In the era of modern medicine, a great many human afflictions can be treated, if not cured outright. Medicines easily defeat diseases that once would have killed us, while prosthetics and pain-relief drugs help us adapt to disabling symptoms and incurable illnesses. Dementia, unfortunately, remains neither curable nor especially treatable—and it is only getting more common as our population ages.
Dementia is especially fearsome in a culture like ours, one that treats autonomy as essential to human flourishing. Losing the ability to think and make rational decisions is always a profound loss, but it is especially terrifying for people who value independence so highly. Thankfully, Finding Grace in the Face of Dementia by physician John Dunlop is an excellent companion in thinking through the questions that dementia raises.
The first half of the book covers some basic theological precepts about sin, illness, and the body, as well as medical and scientific details about dementia. Dunlop then describes the daily experience of those who suffer from dementia and the people who care for them. Plenty of books and resources contain this sort of information, but this book remains immensely useful for anyone—pastors, family members, or even people in the early stages of dementia themselves—seeking basic facts about the disease and subjects like in-home care or nursing homes. Having spent many years caring for demented people at every possible stage, Dunlop helps readers step into the non-slip socks of a person with dementia and understand his or her frustrations and sorrows.
For the rest of the book, Dunlop asks whether we can find any grace in dementia. To do this, he first confronts the assumption that makes people queasy when they interact with someone who has dementia (or consider the possibility of developing it themselves): that human beings who have lost their intellectual capacity are aren’t quite fully human anymore. People might say, “He’s not there anymore” or “His soul is gone, but his body is still hanging on.”
Dunlop regards such sentiments as unbiblical. The human body and soul are always intertwined, he argues, even in the grip of the most horrific illness. Our surrounding culture (and, sadly, most popular medical ethics) treats rational thought and autonomous decision making as lynchpins of human dignity. But a Christian view of the body wholeheartedly affirms our intrinsic moral worth in the face of dementia. To fully respect and honor God’s fellow image bearers, we have to teach and preach that human dignity survives when the mind goes into decline.
Having emphatically rejected the possibility of euthanasia, it may seem curious that Dunlop argues against using feeding tubes for people with dementia who no longer eat. However, if dementia is a terminal disease and people too affected to eat or drink have reached its final stages, then withholding feeding tubes becomes a gesture of compassion. As Dunlop explains, “people in advanced stages of dementia stop eating because they are dying; they don’t die because they stop eating.” His perspective is similar on other end-of-life interventions: For people in the later stages of dementia, aggressive measures are often harmful.
Dunlop sees a strong role for the church in serving people with dementia. We can sing hymns and memorize Scripture that people will remember even when they have forgotten everything else. We can teach important truths about our bodies and souls that animate compassion for fellow human beings whose rational capacities are diminished. We can provide practical help to families overwhelmed by the physical needs of caring for someone with dementia. Dunlop expects that people with dementia and their families can grow in faith through the disease by God’s grace, but he also expects the church to come to their aid with theological and practical resources.
Is there grace to be found in dementia—in losing control of bowel movements or forgetting the names of children? Dunlop gives an emphatic yes. To find this grace, though, churches must form the sorts of people who will honor the dignity of brothers and sisters whose minds are lost. This book serves that preparation well, giving advice for some of the most practical problems while also wrestling some of the most serious spiritual issues. At the very end of the book, Dunlop quotes Philippians 3:21 (ESV), looking forward to the hope we have in Christ as the animating force behind our compassion for those with dementia: “[He] will transform our lowly body to be like his glorious body, by the power that enables him even to subject all things to himself.”
Matthew Loftus is a family physician who has practiced in West Baltimore and East Africa. You can learn more about his work at matthewandmaggie.org.
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