During the latter years of her life, until she passed away in 2016, my grandmother suffered from severe dementia—Alzheimer’s disease, to be precise. It’s still unclear when it all started, but I’ll never forget how quickly it worsened and how much it seemed to change her.
She used to fly from Malaysia to California every year to visit us—that is, until she had to stay with us indefinitely due to her declining condition. But Malaysia was where home was, and it’s also where my parents had lived before they immigrated to America. During the summer holidays (when my siblings and I were much younger), my grandmother would often be the one to care for us while mom and dad were away at work.
Fast forward some years and suddenly, we were the ones taking care of her. At least, that’s one way of putting it. As the disease got progressively worse, it wasn’t so much us “taking care of her” as much as it was her driving all of us crazy. She would throw temper tantrums, wander away from home, accuse us of stealing her belongings, and constantly wake us up at some ungodly hour in the night. Sure, it became increasingly annoying and rather inconvenient for us, but for her, it was a living nightmare. There was visible terror in her eyes, not knowing where she was or when she was, or at times even who she was…
Through all of these moments I witnessed the tremendous toll that dementia has on a person, as well as the overwhelming burden that it places on families and caregivers of those who suffer from similar diseases. As a Christian, I knew that God offers us help and hope in the midst of trials, but I couldn’t help but think to myself… How is anybody supposed to live with this kind of suffering? What hope could there possibly be for them? How do we respond to this disease from a biblical worldview, and what is our call as caregivers of those who are facing this?
As I watched my own family’s desperate attempts to care for my grandmother, I wrestled with these questions. Here are five things that I learned throughout the process:
1. The battle we face has both physical and spiritual components.
When God formed man from the dust of the ground, he also breathed into him the breath of life, making him a living soul—not just a spiritless body. In other words, we’re not just animate creatures. We’re worshipping beings made in the image of God so that we would represent him throughout the entirety of our existence.
At present, there is no cure for Alzheimer’s disease. Many of the available treatment plans involve strategies for managing the disease’s influence in order to improve the person’s quality of life and to make things more bearable for caregivers. Perhaps, at best, they might be able to slow the progression of dementia. However, the disease will eventually run its course.
With such a dismal prognosis for this disease (and so many others), we as Christians need to remember where true hope is found. Specifically, we must remember that the most substantial, impactful, and lasting change can only be had through the power of God to transform us at the deepest level of our hearts.
Paul reminds us in 2 Corinthians 4:16, “So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day.” In other words, our physical bodies (what Paul refers to as the “outer self”) are deteriorating. And even though our bodies are good gifts from the Lord, being in good health was never meant to be our everything. If we place our hope in these things, they will surely fail us. But if we place our hope in the God who promises to renew the “inner self” of our hearts and minds for his glorious purposes, we can be assured that God is faithful to keep his word and to provide us with all that we need for the task.
2. Be gracious toward those who suffer, but don’t ignore clear signs of sin.
Nature versus nurture—or perhaps some combination of nature plus nurture. In many ways, our world has come to accept the idea that these are the things that determine who we are. “That’s just how I am” or “That’s how I was raised” or “I can’t change who I am or who I’ve been brought up to be”—we’re all too familiar with these explanations.
But do we truly understand the implications of this kind of reasoning? Instead of calling sin, sin, we’ve become experts at relegating the source of our problems merely to the external—that which is outside of ourselves and therefore out of our control. We are left powerless over our genetic disposition and powerless over our upbringing. Consequently, we are also left powerless over our sin. Do nature and nurture matter? Do they really make a difference in our lives? Of course! By God’s brilliant design, these factors have a tremendously formative influence in our lives, but they are not what ultimately defines us. And they are certainly not the source or cause of our sin.
Jesus himself reminds us that it’s not the external circumstances of life or even our genetics that accounts for the sin in our lives. Rather, we each bear this moral responsibility in our hearts as image-bearers of a holy God. In Mark 7:21-22, Jesus says, “For from within, out of the heart of man, come evil thoughts, sexual immorality, theft, murder, adultery, coveting, wickedness, deceit, sensuality, envy, slander, pride, foolishness. All these evil things come from within, and they defile a person.” The problem of sin is not primarily a problem of genetic and social determinism. The problem of sin is a problem of the heart—a thinking, wanting, choosing heart that either worships God or the numerous God-substitutes in this world.
In Galatians 6:1, Paul says, “Brothers, if anyone is caught in any transgression, you who are spiritual should restore him in a spirit of gentleness. Keep watch on yourself, lest you too be tempted.” Too often, we dismiss what should clearly be called “sin” when we say things like, “They probably don’t know any better” or “They’re just not acting like themselves”. Maybe we’re thinking, “What’s the point if they’re just going to forget again? Why should I even bother?”
