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January 14, 2011

Blessed Are Those with Alzheimer's

Discovering God’s image in a nursing home called “The Beatitudes.”

Amy Julia Becker

Americans are living longer and longer. For many individuals, this comes as good news, and yet for the larger culture, it brings social change, significant increases in health-care costs, and a higher prevalence of diseases such as Alzheimer’s. According to the Alzheimer’s Association, 5.3 million Americans currently have Alzheimer’s, but the disease impacts an even greater swath of the population. Nearly 11 million unpaid caregivers (many of them women) often work around the clock to try to understand and deal with the impact of dementia on family members.

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Recently Pam Belleck reported on a novel approach to Alzheimer’s care in the New York Times. Her article “Giving Alzheimer’s Patients Their Way, Even Chocolate,” focused on a nursing home in Phoenix, Arizona. This nursing home has served elderly men and women with dementia for decades, and in recent years the staff implemented a series of measures to care for their patients more effectively. At first glance, their approach appears indulgent, even potentially harmful. As Belleck writes, patients “are allowed practically anything that brings comfort, even an alcoholic ‘nip at night.’” They eat whenever they want and whatever they want—chocolate, bacon, and so forth. The state of Arizona resisted, and even tried to regulate, many of The Beatitudes unconventional methods. But over time, this small facility, with only 30 patients, has become a model for individual caregivers and institutions alike.

The New York Times’ article did not mention the origins of The Beatitudes and their ethos, but the name alone suggests the Christian roots of the institution. “The Beatitudes,” of course, refers to Matthew 5, the beginning of Jesus’ Sermon on the Mount, in which he proclaims God’s blessing upon “the poor in spirit,” “those who mourn,” and “the meek” (among others). According to The Beatitudes’ website, the facility began in the 1960’s as the response of a church congregation to the need for a welcoming retirement community. In fact, “the young church congregation decided to build the Campus before they built the church sanctuary because the need was so great for comfortable, caring, and affordable retirement living to meet the needs of seniors with modest economic means.” The Mission Statement of The Beatitudes refers to a “heritage of Christian hospitality” and “a model of wellness that promotes soundness of mind, spirit, and body.”

Their approach goes far beyond indulging the desires of patients.

In her article, Belleck notes a series of measures to promote health and well-being: “using food, art, music and exercise to generate positive emotions,” “eliminating anything potentially considered restraining, from deep-seated wheelchairs that hinder standing up to bedrails,” and “keeping residents out of diapers if possible.” As a result of these and other caregiving strategies, patients at The Beatitudes demonstrate virtually none of the “agitated, delusional behavior common with Alzheimer’s.” The staff recognizes patients as individuals with bodies, minds, and spirits who need affirmation, emotional support, and relationships.

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Negative language surrounds Alzheimer’s disease (and many diseases). We talk about how individuals “suffer”, about how the person has been “lost” to the disease. While this language certainly describes some of what it means to have Alzheimer’s, it can also deter caregivers from understanding patients with dementia as individuals who not only need care but also retain their individuality and their ability to offer something to those around them. A Christian model of care assumes that every human being—no matter how ill, or addled, or young, or old—has been created in the image of God. Bearing God’s image implies that each individual has a wholeness to their being (albeit a wholeness marked by the negative impact of sin), a wholeness of mind, body, and spirit. Bearing God’s image also implies that every individual is created for relationship—with God and with others. Every individual maintains an ability to give and to receive.

The Beatitudes is a Christian nursing home, and it provides an effective model of care in large part because it retains a Christian understanding of personhood. The staff approach their patients as full human beings. As Peggy Mullan, the President of the facility, remarks, “although weathered, although tested by dementia, people are beautiful and have certain strengths.” The Beatitudes offers an example of what can happen when an institution translates an abstract principle—seeing every individual as a person with beauty and strength—into concrete policies and activities.

Jesus called the meek, the poor in spirit, the ones who mourn, blessed. The Beatitudes demonstrates the reality of his words as it translates those words into action with a handful of elderly men and women with dementia. Moreover, millions of Americans suffer as a result of Alzheimer’s disease. That suffering can be modified, or even transformed, through a Christian understanding of human personhood through this model of incarnational love, the word made flesh.

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Posted by Sarah Pulliam Bailey on January 14, 2011 10:39 AM

Comments

Alzheimer's is common in my family and baring some major advances I think it is likely that I will end up with it. This is the kind of place I would like to be. (Although giving my savings for retirement, it is likely I will not be able to afford it.)

Posted By: Adam Shields | January 14, 2011 11:36 AM

I would just want to say to the person who posted about the likelihood of getting Alzheimer's that genetics is really only a small part of the likelihood of getting the disease! Keep active, mentally and physically, and stay hopeful! Thanks for this good article.

