Blessed Are Those with Alzheimer's

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.

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.

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.