The Dementia-Friendly Church

How to Get Started

Help the church staff, volunteers, and others understand how dementia affects a person physically, emotionally, and mentally. Understanding dementia goes a long way toward making a church more dementia friendly. Training in the illness’s progression and the various types of dementia is a great place to start. Invite representatives from the Alzheimer’s Association to speak to the leadership team at the church council meeting or to the entire church during the midweek fellowship meal. While it is nice to have as many people as possible be aware of what it takes to be a dementia-friendly church, the most important people to reach are the professional staff and key church leaders.

Five key areas are affected by dementia. Training should include how to design programs that take these 5 key areas into consideration:

• Judgment: For example, forgetting to turn off the stove or making irrational decisions.
• Time and Spatial Relationships: Getting lost or being unable to recognize where they are.
• Unusual Behavior: Being agitated or fearful.
• Physical Challenges: Having difficulty with balance and hand-eye coordination.
• Decline in Sensory Perception: A decline in vision or hearing or depth perception; sensitivity to temperature.

Church leaders should not only be aware of the changes dementia creates, but also how to look for the characteristics of dementia. Such changes may happen quickly, and leaders need to be flexible if their churches are to be perceived as dementia friendly.

Take Action to Become a Dementia-Friendly Church

The next step to become a fully welcoming church for those with dementia is to evaluate the current settings and programs. Dementia caregivers and maintenance staff should do an environmental assessment. Involving caregivers in the process conveys support and acceptance. At the end of this article is a checklist for making such an assessment. Evaluations should include the following:

• Assess physical settings. Look around the building for objects that could cause injury or be hazardous for those who have physical challenges, difficulties in judgment, or declining sensory perception. Identify areas of possible danger. Look for dangerous areas such as steps, HVAC, kitchen, and restroom areas. Look at areas that might affect sensory perception -- lighting, sound systems -- and areas that might cause a fall. Focus on adaptions the church can make rather than expecting a person with dementia to make the adaptations.
• Simplify activities and programs: Break up activities into simple, step-by-step tasks, and allow individuals plenty of time to complete them. Have extra help available for tasks that may be difficult for people who have dementia. Respect the dignity of all by not asking dementia sufferers to do complicated or public tasks they are unable to complete successfully.
• Support the individual’s reality. This is called validation. If, because of memory impairment, a person begins to live in an earlier life stage or forgets key details of his/her life--do not correct the memory unless the person is in danger. For instance, if a wife is looking for her husband who is deceased, do not correct her by saying, “He died a long time ago.” Monitor behavior, especially the tendency to wander, and gently reorient the person with dementia to different locations or to the activities of the group.
• Affirm individuals and their gifts, but note their limitations. Encourage church members not to condemn the mistakes of those with dementia, but to acknowledge they still have gifts to offer the community. Remember, the point of being a welcoming church for those with dementia is to prolong their active relationship within the body of Christ and to encourage their growth in faith with Christ. Yes, even those with dementia can still have a growing faith. It is okay to celebrate the relationship that has been, even if it is changing daily because of dementia.
• Anticipate Challenges. It’s impossible to prevent every problem from arising, but anticipating the challenges is important. For example, some who suffer with dementia are prone to wander, so providing alarms on doors is one solution. Another approach would involve covering doors that lead outside with a mural that looks like a bookcase (The Alzheimer’s Store, www.alzstore.com, is a source for products designed for people with Alzheimer’s and dementia.)

Put It All Together

The final step in becoming a dementia-friendly church is to look for new ways to include those with dementia and their caregivers in the life of the church. The Office on Aging and Older-Adult Ministry has resources to assist churches desiring to become more dementia friendly. Many of our churches have older adults that currently suffer or will suffer from Alzheimer’s and other forms of dementia, so preparation is important. Churches that desire to be dementia friendly will begin to plan now even before they have a number of members with dementia present at worship and church programs. These churches will continue to seek better ways to minister to those with dementia. A list of a dozen ideas of targeted programs for those with dementia and their caregivers is listed at the end of this article.

Dementia-Friendly Church Checklist

_____1. Are all areas of the church clutter-free, well lighted, and mapped out or marked where they lead? Are there adequate storage places available for unused items? Is there a process for checking to make sure items are put away when they are not in use in public areas?

_____2. Are classrooms free of complicated and misleading stimuli? Have you minimized background noise (radio, TV, computer, overhead speakers)?

_____3. What are the expectations of caregivers when church members visit their family member who has dementia? Are caregivers’ needs being met with support groups? Are respite programs available? What strategies have been developed to deal with behavioral difficulties of those with dementia?

