Dementia-Friendly Worship

A Multifaith Handbook for Chaplains, Clergy, and Faith Communities

Virginia Biggar, Lynda Everman, Steven M. Glazer

• Publisher: Jessica Kingsley Publishers
• Year: 2019
• ISBN:
  9781785926662
• Topic: Theologie & Religion
• Subtopic: Religion

Religious faith is a powerful source of comfort and support for individuals and families facing dementia. Many faith leaders need help in adapting their ministries to address the worship/spiritual needs of this group. A product of Faith United Against Alzheimer's, this handbook by 45 different authors represents diverse faith traditions, including Christianity, Islam, Judaism, Sikhism, Buddhism and Native American. It provides practical help in developing services and creating dementia friendly faith communities.

It gives an understanding of the cognitive, communicative and physical abilities of people with dementia and shows what chaplains, clergy and lay persons can do to engage them through worship. Included are several articles by persons living with dementia.

WORSHIP SERVICES

CHAPTER 1

THE PERSONHOOD
OF THE CLERGY

Be Open. Be Humble.
Be Adaptable. And
Definitely Laugh!

Rev. Theresa M. Brion (Episcopal)

I am a full-time chaplain for a nonprofit religious-affiliated continuing care retirement community (CCRC). My community includes approximately 500 residents, 400 staff, and the family members of both groups of individuals. Thus, I am responsible for attending to the pastoral and other needs of a large community that, although predominantly aged 80 or older, is a rather diverse one in terms of age, education, culture, national origin, and experience. Much of my time is devoted to “serious” matters like running the chapel, leading religious services and spirituality groups, and ministering to the spiritual needs of the community both in life and in death. Fortunately, I have a strong legal, editorial, and business background, which assists me in attending to matters comparable to those of a corporate-sized church. I take seriously the importance of offering a sense of order, calm, and liturgical reverence for the community. Even though it plays to my skills and strengths, delivering this program with compassion and cheer is undoubtedly a challenge. Despite my managerial background and experience, it is my role as chaplain to the residents experiencing increasing or significant dementia, including Alzheimer’s disease, that frees my soul and offers me release. In this role I am the wispy and coordinated ballet dancer who also can break out into a Gracie Allen comedic routine with great ease and a hint of a smile. Let me tell you what I mean, for I greatly love what I do as a CCRC chaplain. As I tell others who remark about the joy that radiates from my face, this is the most difficult and yet also the most fulfilling role I have ever assumed in my ministry.

Serving a CCRC community means that I have a deep relationship with the people whom I serve. It frequently is a very intimate relationship, where I know the residents’ deepest fears, their greatest joys, and some of the most intimate details of their lives, including their health-care needs, their family dynamics, and the sources of their beings: their remembered selves. I am thinking of not just what feeds their souls, but how they still envision themselves and attempt to live this out, even if that isn’t evident to others. It is a joy and an honor to be invited into that place of intimacy. I am invited to become acquainted with who they are—and it is very important that I use the present tense, for the former colonel or chief executive officer who now depends on others for several activities of daily living or who cannot remember what she ate that morning is still that colonel or chief executive officer. Each person has accomplished so very much, from household to military, from corporation to agency. They have dignity and grace. They are not children, even if their dementia now means that they enjoy “dress up” or coloring and can no longer make their own legal and health-care decisions. The mantra from the movie The Help, “You is kind, you is important, you is smart,” is a great reminder to me that, yes, they are important and they are smart, but the truly best part is that they also are some of the kindest, most gracious people with whom I have ever worked. They are so appreciative of all things and peoples. They are so accepting of me when I stumble or fail. They also are more than willing to share from their own rich fountain of knowledge if and when it can be helpful.

Be open.

I began this article with the advice “Be open” because being open is at the very core of being a chaplain to and with persons experiencing dementia or similar difficulties. Be open to the possibilities of many surprises. On Sundays, another clergy person and I visit with the health-care center residents to bring them communion and check in with them. During that time, we assess changes since we last visited with them, offer them communion, and ask them if they wish to attend our Sunday afternoon mini-service after lunch. We can walk with those who have rollators or walkers (or are just plain confused) and push those who are wheelchair-bound. This requires that both of us and the two or three residents who assist us be open to the possibilities and to change.

