Ministry to Persons with Dementia

COMPASSIONATE MINISTRY to PERSONS with DEMENTIA
A Traditional Christian Perspective

Eli the Priest & his Sons, Phineas and Hophni

The Winchester Psalter, 11700

1. THE ELDER in CHRISTIAN TRADITON

1.1 MODELS of STRENGTH

LEADERSHIP
WISDOM
COUNSEL
EXPERIENCE
AUTHORITY


ST. ELIZABETH, Dürer, 1520	ST. ANNE, Dürer, 1520


SISTINE CHAPEL, Michelangelo, 1510	GOD THE FATHER, Illum.MS., 1430

EXODUS 20:12

HONOR your father and your mother, that your days may be long in the land which the LORD your God gives you.

ΤΙΜΑ τὸν πατέρα σου καὶ τὴν μητέρα ἵνα εὖ σοι γένηται καὶ ἵνα μακροχρόνιος γένῃ ἐπὶ τῆς γῆς τῆς ἀγαθῆς ἧς κύριος ὁ θεός σου δίδωσίν σοι

כַּבֵּ֥ד אֶת־אָבִ֖יךָ וְאֶת־אִמֶּ֑ךָ לְמַ֙עַן֙ יַאֲרִכ֣וּן יָמֶ֔יךָ עַ֚ל הָאֲדָמָ֔ה אֲשֶׁר־יְהוָ֥ה אֱלֹהֶ֖יךָ נֹתֵ֥ן לָֽךְ׃ ס

HONORA patrem tuum et matrem tuam ut sis longevus super terram quam Dominus Deus tuus dabit tibi.

SIRACH 7:27

WITH all your heart honor your father, and do not forget the birth pangs of your mother.

ΕΝ ὅλῃ καρδίᾳ σου δόξασον τὸν πατέρα σου καὶ μητρὸς ὠδῖνας μὴ ἐπιλάθῃ

IN toto corde²⁹honora patrem tuum et gemitus matris tuae ne obliviscaris

SIRACH 3:8

HONOR your father by word and deed, that a blessing from him may come upon you.

ΕΝ ἔργῳ καὶ λόγῳ τίμα τὸν πατέρα σου ἵνα ἐπέλθῃ σοι εὐλογία παρ᾽ αὐτοῦ.

IN opere et sermone et omni patientia honora patrem tuum ¹⁰ ut superveniat tibi benedictio a Deo et benedictio illius in novissimo manet

1.2 MODELS of FRAILTY

LIMITATIONS
WEAKNESS
DEPENDENCY
SHORTSIGHTEDNESS
PERSEVERATION (tendency to repeat onesself)
FAILING MEMORY
FAILING INTELLECT


DEATH of ST. JOSEPH, Cano, 1560	ELI and his SONS, Winch.Psalter, 1170

DORMITION of MARY, Cano, 1560

THE NEED for COMPASSION in the WAKE of the NATURAL REACTION of FRUSTRATION

PROVERBS 23:22

LISTEN to your father who begot you, and do not despise your mother when she is old.

AΚΟΥΕ υἱέ πατρὸς τοῦ γεννήσαντός σε καὶ μὴ καταφρόνει ὅτι γεγήρακέν σου ἡ μήτηρ.

AUDI patrem tuum qui genuit te et ne contemnas cum senuerit mater tua.

שְׁמַ֣ע לְ֭אָבִיךָ זֶ֣ה יְלָדֶ֑ךָ וְאַל־תָּ֜ב֗וּז כִּֽי־זָקְנָ֥ה אִמֶּֽךָ׃

SIRACH 3:12

O SON help your father in his old age, and do not grieve him as long as he lives;
even if he is lacking in understanding, show forbearance; in all your strength do not despise him.
For kindness to a father will not be forgotten, and against your sins it will be credited to you.

