- Grief and loss are spiritual concerns for those with dementia. Because of an altered sense of time, a confused person may experience grief from previous years as intensely as if the loss had just happened. Validating the moment, hearing of their sadness is critically important. In the early stages of dementia grief is common. The patient is aware of their situation and their inability to do certain tasks. Besides the grief of the patient, there is also the grief of family members and caretakers. The role of the chaplain is not to solve the issues but to listen and be a support.
- Anger. It is not uncommon for those with dementia to be angry at the situation which they find themselves in. Often they know they are angry but do not know why or what to do with that anger. Sometimes the anger is addressed to family members who are the primary caretakers. Often the family are viewed as the enemy. Sometimes the anger is addressed toward God. Again the role of chaplain and caretakers is to listen. Don’t say “don’t be angry.” What the patient wants and needs is someone to listen to them.
- Simplify. As the dementia progresses this becomes very important. Focus on one thought, theme, or topic. Do not bombard the patient with questions. Use familiar prayers, hymns and readings. Touch the patient if they allow you to do so. Sometimes the most important ministry to a hospice patient with dementia is a ministry of presence. This becomes critical when the patient cannot longer speak. At times this ministry of presence may take the form of walking up and down the hall with the individual, or sitting next to them in the dining room or quietly sitting next to their bed.
- Music is an important gift to be used. We know that one of the last parts of our memory to be lost is musical memories and religious memories. If you can, sing to and with the patient. Use music to calm the patient during “sun downing.” Use music at the bedside of the dying patient. Remember to use music that the patient is familiar with.
- Be flexible. Expect the unexpected, do not be embarrassed or shocked at what the dementia patient may do or say.
- Keep a sense of humor. It will help you survive the difficult days.
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