My in-laws are in their 80s and slowing down, but don’t have dementia. My mom died young — a heart attack after many decades of smoking — and didn’t develop dementia. And neither did my dad who passed on six months ago.
But I have had the opportunity of counseling folks whose loved ones have these life-stealing, memory-dimming cognitive disorder. And the church needs to be ready. Yesterday. My article appeared first here at The Biblical Counseling Coalition and is used with permission.
When you hear the word dementia, what first pops into your mind? Old age? Alzheimer’s? Nursing homes? The high cost of care? No one likes to talk about dementia. Nobody wants to have dementia. Still, biblical counselors need to know about it because chances are they will counsel a person with dementia or, more likely, family members who provide care.
There are several types of dementia. The best known is Alzheimer’s, which was experienced by former president Ronald Reagan.
In 1900, people aged 65 or older made up 4 percent of the U.S. population. In 1980, this number nearly tripled to11 percent of the population. Do you know the estimate for the year 2030? 22 percent – almost a quarter of the population! And the “geriatric” slice of pie keeps growing.
Obviously, not every person aged 65 and older develops dementia (like my parents and in-laws). In fact, researchers found that just over 1 percent of those from 65 to 74 have this cognitive disorder. The percentage jumps to nearly 4 percent for ages 75 to 84 and rises to about 10 percent of folks over 85.
However, some researchers estimate that dementia of the Alzheimer’s type may affect nearly half of those at the older end of this spectrum.
Secular Understanding of Dementia
The secular term for dementia in the DSM-5 is “neurocognitive disorder” that progressively worsens. It is specified by severity. A person with a “mild” case needs help with some activities of daily living, such as housework. A person with a “moderate” case needs help with basics like dressing and eating. And a person with a “severe” case is fully dependent on others for almost everything.
At age 66, he took a job as a greeter at a big box store. He was a retired accountant and a smart guy. When he started as a greeter, he memorized the locations of many of the items in the store so he could direct customers. But nearly a year into the job, his memory noticeably slipped. His solution? To write information in a small notebook to help him remember things. But then he began forgetting to shave and to get to work on time.
His daughter brought him to a doctor for an evaluation of his cognitive ability. Using the Medical Model, the doctor ordered tests including a blood workup and an MRI, and they ruled out illnesses and conditions other than what his daughter feared most: major neurocognitive disorder due to possible Alzheimer’s disease.
In the Medical Model, a doctor might prescribe an antidepressant for his mild depression and recommend ongoing care in a nursing home.
A Biblical Approach for Dementia
Like the secular Medical Model, the biblical approach has a standard definition of dementia: decreased mental capabilities such as memory loss, inability to think abstractly, impaired decision-making, and the inability to communicate normally. The biblical approach values the contributions of physicians and considers dementia a medical condition that should be managed by a physician.
In addition, the biblical approach recognizes that people with dementia and their loved ones need counseling based on biblical truth. A biblical counselor is advised to take a personal interest in a counselee with dementia and visit frequently, be sensitive to spiritual needs, and encourage him or her from Scripture.
Many Christian families may choose to care for their loved one at home rather than send them to a nursing home, if possible. We see an application of this in 1 Timothy 2:3-16, a passage that focuses on the treatment of widows. The apostle Paul says that widows first need to provide for themselves or remarry. If this isn’t possible, then the family is to help.
Finally, if the family is unable to help, then the church would provide for her needs including proper housing, clothing, and food.
In his book The Art of Aging, Dr. Howard Eyrich shares an account of how their family cared for his father in their home. Diagnosed with Alzheimer’s disease, he developed a negative attitude and everything needed to be done for him – dressing, eating, and eventually toileting. Much of this care was done by his daughter-in-law, who was “on call” nearly all day every day except for those times they arranged for someone to come in.
Eyrich fondly remembers an encouraging incident before his father’s death. His father told him, “Kid, I’d be in an awful fix if it weren’t for you. Thank you.” Then a blank stare returned to his eyes.
The wise biblical counselor also pays attention to the caregiver(s), helping them choose to believe the Word of God and apply it to their lives, no matter how they feel in the trial of dementia. Part of this includes planning, preparation, and team meetings among the family members who are providing care. Where will the loved one with dementia live? Does someone need to quit employment to provide care? And so on.
Also, a biblical counselor would demonstrate love to the family by helping to ensure that the family’s church provides emotional support and also meets physical needs. One physical need that a family will have is time to take a break. Another need might be meals delivered to the home. Still, another is for someone to fill in for the caregiver so that he or she may attend church.
The caregiver(s) too need personal biblical counseling as they consider their own heart and responses to the trial of dementia. Emotions like anger, fear, and sadness are common. It’s important that the church’s response is organized and methodical. Otherwise, the family may be forgotten and neglected.
Just Because You Can, Doesn’t Mean You Should
One last note: The biblical approach recognizes that just because a family is willing to care for a loved one with dementia, this doesn’t mean the family should. As a biblical counselor helps family members work through these crucial questions, they may choose a suitable alternative. These might include adult daycare, hiring in-home care, or even a nursing home – all of which are costly.
Caring for a loved one with dementia doesn’t have to be a negative experience, although there will be negative experiences along the way. The Lord will enhance growth in Christlikeness as His children glorify God in thought and deed.
Questions for Reflection
Have you counseled caregivers of those experiencing dementia? How can you come alongside families like these to provide physical and emotional support?
 Howard Eyrich and Judy Dabler, The Art of Aging: A Christian Handbook (Bemidji, MN: Focus Publishing, 2006), 112.  Marshall Asher and Mary Asher, The Christian’s Guide to Psychological Terms, Second Edition (Bemidji, MN: Focus Publishing, 2014), 57.  Eyrich, The Art of Aging, 75.