Posted By: Lisa Lamb | January 14, 2011 1:13 PM

Good advice, Lisa! Also, avoid anything with aluminum in it, and don't cook in aluminum cookware (unless it is coated. When you go out to eat, insist that your meals not be prepared in aluminum pots or pans. Check the ingredients of all packaged and convenience foods (including baking powder) to make sure there is no aluminum. Too much aluminum in the diet has been linked to Alzheimers.

Posted By: Anonymous | January 14, 2011 2:17 PM

For years it had been apparent that my wife had some kind of mental problem. When I would approach her about seeing a Dr. it would be received like a nest of hornets; she was adamant that there was no problem. She wrecked the car twice - no body was hurt. She could not follow me home in her car. When I discovered that a number of bills were not being paid and we had money, I took that duty from her. Finally, on a trip back home from a short vacation when she said to me, "Now how did you get to here (Florida, our home)? What is your name?", I decided no matter what her response was going to be, I was taking her to the Dr. I did under the pretense of her "lack of coordination."

After many test, the neurologist said that she did have Alzheimer's and why did I not bring her in sooner "I could have done more for her." I told him I appreciated his comforting words.

I have decided that with the few cognitive years that are left for her I will give her all that she ever wanted. I have turned my life over to her with God as my leader. Throughout this time a great discovery appeared to me: to be blessed we must first bless; blessed are those who morn for they shall be comforted and blessed are the peacemakers for they shall be called children of God.

I dare say my wife and I are happier .... no not happy .... but full of more joy than most people we encounter. I read once something from Peter Kreeft that went something like this. Happy is from the old English 'hap' which means luck. When your daughter comes home with just the right guy that is happiness, that is luck; when your daughter comes home addicted to drugs that (again) is a form of luck. But, Kreeft says, joy you can always have when you give up and let God take over; when "Thou will be done" is every part of your self. Joy can be yours in the deep hole of hell or the mountains of ecstasy.

I have found doing for another dutifully as an obligations however painful eventually becomes an inward joy and with God on my mind always joys overwhelms me.

My wife and I go to Mass every day. She can not say a word or respond. But she insist in her own way that we go to Mass and to communion. Unlike many with Alzheimer's she is never irritable unless we do not go to Mass. I was told that this is so because of an old habit of hers. But that can not be; she had always been a Baptist.

I had a friend that I thought needed some money. So I attempted to give him some incognito. He discovered my plot and called me to let me know that he was in good shape and that in fact from time to time he was short but he hoped others knew the joy he had from living a simple life with just God and his few possessions. I feel the same way, I wish all could know what a joy there is in giving WHEN God is controlling ones life. This is the heart of the problem with our social government - we Christians have sold our birthright - we let the government do the giving and we loose this great joy we could be experiencing - perhaps I digress

Posted By: David | January 14, 2011 3:23 PM

Interesting comments -- I have cooked with stainless steel the whole 52 yrs. we have been married and yet my husband has been diagnosed with Alzhemiers. Thank the Lord he is doing fairly well so far with medication.

Posted By: Anonymous | January 14, 2011 3:30 PM

Thank you for posting this encouraging report. Most of the time I read all Alzheimer's caregivers blogs, and so since I follow this blog as well, I took a double take and got so thrilled to read this post.

My husband has Mixed Dementia and it is a daunting task becoming his caregiver. Daily the LORD'S mercies surround me, however, and blogging is such an encouragement to those of us who are going this road.

Posted By: Carol | January 14, 2011 6:40 PM

There is no demonstrated connection between aluminum and the onset of
Alzheimer's disease. The latest research has found a genetic link in rats. If it holds true for humans researchers will be well on the way of discovering preventive measures, including inoculations. Stay tuned!

Posted By: William Hooper | January 14, 2011 8:30 PM

I think that genetic component seems most likely in my family. As to prevention. I think that keeping a mind active seems like a good idea. There are too many things that are always killing us (if the health news is ever to be believed) so I don't worry much about what is currently going to kill us. That being said, I do hope that a cure comes soon. I am not yet forty. But I have friends' who's parents are already in early stages in their mid 50s. Alzheimer's is not a pretty disease to watch loves suffer with. And the early stages seem to be the hardest, when you know that you are functioning below the level that you used to function. A sad sad disease

Posted By: Adam Shields | January 15, 2011 1:12 PM

My health fails, my spirits droop, but God remains. He is the strength of my heart, He is mine forever. Psalm 76: 25-26 (TLB).

God will never let go of what is His! I cling to these promises as I get older...He's stuck with me!