Many times, the residents have changed their minds in the 45 minutes since we have asked them and no longer wish to attend the service. Even more of them have forgotten. Some are now taking a nap. Some are still enjoying their dessert or coffee, so we will need to allow them time to finish. Another resident will say no but might be persuaded to come by our suggesting, “Let’s give it a try!” Her face will then brighten to a broad grin and she will agree. Some will express a concern that is easily remedied—like borrowing a wheelchair for the weary or assuring that I will get him or her back in time for their expected visitor. If they still decline the offer to attend the service, I gracefully accept their decision without trying to guilt them with my disappointment. Further, I never bring them to the service without their permission.

Be open. Be humble.

My most profound learnings have been from these wise but admittedly confused elders. They look at life so simply and with such great appreciation, making me realize that food, shelter, and family or friends are all that we need. During one Bible study class, I made a colorful Thank You card that I then signed, photocopied, and distributed as part of the lesson of the day. One of the women in our class was so grateful for this simple gesture that she held it close to her chest and thanked me profusely. I felt bad that I had not at least signed each one personally. A simple half-a-cent copy and ten minutes of time yielded such an amazing outcome. Because I know that this particular resident receives regular visits from her attentive family members, it makes me wonder and perhaps worry about the few who receive only infrequent visits because of distance and limited family or friends. The lessons that I learn about gratitude and the importance of sharing one’s thankfulness with others for all they are and do is truly invaluable!

Be open. Be humble. Be adaptable.

The Bible studies and health-care center services that I lead require considerable flexibility and adaptability. I am blessed to work with another clergy person who understands that we cannot script these encounters. We never know if we will have five or 15 (or more) for a Bible study or service. We never know if they will be sleeping or responsive, be talkative without regard to the activities in process, or be totally on task.

Some are deaf and cannot follow where we might be in the service or study. Some are unable to respond verbally but will follow along and nod their heads if I sit beside them for singing or whenever else I can and run my finger along the music or other written page. I may need to wake up a resident to offer communion.

Someone may be confused but demand that she be allowed to intinct (dip) the wafer into the small chalice instead of my doing it for her; however, when I hold the tipped chalice before her, she throws it into the chalice like she had dunked a basketball through the hoop as she gleefully exclaims, “I did it, didn’t I?” With a laugh, I join her in her joy and exclaim, “Yes, you did!” Jesus was present with us in our delight, even if a purist might say that she did not receive the Holy Sacrament—a conclusion with which I would disagree. She certainly participated in the sacrament of love and acceptance, didn’t she?

We frequently begin our services late or are interrupted by late comers. My Bible study topic may soon morph to another topic based on a resident’s response to a particular song or reading. More often than not, the discussion goes a direction that I did not plan. God is present, deciding where we need to be, and that is good. God knows what we need to discuss, and we all know that each of these residents needs to be heard. In the outside world, far too few people take time to sit, listen, and appreciate what our elders might wish to share. What a waste of such rich knowledge and experience!

Adaptability also is key to having a service or study that fits with the attention spans of the residents. We use an abbreviated worship service that includes three or four familiar seasonal hymns on a single song sheet, a brief reading, prayers, and communion. We distribute three pieces of paper: a song sheet; a liturgy sheet; and the brief Bible reading. Each time that we switch between sheets, we go from person to person to make sure that they are at the right place on the correct sheet. Our pianist knows not to begin playing a hymn until everyone is oriented again. The volunteers sit beside one or two residents and assist them as needed. The full service is immediately after Sunday lunch and takes no more than 25 minutes.

My Bible study usually includes a handout or display of colorful pictures or perhaps items that they can see or touch. The study begins with a familiar song and ends with another song, as selected by the residents from a songbook that accompanies a CD with the vocals. The actual lesson takes no more than 20 to 25 minutes. Because the residents have limited short-term memories, they often choose the same songs week after week, and many of our themes revolve around the holidays and popular themes like faith and love. I also must adapt to changing emotions and energy levels, not to mention illnesses and deaths that change the group’s dynamics. A disappointing day may mean that the ordinarily perky resident will...