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. REINFORCING DUTY 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 Alzheimer’s Disease (62%) Vascular Dementia (17%) Dementia with Lewy Bodies (4%) Other Causes (3%) Mixed (10%) Fronto- temporal Dementia (2%)

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.