Posted By: C A Kuhn | January 15, 2011 2:50 PM

My younger brother was diagnosed in his 30s with early onset Altzeimer's disease; died at 44. A big, robust, healthy, physically & mentally active law enforcement officer -- the "Big A" is no respecter of persons. Now....his oldest son in in a rest home -- age 42 -- with the same diagnosis and is rapidly declining. Just recently, the youngest son (and only other child) was diagnosed at age 38 and is now being cared for by his mother.
Early Onset Altzheimers is even more difficult to understand and accept; and the suffering of a woman who loses her entire family -- husband, and both children, to the disease is indescribable. And, no hope for grandkids seems like the final straw.
This is one of those "Why, God?" questions. The only resolve I see is found in Romans 8:33-39. To that we rest in peace.

Posted By: Larry C | January 15, 2011 3:47 PM

What a beautiful model of care for a treacherous disease. I remember taking my daughter and my cousin's children to visit my grandmother, and explaining to them that she might say things that didn't make sense because "it is hard for her to think."

The children were less distressed by her rambling than I was. It was a lesson for me.

Posted By: Sheila | January 17, 2011 7:48 AM

I just flew back from Washington last night from visiting my mother who is 84 years old and has been suffering from Alzheimer's for the past 9 or 10 years. When I held her hand and spoke to her, she obviously did not know who I was. I began to cry because I saw someone's face whom I knew, but the person I knew was gone. I have been told that she is not in pain while she is in this state. I am so glad. But my heart is broken over what has become of my beloved mother. I can only have hope in the fact that I shall see her one day in heaven and she shall be herself again. We shall hug and I shall tell her again of my love for her.

Posted By: Pamela Braithwaite | January 17, 2011 2:24 PM

I care for my mother in law who has gone through early, mid and now late stages of Alzheimer's. She recently went into a special Alzheimer's area in our local nursing home just down the street. We also care for my mother now in the mid-stages of Alzheimer's and my father who has been diagnosed with Parkinson's who live with us in our home. My mother in law has lost language or her ability to communicate with us, but when you look into her eyes they still will light up. We connect with her soul. And while we may not be making "memories" for her in the way that we understand memories, we do something for her in the now - which is where the Alzheimer patient lives. And the now is what touches eternity. All the more, we have these memories that we are making for ourselves to look back on when she is gone. There is much that Alzheimer's and Dementia can give to us as caretakers. It can give us the experience of giving without expectation, and of unconditional love. It gives us the opportunity of seeing life that has gone full circle and returned to the innocence of a child. We are often challenged and at times discouraged, but over all I feel blessed to have this experience.

Posted By: Jan B. | January 17, 2011 3:48 PM

My dad was diagnosed with Alzheimer's this past year. I can only hope that, if he gets to a point where he needs constant care, I can find a place as attuned to his needs as The Beatitudes. Just because people get old and sick doesn't make them any less a person...

Posted By: Beth | January 18, 2011 7:01 AM

I enjoyed this article with one exception. I hope this author will be a little more cautious with the word "patient." While Alzheimer's is a disease, the term "patient" does not apply to someone in a nursing home any more than it would apply to someone who has been diagnosed with cancer, but is living at home. A "patient" is someone who is in a medical setting such as a hospital or a medical clinic. Generally, one should use the term "resident" or "client" when referring to an individual living in a nursing home. Perhaps I am being overly sensitive, but I think that language is important.

Otherwise, well written and thank you for directing our attention to this inspiring organization.

Posted By: Emily | January 19, 2011 1:45 PM

Emily, Thanks for that helpful and important clarification. Your point only underscores the attitude that the staff at the Beatitudes seeks to create--an environment of mutual giving and receiving where residents are seen as full human beings even in the midst of their struggles. Thanks again for pointing out the inconsistency in my own language/thinking!

Posted By: Amy Julia Becker | January 19, 2011 7:55 PM

What a wonderful article, my father's mother and one of his brothers died from this disease. It was heart breaking to see the people we loved slipping away and there was nothing we could do about it.
My grandmother was an expert in so many craft fields, crochet, cake decorating to name a few and to see her not be able to do the simplest tasks was terrible. The family tried to help her do whatever she put her mind to or whatever she wanted to try but eventually she became unable to so the simplest things. I remember standing at the kitchen sink washing dishes and she asked could she help. I said yes you can dry the dishes, she looked very perplexed and said "I can't do that" I showed her how to take the plate and wipe it with the towel and she brightened up and said "Oh I can do that!". I guess at that point I fully realized just how terrible this disease was to rob a family of its loved one.
The concept this facility has worked on is wonderful and I would hope other places would try it.
I had always wondered (and a little scared) if this was hereditary but my family doctor assures me it is not.
Thank you for letting us know there is light at the end of the tunnel.

Posted By: Gail Rogers | January 26, 2011 2:34 PM

Bless you for this article! My mother is suffering from quite early stages of Alzheimer's, and even that is hard to watch. What a wonderful community you describe!

To David, who wrote about caring for his wife above- what a beautiful statement of love and caring! I am reading this at work and almost broke down and cried. May God bless you and give you strength, hope and joy.

Posted By: Mary C | February 1, 2011 9:20 AM

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