Events

An objective of the Dementia Resource Series is to offer ways for pastors and worship leaders to connect with those with dementia in worship. Duke Divinity Professor, Lester Ruth, offers his perspectives in “A Letter to My Pastor: If My Mind Should Start to Slip, What to Do with Me in Worship.” This letter is a personal reflection of what Ruth would want from his pastor should he be diagnosed with dementia.

Following the letter, Ruth reviews the book, Dementia-Friendly Worship: A Multifaith Handbook for Chaplains, Clergy, and Faith Communities. We hope you find value in each of these offerings as you serve your congregation.

A Letter to My Pastor: If My Mind Should Start to Slip, What to Do with Me in Worship

Dear Pastor,

As I’ve discussed with you, dementia and Alzheimer’s run very strongly in my family. Because of that, it’s hard for me to not see it as a genetic disposition which is likely to rise up and capture me. I—and you—should not be surprised if one day my mind starts to slip. And, as you know from being my pastor, the worship of God is very important to me, whether personally or professionally. And so, I write this letter in the hope that my mind and memory will escape the clutches of whatever disease would want to ensnare them, but also in the realization that the day may come nonetheless. If that day should come and my mind begins to dull, even as God’s grace remains sharp in all its mercy-filled clarity, here are some things I would like for you to keep in mind as you continue to minister to me.

Know and use my heart songs. There’s something magical about the way a song can continue to hold its grip on us—and vice versa—even as remembrance of other things fade. Let’s talk now about what worship songs and hymns have penetrated deep into my soul. Let me tell you how each have been windows into heaven and the ways of God in Christ. Keep a list. And use the songs off of that list in the future. I have already invested deeply in my heart songs. Using them will enable me to continue to participate in worship even if outwardly my capacities seem diminished. My lips may become faltering, my concentration distracted, my gaze vacant, but, as St. Augustine said about worship music, the one who sings loves God. I want that to still be me.

Likewise, know and use my heart scriptures. (Colossians and its vision of Jesus Christ is a particular favorite, by the way.) Like songs, I have tucked away certain passages into my spirit as the cornerstones of my spirituality. My mind may lose its ability to do crystal-clear exegesis so that I could preach on a particular passage, but my heart will still be engaged by hearing the scriptural story that expresses how I know of God’s love for me in Jesus Christ and gives me the reasons for which I love God.

However, even as you utilize materials drawn from deep in the wells of my own spirituality, do not forget this non-negotiable reality: my worship is not just my worship. I am a baptized member of the Body of Christ, the Church which is unified with Jesus Christ, its head, and extends across time and space. Make sure there is a breadth and balance so that saints from across time and space can likewise say “Amen” to the worship you’re leading me in. As a pastor and worship professor, I’ve long railed against congregational worship in which a congregation’s worshipers are fooled by thinking that the only criteria to be used in assessing their worship is whether it fits them or not. In the words of our own Communion prayer, let us join in the worship of all God’s “people on earth and the entire company of heaven.” Perhaps the best way to ensure this breadth is by using acts of worship that are the common treasure of the whole church that I already know, things like the Lord’s Prayer, the Te Deum, and the Apostles’ Creed.

Speaking of the Lord’s Supper, don’t forget it. I’ve always chuckled when folks have suggested that perhaps children shouldn’t receive because they don’t fully understand it. To me, that’s like saying we shouldn’t draw life-giving water from a bottomless well just because we can’t see the mysterious origins of the water. Children don’t understand? If they do understand anything, it’s the value and necessity of eating. They come from the womb with that primordial instinct and capacity. And so, don’t forget the Lord’s Supper. Feed it to me, and give thanks and praise to God while doing so. Again, as the prayer says, it is always good and right to do so. I trust that somewhere in my memory-dulled brain, I will still acquiesce and understand.

