DEMENTIA & THE LOCAL CHURCH

1. DEMENTIA & THE LOCAL CHURCH Presentation by Roger Hitchings

2. IMPORTANCE OF SUBJECT Many people feel fear and anxiety about Dementia • Dementia is a reality • 820,000 dementia sufferers in UK. • 550,000 caregivers. • Affects many people through family or friends • The Local Church has a responsibility • Be informed- ensure one person has good level of knowledge. • Be involved– Galatians 6:2 & 10 - much good to be done. • Be practical– support sufferer and carer alike. • Be spiritual– address spiritual issues as well.

3. REINFORCINGDUTY • A duty to be kind to needy people - “whoever is kind to the needy honours God” (Prov.14:31) • A duty to promote their interests - “Speak up for those who cannot speak for themselves, for the rights of all who are destitute. Speak up and judge fairly; defend the rights of the poor and needy.” (Prov. 31:8-9) • A duty to serve them - “The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me” (Matt. 25:40) • A duty and blessing to help – “God is not unjust; he will not forget your work and the love you have shown him as you have helped his people and continue to help them” (Heb. 6:10)

4. WHAT IS DEMENTIA? Dementia is an umbrella term that refers to a condition that results from organic/neurological damage to the brain. It is a PHYSICAL condition which has nearly 100 different causes including Alzheimer’s Disease, stroke, head trauma, metabolic disorders etc. • Also related to alcohol abuse, aids, downs syndrome Our concern is with people not simply a condition.

5. CAUSES OF DEMENTIA

6. COULD IT BE DEMENTIA? • Memory loss – often the initial indicator. • Not all memory loss is dementia (mild cognitive impairment). • Depression- can be like Dementia – can be associated with Dementia – increased anxiety levels. • Lost ability to do familiar tasks - looking after oneself. • Language problems – losing words – losing thread of a conversation – repetition of things said. • Inability to make decisions- loss of confidence. • Mood swings – unexpected changes – out of character. • Disorientation– place and time - sense of dislocation. • Struggling to assimilate new facts- unable to engage in abstract reasoning – difficulty in following conversations. • Apathy and sleepiness.

7. DIAGNOSIS • Early diagnosis is very important. • People are often reluctant to consider possibility – fear, denial and stigma hinder action. • Proper diagnosis is vital. • There are other conditions which have similar symptoms to Dementia in early stages – ranging from chest and urinary infections to brain tumours. • Diagnosis is a process – GP will send to Old Age Psychiatrist or Memory Clinic. • Diagnosis is the first step – enables changes to be made in lifestyle – learning to live with Dementia.

8. MORE ABOUT DEMENTIA • Exact causes are still not known – genes are not as important as ‘gene expression’. • Prevention– lots of advice around – exercise, diet, physical stimulation, intellectual activity, involvement with others etc. • Avoid stress!! • Difficult decisions may follow – lifestyle changes may include driving, cooking, practical tasks, finances etc. • Changes in the home – especially with safety in mind. • Discus wherever possible – avoid humiliating – recognise limitations. • Challenging behaviour– often a cause – sometimes go with flow. • The Person remains – though hidden by the disease.

9. AFTER DIAGNOSIS • Many dementias are slow in development. Rate of progressions varies with each person. • Can be delayed by medication but not yet prevented • Treat depression – don’t live with it • Much useful and effective living possible - Contented dementia is a real possibility. • Relationship/care approach – maximising person’s skills and remaining faculties. • Three stages in development – stages not watertight: • Early - uncertainty and anxiety. • Moderate – increased confusion and losses. • Advanced – full assistance; physical frailty etc.

10. LIVING WITH DEMENTIA It is possible to continue to live normally for some time: • Acceptance & Cooperation– involves seeking diagnosis, developing understanding condition. • Avoid isolation - dropping out to avoid embarrassment - share needs with the church family – be involved with others attend worship. • Adapting– focus on what you can do rather than what you have lost - change patterns of living – emphasising abilities. • Activities– areas of interest and activity to keep mind and body functioning– “ordinary” groups and “specialist activities”. • Adjusting– “dancing with dementia” – making changes to life patterns as disease progresses. • Prepare for the future – but live in the present. • Build a life - story contact with past – help to supporters.

11. Local Church Responses • Value of being aware – encourage in necessary steps • an advocate – church understanding – constant prayer for grace. • Visiting and keeping in touch – personal involvement – relationships that allow respite time to caregiver. • Doing practical things – be available to caregiver – negotiate level of support. • Encourage participation in “ordinary” worship - level of involvement will decrease as disease develops • Church must be ready to accommodate changing behaviours and even adapt to allow participation. • Support group can play vital role in helping in times of worship • Special services and communion may prove useful. • CD’s not over helpful to caregiver or sufferer.

12. Ministering to Sufferers • Remember each person is unique and made in God’s image – “focus on the person not the disease” • Person centred care -relates to the individual and retains the ‘personhood’. Remember their core beliefs, values, significant events • Communication is possible and vital– just do it – Scripture and hymns minister – spiritual life still exists. • Be appropriate to the condition – learn from caregiver and sufferer. • Be patient – love the person – feel the frustration and pain • Treat with integrity and respect at all times – Leviticus 19:32 • Bring God’s truth to bear – in encouragement – speak of the cross, grace and heaven • Rementing – spontaneous intermittent remissions when the person reappears – hymns and Scripture verses • There is full relief in heaven

13. THINK ABOUT THE CAREGIVER • Many negative emotions and considerable demands • Facing continuing losses – in sufferer and own life • Sad over situation grieving in advance • “Role captivity” – loss of social contacts and other roles • Depression, frustration, anger – counter emotions in care receiver • Inadequacy and fear – guilt and self-blame • Personal health seriously affected – 63% higher death rate – important that caregiver attends to their own health needs • Spiritual decline and losses – neglected by friends • Need for help and support – appropriate and consistent • Value of respite care – dementia is a physical illness.

14. SPIRITUAL Needs of caregivers • Ministry of God’s Word and Christian fellowship • Empathy and compassion – acknowledgement of their losses • Reassurance and encouragement about their role • Relief - Human contact and opportunity to be away from caring • Reminding of spiritual truths - 1 Peter 5:7; Hebrews 13:5-6; Psalm 38:9-11. • Encouragement – support in learning the facts and facing the future - Romans 8:28, 32 & 37 • The support and prayers of fellow Christians

15. CLOSING SUMMARY • Dementia is a physical illness that affects the brain. • Good care that focuses on the person can help hold the person together. • Nurturing the spiritual life is essential – even in non-Christians ministering spiritual truth and love is VITAL. • Churches have a major role to play in caring for the sufferer and supporting the caregiver.