By John Gillman
John Swinton, Dementia. Living in the Memories of God. Grand Rapids, MI: Eerdmans, 2012. Softcover. 298 pages. $25.00.
One of the most feared diseases today, dementia affects over a quarter of the population in their 80s and 90s. This increasingly prevalent affliction is an ongoing challenge medically and theologically. In this volume, John Swinton, professor of practical theology and pastoral care at the University of Aberdeen, Scotland, articulates a practical theology of dementia that serves as a solid foundation for dialogue among chaplains, the faith community, and beyond that, the medical community.
With thorough research and persuasive argument, Swinton addresses the question: Who am I when I’ve forgotten who I am? He rejects the notion that loss of memory means loss of self-identity.
Drawing upon Buber’s perspective, Swinton maintains that those with dementia are indeed persons by reason of their being in an “I-Thou” relationship with God. He adds: “Even if human beings do not or cannot respond, they remain persons as God the absolute Person continues to relate with them.” The value and identity of human beings is assured ultimately by God who created them and sustains them through the power of the Holy Spirit.
The invitation for pastoral-care givers is to approach those with dementia with the intention of engaging in an “I-Thou” relationship and thus to bear witness to the Divine who may be experienced in “the between.” This implies that any tendency to objectify, analyze or conceptualize the other – thus limiting this to an “I-It” interaction – is put aside, so that there is the possibility of a real meeting of one human being with another, both of whom have been created in the image of God.
Swinton affirms that it is not a person’s memory that assures one’s identity; rather it is the memory of God. In suggesting that God remembers those with, for instance, advanced dementia, the author asserts “that God is with and for them and that God is acting with and for them in the present as they move toward God’s future” (p. 217, emphasis in original). Speaking collectively, he concludes that since we are held in the memory of God, then dementia does not destroy us.
The church has a special role as well, which is to be an attentive community of memory and hope for those suffering with dementia. By including them in community worship, prayer and ritual, the church attests to their meaningfulness and dignity as full members of the People of God.
Swinton’s contribution to the theology of dementia merits careful attention and ongoing reflection. In particular, I believe that more consideration needs be given to the meaning and implications of the assertion that those with dementia are in an “I-Thou” relationship with God. Also, what are some meaningful ways for chaplains and the community of believers to hold the memory of those who no longer recall their own identity?
John Gillman is an NACC and ACPE supervisor at VITAS Innovative Hospice Care in San Diego, CA.