_____4. Have you simplified tasks and directions so that everyone, including people with dementia, can follow them?

_____5. In what ways is the church engaging people with dementia to prevent boredom, depression, and agitation while they are present? In what ways are church programs helping members with dementia experience service to others, purpose, joy, and hope? How can the skills and abilities of those with dementia be best used during their time at church to give them a sense of being normal?

_____6. What activities does the church offer that help to maintain the current cognitive function and spirituality of members with dementia? What new activities could a church offer, such as art therapy or dementia-oriented worship, which could be a family event?

____7. What role can the church play in preserving the history and relationship of people with dementia with other members of the church? (For example, recording their memories before they are lost.) What opportunities exist to help those with dementia continue to express who they have been in life? Do activity designs allow people to be remembered for who they are, and not for their illness?

____ 8. What is a church’s “Plan B” for ministering to members with dementia and caregivers when they are no longer able to continue to participate in church activities? How will the church continue to minister effectively to, for, and with members when they become homebound or move to a skilled medical center?

____9. Have you completed educational programs and training for leaders about dementia? Have you taken into consideration the needs of church members with dementia and their caregivers?

____10. Has a careful study of the building and grounds been undertaken? Have the following areas been checked?

Restrooms
Have you set the hot water heater temperatures at 100˚F or lower? Have you installed grab bars? Have you added textured stickers to slippery surfaces? Have you removed locks from the bathroom doors?

Kitchen
Is there a designated area for storage of cleaning supplies that is kept locked? Can electricity be turned off to the garbage disposal and any appliances when not in use? Are knives and other utensils stored in locked areas? Can appliances such as toasters, microwaves, and blender be locked up or turned off? Can gas service to gas appliances be switched off when not in use? Or can the stove be connected to a hidden gas valve or electric switch, so it is impossible for it to accidentally be turned on? Is there a fire extinguisher nearby? Are the refrigerators cleaned out regularly?

Storage areas.
Is there a plan to ensure that doors to storage areas are locked from the outside? Are tools such as drills, axes, saws, and picks locked up? Is there only limited access to large equipment, such as lawn equipment? Are all poisonous chemicals, such as paints and cleaners, locked up?

Throughout the church.
Have you disguised doors or set door alarms to the outside to prevent people with dementia from wandering? Have you removed or taped down throw rugs? Have colored stickers been applied to large windows and sliding glass doors? Have you removed poisonous plants or other items that might accidently get eaten? Is there sufficient lighting near doorways, stairways, and between rooms? Have you removed objects that block walking paths?

A Dozen Quick Ideas to become a More Dementia-Friendly Church.

1. Host Alzheimer’s and dementia caregiver’s support group meetings. (Group leader training is available free through the Alzheimer’s Association, www.alz.org).
2. Offer a monthly respite time or day for caregivers of members with dementia. Include activities for those who have dementia besides sitting, sleeping, or watching television.
3. Help people with dementia and caregivers look good by sponsoring a quarterly makeover day with area volunteers and cosmetologists.
4. Offer a weekly or monthly special worship service for members with dementia, or designate special Dementia Sundays where the main worship service is designed specifically for those with dementia. Include familiar hymns rather than new ones in the service. (Resources are available from the Office on Aging and Older-Adult Ministry.)
5. Look for talents and abilities in people with dementia that they can develop and share with other people in the church. Affirm them in performing their service by acknowledging and thanking them before the entire church.
6. Train church leaders and members in dementia awareness and strategies for dealing with potential challenges that might arise.
7. Offer a Memory Café (see “Are Cafes the Leading Edge of Older-Adult Ministry?”), where the memory-impaired and their caregivers can gather to remember. Consider a workshop on making memory boxes for members with dementia and their caregivers.
8. Have leaders of the church agree to and sign a code of behavior for interacting with members with dementia. (Examples of this would be listening patiently when members with dementia tell the same story over and over again; listening to what people with dementia are saying; avoiding correcting people with dementia when they do something improperly.)
9. Offer a resource or reading center on dementia as well as a dementia newsletter with a review of some of the latest news on Alzheimer’s. (This information can be obtained by joining US Against Alzheimer’s and signing up for daily updates.)
10. Develop a visitation team to visit members with dementia when they become homebound or move to a skilled medical center. Include regular Communion delivery and videos of worship services in the visits.
11. Research, develop, and print a community resource guide for caregivers of those who have dementia.
12. Develop a daily or weekly prayer chain and checking-in program for the families and caregivers of those who have dementia to minister to their mental, emotional, and spiritual well-being.