ΤΕΚΝΟΝ ἀντιλαβοῦ ἐν γήρᾳ πατρός σου καὶ μὴ λυπήσῃς αὐτὸν ἐν τῇ ζωῇ αὐτοῦ
κἂν ἀπολείπῃ σύνεσιν συγγνώμην ἔχε καὶ μὴ ἀτιμάσῃς αὐτὸν ἐν πάσῃ ἰσχύι σου
ἐλεημοσύνη γὰρ πατρὸς οὐκ ἐπιλησθήσεται καὶ ἀντὶ ἁμαρτιῶν προσανοικοδομηθήσεταί σοι

FILI suscipe senectam patris tui et ne contristes eum in vita illius ¹⁵ et si defecerit sensu veniam da et ne spernas eum
in tua virtute elemosyna enim patris non erit in oblivione

1.3 THE TRANSITION from STRENGTH to FRAILTY


DECMBER 1999	NOVEMBER 2014


DECEMBER, 2014	JUNE 2015

2._A_DESPAIRING_CULTURE

2. A DESPAIRING CULTURE

2.1. DESPAIR and MEANINGLESSNESS as CULTURAL NORMS


Friedrich NIETZSCHE	Jean-Paul SARTRE

2.1.1. MODERN MASTERS of SUSPICION

1. IMPOSE OWN MEANING WHERE NONE EXISTS [Nietzsche]
2. OR EMBRACE DESPAIR as HEROIC

2.1.2. ARTISTIC/LITERARY/CULTURAL Preference for the “gritty,” “morally ambiguous,” “dark,”

So-called HEROES “unencumbered by traditional morality”
= PSYCHOPATHY

BENUMBED CONSCIENCES, UNABLE to PERCEIVE or ADMIT WRONG

Allen, Maciel, Mercieca

2.1.3. PSYCHOTHERAPIES that encourage resolutely turning away from questions of ultimate concern because there is no answer to such questions

2.2. A BROKEN OPERATING SYSTEM

PSYCHIC OPERATING SYSTEM always primed to believe the WORST about the SELF

Original sin in Catechism as predisposition to be afraid, mistrustful of God [and others]

2.3. ALTERNATIVES

DANTE and the DIVINE COMEDY

ACKNOWLEDGE and PROCLAIM JOY and GRACE

Pope Francis in YEAR of MERCY” recommends reading Dante's Divine Comedy
– but don’t spend time in Inferno

NEW APPROACHES to MENTAL HEALTH::

“POSITIVE PSYCHOLOGY” not based on pathology/disease-model, but rather traditional (classical) model of virtues/

3. THE SIGNIFICANCE and INEVITABILITY
of DEATH

3.1 DEATH as RELEASE from SUFFERING

A PAINLESS DEATH AS CONSOLATION

LEGAL EFFORTS to AVOID SUFFERING:

Advance Directives
POLST

FEAR of an UNPREPARED DEATH:

Contrast between older model where prayers and litanies against sudden, unprepared death, versus modern fear of lingering suffering – preference for “it was quick – [s]he did not suffer”

DESIRE FOR SACRAMENTAL PREPARATION

Ars Moriendi; Deathbed Anointing

PALLIATIVE CARE and PREPARATION of FAMILY and PATIENT

3.3 CHRISTIAN CONVICTION of DEATH as POSITIVE – JOY of HEAVEN

ORIGINAL EMPHASIS in Early Church of Nearness of Kingdom of Heaven

Apocalypse - John's meditation

Eschatology; Dante’s Celestial Rose

Kingdom of Heaven as Dynamic Basis of Evangelization

THE CELESTIAL ROSE and THE BLESSED TRINITY

THE CELESTIAL GARDEN

THE GARDEN of THE BLESSED TRINITY

3.4 THE UNCOMFORATBLE ISSUE
of OUR OWN MORTALITY

MODERN FEAR of DYING, is not necessarily FEAR of DEATH

Increasing secular conviction of RIGHT to AVOID LIMITATION, DEPEDENCY, DETERIORATION

DEMENTIA as DISTURBING SIGN of WHAT WE MOST FEAR

FOR family members, to visit a person with dementia is to visit their own future. (Swinton, Dementia: Living in the Memories of God)

CAREGIVERS and FAMILES of PATIENTS with DEMENTIA GO THROUGH KÜBLER-ROSS’ FIVE STAGES of GRIEF

(EVEN if AFFECTED PATIENT DOES NOT)

because they are unswervingly and undeniably confronted with death and limitation in a way only a little less would/will be in own situation.

