People with Dementia and the Local Church


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QUESTION & ANSWER FORUM

This question and answer forum is now closed to new questions.

These questions have been sent in to us - all replies will be forwarded to the individual sender and then published here, so that we can all benefit from people's views.



Question:   I was surprised that there was no mention of pets in the book; I was under the impression that they could provide a welcome stimulus for people with dementia - is that correct? (From: PG)
Response:  You are quite right, and there really should have been a short section on the value of pets.   Cats and dogs (in particular) can provide companionship and a relationship that depends neither upon speech nor upon intellectual engagement.   There is often a sense of deep unconditional acceptance, and the opportunity for physical contact which can be very important, especially if the person with dementia lives alone.   As the condition advances, however, there may be problems relating to feeding, cleaning and exercising if the person lives alone and is responsible for these things.   Many Nursing Homes welcome visitors who can bring a dog - but it is best to check this out first!

See also Pets and the Elderly - the therapeutic bond by Odean Cusack & Elaine Smith The Haworth Press, NY, 1984


Question:  I know that there is a great deal that churches can do in trying to understand and ensure that people with dementia are welcomed in our churches, but is there anything that we ought to be thinking about to make sure that our actual buildings are dementia-friendly?
Response:  In the UK, the Disability Discrimination Act requires from the autumn of 2004 that all public buildings are accessible to people with disabilities.  Cognitive impairment (resulting from dementia, learning disability and brain damage etc) is generally not mentioned.  However, buildings can be made more accessible for this group of people.

  1. Use good clear signage incorporating an easy to understand picture and words (capitals and lower case)
  2. Make important doors (eg toilets) conspicuous
  3. Do not just rely upon colour for orientation. Use colour contrast (e.g. for toilet doors) and landmarks (furniture, pictures, objects).   Then people can find their way by remembering to turn right when they reach that picture, or particular object.   Do not rely upon memory to reach 'difficult' decisions - such as the way to the toilet or the hall . . .
  4. Improve the lighting - the better the lighting the more helpful it is for people with dementia.  Ensure that there are no dark passages to go through after being in a bright area.
  5. As far as possible reduce distracting noise.  People with dementia find it more difficult to 'filter out' non-essential stimuli
  6. Use glass wherever possible - glass panels in doors, glazed walls etc.)   This reduces the element of fear as to what is beyond them and lessens the likelihood of being taken by surprise
  7. Conceal unimportant doors by painting them the same colour as the walls, and extend the hand-railing or skirting boards accordingly.   In this way a cleaning cupboard, for instance, merges into the background
  8. Ensure that there is a colour contrast in toilets (seats must contrast with the pan and floor and cistern)
  9. Use easy to understand fixtures and fittings (toilet roll holders, soap and towel dispensers, flushes and light switches)
  10. Keep the floors the same colour and ensure that the edges of steps and stairs have a bright nosing.
(based upon advice given by Professor Mary Marshall of the Dementia Services Development Centre, Stirling University)


Question:  Should people with dementia attend the funerals of loved ones?
Revd Paul Wilson, Methodist minister and associate member of the Christian Council on Ageing Dementia Group writes:  Recently, I have been reflecting on the care given to those with dementia at times of bereavement. In conversation, many family members conclude that it would be inappropriate for the dementia sufferer to attend the funeral for a variety of reasons:
  1. The person is too ill.
  2. The person is not aware that their loved one has died.
  3. The person's presence would inhibit the family's grieving process.
  4. The family are afraid of inappropriate behaviour at the funeral.
These pastoral issues need to be carefully considered without anyone feeling guilty but rather enabling them to feel that they have cared for the one with dementia. The last two bullet points may be overcome by the presence of the principal carer from the residential home or day care.

I now offer a service with the person living with dementia at their home at a suitable time. Where the person has been too ill to attend the funeral but was aware that their loved one had died, it helped the family to have a service at the bedside on the day of the funeral. This involves taking the service sheet, perhaps listening to a tape of the hymns, reading the lesson, showing and talking about pictures and offering prayers. The families feel that their loved one has had the opportunity to grieve, say farewell and experience the pastoral care of God. Continued visits by family and myself have indicated that the one with dementia remembered this.

Where it has taken time for the one with dementia to realise that their loved one has died, I lead a short service in their room when the family consider the time is right. By talking about the spouse, an expression of love and remembrance can be made and confirmation that the loved one has died. Prayers, readings and a shared saying of the Lord's Prayer held the person in the love and care of God. The family were pleased to have shared in a joint act of remembrance and not to have excluded their loved one.

I offer these reflections as a way forward in enabling the one with dementia to grieve. The remembrance may soon be gone, but at the time the person and the family feel that an opportunity for grieving and pastoral care has been given.

If you have any further reflections on good practice I would be privileged to hear of them at revpwilson@msn.com




Question:   Do you know of any work that's been done about including people with dementia in Quaker worship?  (From: JG)


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