Elder Journal: Faith Issues and Dementia Care |
By Paul Takayanagi One of the myths of aging that is often purported is that as people age they become more religious. In my experience, I have found that this is not exactly true. It is more usual that if people are religious in their younger years, they are remain so in their older years. If persons are not religious in their younger years, they remain so in their older years as well. There has been some research showing a variance of religious affiliation and activity by generation with more elder ones being more religiously involved than younger ones. It is possible, of course, that a person who was not religious in younger years, has a life changing experience as she or he becomes older that facilitates a religious “epiphany” as it were. This can happen when an elder is diagnosed with cancer and then unexpectedly recovers completely or when she or he reaches out to a faith-based senior social service program. But it is equally possible that a person who was very religious in younger years, has some life changing experience that facilitates a religious “departure” as well. This can occur when an older person is suddenly widowed and has difficulty in understanding how a “just God” could allow such a thing to happen. Or when an elder is diagnosed with dementia and becomes isolated from her or his faith community. While research on the changing faith of elders is not conclusive, what is known is that if faith and religious affiliation is important to a person, this can be beneficial when that person is diagnosed with Alzheimer’s disease or a related dementia. Professionals in the field of dementia can often heighten the effectiveness of their services to these individuals by recognizing, honoring and incorporating the elder’s faith and religious affiliation in positive ways. This month, we’ll look at three situations where recognizing and respecting the faith and religious affiliation of a person with dementia made a difference in their care. John John was a 67 year old African American man who was a participant in a dementia specific Adult Day Care program in California. He had been diagnosed with Alzheimer’s disease at the relatively young age of 62 years and had been in the program for two years. The day care program was housed in a community building adjacent to a large church in the neighborhood. John was one of the program’s most active participants because of his younger years and usually added a very upbeat and positive face to the group. One day, however, in the midst of a very chaotic day, John became uncharacteristically agitated and upset. Some of the program staff were clearing away the dishes from lunch while other staff persons began to noisily move tables and chairs for the next activity. John began to pace back and forth and made discontented noises under his breath. At first, the staff just thought John must not feel well or may be having a challenging time at home. But his behavior was so uncharacteristic that one of the staff took John aside, sat him down and asked him what was wrong. John blurted out, “You can’t do this in church. You can’t be this noisy in church!” Earlier that day, John had been dropped off at the program in the back of the building rather than the front of the building because a bus was parked there. The back of the building faced the large church adjacent to the program. John believed that he was in church that day and had become agitated when he perceived that all of the noise and activity was disrespectful. The staff knew how active John had been in his church as a deacon and rather than try to convince John that he was mistaken and not in church that day, they decided to honor his feelings and quieted down their commotion. This pleased John and he instantly became more amenable to the next activity. Ruth Ruth was an 88 year old woman who was admitted to a large nursing home facility after she had fallen at home and broke her ankle. She had been diagnosed with Alzheimer’s disease the year before. As she approached the facility, she shrank with fear and it was very difficult to get her into the front door. The facility was institutional looking and surrounded by a long, high wall. Once inside, caring for Ruth was extremely challenging. In particular, it was impossible to get her to take a shower or bath. The direct care staff of this facility were predominantly male and they wore white uniforms. Ruth had no living relatives and had lived alone for many years. Upon researching her history with former neighbors, it was discovered that Ruth was Jewish and was a holocaust survivor. The institutional design of the facility, the male staff in uniforms and the insistence that she get into a shower had all reminded Ruth of her experiences in the concentration camps of her youth. She had been unable to fully articulate her feelings or fearful experiences. One of the managers of the facility was able to go to Ruth’s home and bring a number of important possessions of a spiritual nature to her room in the facility and only female attendants were assigned to her. They also brought in a female rabbi from a nearby synagogue who was able to develop an ongoing friendship with Ruth. All of these actions comforted Ruth and she was better able to acclimate to her new surroundings. Rita Rita was a 73 year old Chinese American woman who was also admitted to a nursing home facility following a surgical procedure. She was diagnosed with dementia associated with Parkinson’s disease. Rita was Buddhist and one of the comforting religious activities that she believed brought emotional and physical healing to her was the burning of incense. The fire code, however, prohibited this activity inside the facility. After a number of unpleasant incidences where Rita smuggled in incense through relatives and tried to burn it in her private room setting off the smoke detectors, a compromise was reached. Once a day, a volunteer from a local church, visited Rita and escorted her to a nearby patio. The patio was protected from the wind and under supervision, Rita was allowed to burn incense and chant her accompanying prayers. This calmed her and made her feel that she was performing the religious activities important to her health and well being. All of these stories involve persons with dementia and how their faith and religious activities informed and influenced their care. Not all persons with dementia will display behaviors associated with their religious beliefs in every setting or situation but when they do, it is important to understand and honor those beliefs. The most important thing is to allow a person with dementia to express their spiritual and religious beliefs in ways that are comforting and supportive to them. A holistic perspective of care incorporating the body, mind and spirit can benefit many persons with dementia and their caregivers. About the Columnist: Paul Takayanagi is a holistic gerontologist with a
Masters’ degree in Gerontology from San Francisco State University. He has taught at San Francisco State University
and at the University of California, Berkeley; California State University, Hayward;
Chabot Community College; and the Graduate Theological Union. He was also the Education Director of Alzheimer’s
Services of the East Bay in Berkeley, California. He
is a member of the American Society on Aging and currently is a Chairperson for their
Summer Series on Aging to be held in San Francisco from June 23-26, 2003 and in
Philadelphia from July 14-17, 2003. Paul will
be presenting a number of sessions at these events on holistic gerontology and other
topics. You can find out more information on
the Summer Series on Aging at www.asaging.org. You can also visit Paul’s web site at www.livingoveraging.com. |
Available from ElderCare Online™ www.ec-online.net ©2003 Prism Innovations, Inc. |