DENIAL
ANGER
BARGAINING
DEPRESSION
ACCEPTANCE

4. DEPRESSION in the ELDERLY
and in THOSE WITH DEMENTIA

4.1. OUR PERENNIAL TENDENCY
to BELIEVE the LIE of MEANINGLESSNESS

DÜRER, Melancholia, 1541

DÜRER, Melancholia, 1541: Faces of the Angels

INSISTENT LIE of MEANINGLESSNESS - EMPTINESS

Depression as Capitulation to underlying “faulty operating System” of Human Psyche

Universal, cross-cultural phenomenon to which all are subject if life circumstances impinge and/or brain chemistry conspires

4.2. THE NORMAL HUMAN RESPONSE
to SADNESS and DEPRESSION in ANOTHER

NORMAL HUMAN RESPONSE to Depression/Sadness in Another:

= Initially, CONCERN

Then DISTANCE and AVOIDANCE if prolonged

Depression as Reasonable Reaction to False Belief in EMPTINESS / MEANINGLESSNESS

5._ASSERT_MEANING_HOPE_JOY

5. WE MUST ASSERT
MEANING, HOPE and JOY

5.1. DANTE and THE WATERS
of LETHE and EUNÖE

DANTE INVITED TO DRINK from LETHE
Amos Nattini, (1892-1980) 1936

Gentle Persistent Confrontation with Waters of LETHE and EUNÖE

Realistic Highlighting of GOOD in Present and Past despite negative, repetitive RUMINATING on NEGATIVE

5.2. WE NEED to RESPOND
to PHYSICIAN-ASSISTED SUICIDE


DEATH of JOSEPH, Giantonio, 1727	JEAN VANIER, Founder of L'Arche

1. Value to Wider Community of Care for dependent / Disabled (Vanier, L'Arche)

2. Actual Subjective Experience of Those with Disability / Dependency IS NOT SAME as Able-Bodied / Independent who imagine what such a life might be like (for them or for others)

3. Dependency, Increasing Disability as form of” letting go” – preparation for life to come

ASSERT MEANING, HOPE, JOY for THEM

6. THE SPIRITUAL WORTH of THE
WHOLE PERSON in the LIGHT of ETERNITY

Aquinas and Eternal Life: (Summa Suppl. §79-85): All that is essential to the Person Will be restored in the World to Come.

Benedict XVI and ETERNAL LIFE

6.1. WE DO NOT SEE THE WHOLE PERSON
– ONLY A BRIEF TWO-DIMENSIONAL TIME- FRAME

CONTEMPLATE THE WHOLE PERSON

THE EUCHARIST as KEY: Faith that in what looks and tastes like bread and wine is a Reality greater then the whole Universe. What appears to be LIMITED is actually UNLIMITED and PERSONAL in ESSENCE

WE LIVE FOREVER in the MEMORY of the GOD WHO NEVER FORGETS US

6.1. PURVEYORS of WATERS of LETHE and EUNÖE

WE BECOME GUARDIANS of THE MEMORY AND IDENTITY of the AFFLICTED

WHAT THEY CAN NO LONGER ASSERT or RECALL, WE CAN ASSERT

GREGORY the GREAT on FRIENDSHIP:
THE FRIEND is CUSTOS ANIMAE
(GUARDIAN of the SOUL)

SHOW HOSPITALITY and KINDNESS to the "STRANGER" WHO SEEMS to have TAKEN the PLACE of the PERSON I LOVE

ISAIAH 54:11-14

O AFFLICTED one, storm-battered and unconsoled,

BEHOLD, I lay your pavements in carnelians, and your foundations in sapphires;

¹² I will make your battlements of rubies, your gates of carbuncles, and all your walls of precious stones.

¹³ All your sons shall be taught by the LORD, and great shall be the peace of your children.

¹⁴ In justice shall you be established, far from the fear of oppression, where destruction cannot come near you.

The Easter Vigil, Reading Four_

BOOKS by JOHN SWINTON

Dementia: Living in the Memories of God, (Eerdmans, 2012) ISBN-10: 0802867162.

on the Value of Stories and “Counter Stories” (stories that help us distinguish what is not real or true)
Persons with dementia lose the ability to tell their own stories (pp.21-23)

(ed.) Spirituality and Mental Health Care (Kingsley, 2001)

(ed.) Spiritual Dimensions of Pastoral Care, (Kingsley, 2004)

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