Pastors are frequently asked by people in personal crisis to suggest something "helpful" which they might read to help them make sense of their experience, I have learnt to be cautious of recommending books as a panacea. What speaks to one may not make sense to another and alienate someone else.
But I heartily recommend this book. Malcolm Goldsmith is an Anglican priest with a background in parish ministry, chaplaincy and research. His experience produces a book which is rich in practical advice, but set out in a thoughtful and documented theological and pastoral framework. If the measure of good pastoral care is its "praxis", the linking of what is done and an underlying theological coherence, this book succeeds.
Many parishes and Christian communities have learnt the value and importance of welcoming people with disabilities, discovering the mutual enrichment that can take place. I have certainly not previously come across any writing which focuses on incorporating (sometimes reincorporating) people with dementia and their carers into church life. This book has an aptly named chapter "Don't talk of love - show me!" which suggests how churches might extend and develop their welcome and ministry to people with dementia. We are also rightly reminded that the term dementia is not a 'blanket diagnosis' and that the experience of dementia is not the same for everyone, nor does it follow a set pattern. Carers may also drift away from contact with the church and their departure is sometimes unnoticed! The impact on long term carers is also discussed, and some possible practical and supportive ways of helping are suggested. I have certainly heard from carers many of the mixed feelings about their experiences which are well highlighted in this book.
"Spirituality" is a term which now has some prominence in health care. Its relationship to other factors such as a person's culture and religious practice is frequently examined in "secular" settings. The author sets out some useful definitions of the spiritual issues which are present in working with people with dementia. He stresses that these are not just "add ons" but for many people in long term illness something that can provide meaning and purpose when everything else, experiences of past life and looking towards the future can feel chaotic and without meaning. The title refers to Psalm 137 and raises the theme of trying to sing a familiar song in a strange and unmapped land. It is a poignant image and resonates fully as one reads the book.
This is an area where Christians are reminded yet again of the unique value of ritual and liturgy as a means of trying to put into action and reaching for the unsayable. This implies a challenge to a way of thinking and working that tries to express everything in words. Many people in crisis or long term illness may be able to respond to and use actions, and occasionally words, which may be familiar to them. (I was recently roundly rebuked by a patient, who was apparently unaware of his surroundings and past life, to whom I gave communion on Whitsunday for using the Gospel rather than the Pentecost reading from Acts, which is longer but may be much more familiar to many!)
We are offered some very imaginative suggestions for liturgies which could be used to mark someone's admission to a nursing home or to support family and friends of people in residential care.
Malcolm Goldsmith stresses that people with dementia are not a "client group" but a potential resource. He never sentimentalises or underestimates the difficulties but a thread runs throughout of thoughtful prayerful respect for everyone whose lives may be touched by dementia. It would be an admirable basis for a parish or community based ministry project. The current estimate is that the number of people who may be diagnosed with dementia may constitute within a few years a quarter of the population over 75, not to mention those who may develop the condition earlier in life.
His book is very timely.
Canon lan Ainsworth-Smith is Chaplain, St George's Healthcare NHS Trust