152,000 by 2030. (HealthHub)

One of the panellists, Leow Wen Pin, Chairperson of KIN, pointed us to the work of Stephen H. Post.

Society today, writes Stephen Post, is “hypercognitive”: it places inordinate emphasis on people’s powers of rational thinking and memory. Thus, Alzheimer disease and other dementias, which over an extended period incrementally rob patients of exactly those functions, raise many dilemmas. How are we to view—and value—persons deprived of what some consider the most important human capacities? (Johns Hopkins University Press)

Rational thinking is linked to two other things which are valued in today’s society—productivity and independence. What happens if we lose our capacity for rational thinking? Another panellist asked if we had to choose between dementia and cancer which would one choose? Apparently more chose cancer. Many, including myself, fear that losing our ability for rational thinking is to lose control of ourselves and therefore not be able to participate in life, including fighting serious illnesses. But what then are we to do? We cannot ignore the numbers.
This is a multifaceted issue that resists any simplistic responses. One key question is the question of what it means to be human. Whether we have heard of René Descartes or not, many of us would subscribe to the first principle of his philosophy: “I think, therefore I am.” Does that mean that we become less human when we lose the capacity to think? Are we then worth less?
Again, Wen Pin was helpful when he pointed out that our humanity is defined by our relationships—with others, and with God our creator—and not primarily by our cognitive ability. While we appreciate the gift of thinking that allows us to think God’s thoughts after Him, among other things, our worth and value are not located in the gift of thinking but in the Giver, in God Himself. Human beings have value because they are made in the image of God. The growing numbers of those who have dementia challenges us to think seriously about what it means to be human.
My mum was smart, capable, and independent. Going down the road of dementia she slowly lost all three capabilities. Along this road she would often voice puzzlement as to why the Lord hadn’t called her home. As she began to forget many things, she remembered her Lord. Towards the end as she began to withdraw into herself, she would still stir and respond a little when we sang hymns to her. In the end what counted was her relationship with her Lord. Even until close to the end, she would remember her family, her children and their spouses, and her grandchildren. And then there were also a few key people from her church and from the college she taught in that she responded to. We are defined by our relationships.
There are many other questions we need to consider. How do we disciple people who have dementia? So much of our discipling approaches are cognitive, e.g., memorising Bible verses, doing Bible study, etc. How do we evangelise those with dementia? Our usual approach to evangelism is to present the gospel content and then invite people to respond to that content. What if folks are no longer able to respond rationally? What we cannot accept is that God no longer cares for these people! Unfortunately, the Bible doesn’t give any direct practical help though there is clear teaching on honouring the elderly. What it means is that this will be a key challenge for the church going forward. I see teams of psychologists, theologians, pastors, medical specialists, etc., working on how the church can minister effectively to the many who have dementia. Some of this is already happening but we are barely scratching the surface.
One thing we know for sure. We may forget God, but He will never forget us.

“Can a mother forget the baby at her breast
    and have no compassion on the child she has borne?
Though she may forget,
I will not forget you!”

(Isaiah 49:15 NIV)

God will never forget us. We must not forget each other.