אלקי נשמה שנתת בי טהורה הוא
God, the soul that you have implanted
in me is pure
- Jewish morning liturgy
I have spent
quite a bit of the past year doing per-diem chaplaincy in hospice. A
significant percentage of my patients suffer from some form of dementia or
mental deterioration.
Dementia is
a catch-all category which includes a lot of behaviors: Some patients can carry
on perfectly “normal” conversations that are very out of touch with reality;
others say nonsensical words; yet others are withdrawn or angry and do not
speak at all.
What is
common with all of my patients who suffer from the various forms of dementia is
that they are still fully human beings. Our liturgy, which includes the above
quote as part of the morning blessings upon waking, makes it clear that despite
what physical and mental deterioration we all experience, the soul that God has
given each of us is pure and undiminished at all stages of our lives.
Those of us
who minister to dementia patients ought to have this part of the Jewish liturgy
first and foremost in our minds every time we enter a patient’s room.
Chaplains, who deal with matters spiritual, must be aware that in each and
every dementia patient we serve, there is an undiminished spirit, and conduct
ourselves accordingly.
Additionally,
clinicians must be careful not to write off all patient behaviors as symptoms
of dementia. Since an undiminished spirit still resides in each patient, they
are subject to illnesses such as depression, which in at least some cases has a
strong spiritual component. Clinicians ought to do a better job screening even
dementia patients for mental illness including depression, which is sometimes
treatable with medication. This can significantly improve quality of life for
some patients and help to make the other symptoms of dementia much more
tolerable.
