Tending to the Spiritual Needs of Patients With Dementia

Dedera Baker writes about her experience with dementia patients as a Gilchrist chaplain in honor of Pastoral Care Week, which celebrates the practice of spiritual care through professional chaplaincy and pastoral counseling.

What I have learned most about being a hospice chaplain is that, at the end of life, what divides us seems to disappear. In the face of death, what makes us human unites us. That is spirituality. We all just want to be loved from the beginning of our lives until the end. Patients with late stage dementia are no different.

It is truly a form of faith to sit with a patient who no longer knows where they were born or how many children they have, or the name of their spouse of 67 years. When I first started my ministry in nursing homes and retirement facilities, I was quickly discouraged. I was used to listening to patients tell me their life story. But all I could hear was the silence. Their life before had disappeared.

Over the years I have come to see a beauty in working with these patients. Religion, race and class divisions disappear as I learn to tread water in the deep. I come to sit beside the dying. We call this the “ministry of presence” in the chaplain world. I am no longer a stranger but the embodiment of faith.

Research shows the memory needed to explore one’s spirituality is spared in spite of the effects of dementia. After all, what is the spirit but what we cannot see? I am always amazed when a patient who has forgotten so many memories, faces and names remembers the Lord’s Prayer or Hail Mary. Somewhere down deep in the recesses of the mind come familiar words. I feel privileged to share in these moments.

I have seen one patient nearly every week for two years. She seems to respond to the visit, although she can no longer speak. One day when I visited, carrying a new pocketbook, she said out loud, “That’s a nice bag!” Her private caregiver of many years and I shared in the joy of this moment! Maybe she responded out loud because of the regularity of my visits. I don’t know. But I keep going out of faith.

Kindness has no measure. I have faith the patient feels my compassion and concern. People don’t really remember what you say or do but how you make them feel when they are with you.

One daughter said to me regarding her mother, “It’s like she will die twice—the first time when she no longer remembered me and soon… forever. Because she is not gone yet, I keep coming.”

So do I.