The Need for Spiritual Care in Dementia

 “Dementia is a group of symptoms that affects mental cognitive tasks such as memory and reasoning. Dementia is an umbrella term that Alzheimer’s Disease can fall under. It can occur due to a variety of conditions, the most common of which is Alzheimer’s Disease.” (

On the final Sunday before Christmas when I went to visit mom at her house, my childhood home where she has lived for over 50 years, she was watching Sunday Mass. I use the word “watching” loosely because mom cannot concentrate long enough to follow the Mass proceedings. She wrapped and unwrapped a piece of chocolate that was on her side table, folded and unfolded a napkin placed there by her caregiver, flipped through a random booklet, nodded off to sleep and completely ignored me. Nothing new here.

What was remarkable about this scenario was mom’s ability to snap to attention in time to give some of the proper responses and prayers – most of which were in Latin – and then recede into her cloud of dementia. By the end of Sunday Mass, she was busy re-arranging the contents of her side table and was completely oblivious to the television screen and to me.

“Mom,” I prompted. “Mass is over. Make the Sign of the Cross.” She looked up at me with a start. “Make the Sign of the Cross, mom. Mass is over.” So my mom put down the napkin she was folding, giggled and made a perfect Sign of the Cross.

Mom never remembers my friend, Fr. Tom, but when he visits her, always wearing his cassock, she recognizes the presence of the priest by his attire, his demeanour and the prayers he bestows upon her. Because of her poor balance, I have to stop her from kneeling as Fr. Tom offers her the Holy Eucharist but she receives devoutly on the tongue with a clear, determined “amen.”

One of the most enduring images I carry from my long-ago nursing school days is the sight of a roomful of elderly patients reacting to old Christian hymns. All of the patients needed daily complete nursing care and the vast majority were living with some form of dementia. On Wednesday afternoons, they were gathered into a large room on the unit by the nursing students to listen to music. Old Christian hymns elicited the most emotion as many patients cried and even some of those whose dementia was in the later stages sang along to the music, remembering hymns of days gone by.

More than anyone else, people with this condition live in the present moment. From what I’ve witnessed as I have cared for my mother and my patients is that for many, their encounter with the Faith of past remembrance evokes a deep-seated yearning for God and a fleeting but genuine remembrance of worship. For a split second, their memory of God’s love comes to the fore. It’s like receiving a loving reminder of His enduring presence. It is an amazing sight and I never tire of it. I wonder if, in those moments, Our Father in Heaven bestows an abundance of graces upon them.

I once stopped a priest who was trying in vain to reason with a woman living with dementia. He was becoming increasingly frustrated and it didn’t occur to him that people with this condition have lost the cognitive ability for intellectual reasoning. Another priest reluctantly admitted that he was terrified of visiting nursing homes. I’ve seen priests avoid dementia patients because they don’t know how to communicate with them. On the other hand, I have witnessed priests who showed compassion and brought the love of God to those most affected by this condition. Lest anyone think I am picking on priests, I’ve also seen lay church volunteers who didn’t quite know how to approach or talk to people who have dementia.

According to the Alzheimer’s Society of Canada, currently 564,000 Canadians live with dementia. In fifteen years, a projected 937,000 Canadians will have the condition. Many of them will be Catholic. The Canadian Catholic Church needs to develop creative ways to address this daunting situation. Proper training and ongoing support from Catholics who work professionally with dementia patients are needed to train clergy and lay people alike who are willing to take on the spiritual care of our brothers and sisters in Christ who live with dementia. We should have started years ago but it is never too late. The burgeoning statistics should convince us that this is necessary.

Son, support the old age of thy father and grieve him not in his life.

And if his understanding fail, have patience with him, and despise him not

when thou art in thy strength; for the relieving of the father shall not be forgotten.

(Sirach 3:14-15, Dhouay-Rheims)