Tell me the stories of Jesus. I have intentionally chosen the lyrics of an old hymn here, one that in my youth was taught to us as children. Do not allow your theological sophistication to lead you to underestimate the power of these stories. I’ve long regretted something that seems to occur way too often in church: we assume the stories of Jesus are for children while adults should be chewing on more sophisticated concepts. Beyond the questionable logic of this perspective, the stories of Jesus could still be useful to me as my mind regresses toward its capacity when I was extremely young. Do not think that it is a bad thing to become more child-like. Jesus welcomed and blessed the children. Even though my body is old, perhaps my mind will regress toward its infantile beginnings. My Methodist roots give me hope here. “All” is one of the favorite defining words in this tradition’s spirituality: what Christ has done he has done for all, even those of us whose bodies speak old age but whose minds have slipped toward its beginnings. When doing field placement in seminary, I was once called up to preach at a large institution for folks with a variety of mental incapacities. All I could think to do was use an old-time flannel graph and tell the stories of Jesus. I was struck by how the “congregation” was able to help me fill in the details of the stories and loved doing so.

And, while you are telling me the story of Jesus, tell me the big story of Jesus, too. Don’t let yourself get so caught up with the trees of what Jesus did that you fail to name for me the big picture of the forest. For example, I’ve always been struck by the Eastern icon of the resurrection of Jesus in which the ascending Jesus is also elevating Adam and Eve as he rises from the grave. Remember to keep telling me such a cosmic story. Name for me that what God is accomplishing in Jesus Christ—and will accomplish—will be nothing less than a new heaven and a new earth, one in which, following the path of the new Adam (Jesus Christ), we will inhabit resurrected, spiritual bodies, raised in glory and power. (Did I mention I have heart scriptures? I Corinthians 15 is also one of them!) Even though I might not fully comprehend, other worshipers will. This large vision will give them hope, a hope that will not disappoint, even though that dawn of new beginnings is a ways off. Don’t let any sadness arising from my condition squash hope.

Be patient with me as you lead me in worship. Based on my own observations of family members and others with diminished capacities, the brain knows it needs to try to put things together into a coherent whole, but will struggle to do so. Use gentle wisdom about knowing when to step in and offer the verbal tap so my brain can make the right connection. It can be a gift to help someone caught in the trap of frustration when they know there is a connection to make but are unable to do so.

Finally, remember that love is not necessarily a function of memory, and that love is the critical thing in worship. When in doubt, use your creativity to find ways to help me love God and love my neighbor.

I close by asking you not to be scared or overwhelmed. Trust your gut. Pray like crazy. And, ultimately, rely upon God, who not only desires our worship but who, in Jesus Christ, has provided that which is needed to carry it out in spirit and in truth.

Sincerely, your trusting parishioner, Lester Ruth

To the readers of my letter:

It is very important to remember there is no absolute, set formula, one one-size-fits-all type of worship service for those with dementia. Consequently, do not take my letter as a set-in-stone, mandatory template. Those who work with these kinds of worshipers affirm the need for a variety of approaches and expectations. To see the breadth of ways to minister, a very helpful book is Lynda Everman and Don Wendorf, eds., Dementia-Friendly Worship: A Multifaith Handbook for Chaplains, Clergy, and Faith Communities (Philadelphia: Jessica Kingsley Publishers, 2019). The realization that flexibility is needed in ministering to those with dementia or Alzheimer’s is one of the biggest takeaways from this useful book. As one of the essays in the book says, “If you’ve seen one person with dementia, you’ve seen…one person with dementia.” (p. 135)

The book has several different sections, all useful in their own way, from an overview of what dementia might involve, to articles from those with dementia to some degree, articles sharing strong practices, and essays to guide you in leading your congregation to minister to those with dementia. In the book, you can see examples of those who discovered they had to shift their approach over time, not only to connect with a variety of persons with dementia and Alzheimer’s but also because the progress of the disease can mean a worshiper’s capacities might continue to change, too.

The book is not always highly technical. Indeed, some of its most useful moments are when it highlights the wisdom of simple things and principles: expect the unexpected; not only do our brains have memories but our bodies do, too; it is not only the mouth that can express language but our bodies can “talk,” too; or simplicity and repetition in words and patterns are likely to help.
 
The book is a good, insightful resource, and I recommend it.

Lester Ruth, Professor of Christian Worship, Duke Divinity School