Don’t get me wrong, we need to be gracious (notice the language Paul uses: “restore him in a spirit of gentleness”) and likewise, we need to believe the best about them, giving them the benefit of the doubt when things are unclear. However, we must not forget that we are also called to love—even when that means confronting and counseling our loved ones toward righteous living and obedience. Repentance and faith are critical components of our sanctification, which we all desperately need to make us more like our Savior. Let’s not withhold this means of grace from them because we’ve personally judged their situation to be hopeless or unsalvageable.
Elsewhere, Paul says, “And we urge you, brothers, admonish the idle, encourage the fainthearted, help the weak, be patient with them all” (1 Thessalonians 5:14). When we come alongside our brothers and sisters, even those that struggle with Alzheimer’s or other debilitating illnesses, let’s do our best to guide them in understanding the real problem so that we can point them to the real solution. It might seem like a thankless and impossible task—one which requires much patience on our part, but it is our God-given, Spirit-empowered task and the means by which we grow in the Lord and likewise help others grow as well.
3. God is working on your sanctification as well.
Let me direct your attention back to the verses we just looked at:
Galatians 6:1 – Brothers, if anyone is caught in any transgression, you who are spiritual should restore him in a spirit of gentleness. Keep watch on yourself, lest you too be tempted.
1 Thessalonians 5:14 – And we urge you, brothers, admonish the idle, encourage the fainthearted, help the weak, be patient with them all.
With each exhortation that is given, Paul also offers us some helpful warnings and reminders that we all need to hear. Even in our attempts to care for others, it’s so easy to be right in our own eyes and to give in to our own sinful tendencies. When you’ve had to repeat yourself for the fifth time, the temptation to lash out in anger and frustration becomes all the more real. Oftentimes, the easiest route is to react and respond how you want to—driven by your own sinful desires—wanting what you want more than wanting to honor God. But God calls us to patience. He calls us to love. In Ephesians 4:32, he invites us to “be kind and tenderhearted, forgiving one another as God in Christ Jesus forgave us.” And how lavishly he has forgiven us!
As we step into the lives of others and seek to love them, it makes us vulnerable and exposes so much about us. Don’t be discouraged or shy away from what God might be revealing to you. What a wonderful reminder that we owe everything to the grace of God—that he is conforming us into the image of Christ even as we are being used as instruments in the Redeemer’s hand.
4. Ask for help.
Anyone who has been the primary caregiver for a loved one with Alzheimer’s knows that it is exhausting work. As it turns out, it’s so exhausting that we can’t possibly expect to do it alone. But here’s the good news: We don’t have to! In fact, we were never meant to. As brothers and sisters in Christ, we are called to be practicing the many “one anothers” with—you guessed it, one another.
One of these comes to us in Galatians 6:2 where Paul gives the exhortation to “bear one another’s burdens and so fulfill the law of Christ.” This doesn’t mean that you just do everything for this person. But it does exhort us to Christian unity and love—a picture of fellow believers coming alongside and shouldering the weight of these burdens with one another.
In the case of my grandmother, I remember the times when the church visitation team would come over to our house and spend time singing songs of worship and praying together with her. It didn’t matter that she would probably forget this even happened moments later. They were simply being faithful burden-bearers to her and our family, and much-needed ones at that.
In some of our cultures, however, it’s almost taboo to ask for help. Maybe we want to save face or we’d just rather not trouble anyone else. But this is often a prideful and foolish way of thinking—a trap laid by the devil to isolate and destroy us. On the contrary, it’s times like these when we feel the most helpless that the glory of God is put on even greater display through the body of Christ, where every member of the body is indispensable to the rest. Don’t turn a blind eye to one of the most wonderful blessings we have in Christ: the family of God.
5. Preach the gospel.
My grandmother was a believer, but there were certainly times when I was tempted to doubt God’s work in her life. After all, Jesus says, “you will recognize them by their fruits” (Matthew 7:20). And with the spiraling trajectory of unchristian-like speech and conduct toward the end of her life, the fruits weren’t looking good. I would think thoughts like, “What if she was never truly saved, and this is now evidence of it?” Maybe you’re in a similar position of doubt. Or maybe you can somewhat confidently say that your loved one either is or is not a follower of Christ. Regardless of the situation, salvation is in God’s hands and our work remains the same: preach the gospel.
The gospel is not just for unbelievers. It’s a daily need for believers as well. This is why Paul says to the church in 1 Corinthians 15:1-3, “Now I would remind you, brothers, of the gospel I preached to you, which you received, in which you stand, and by which you are being saved, if you hold fast to the word I preached to you—unless you believed in vain. For I delivered to you as of first importance what I also received: that Christ died for our sins in accordance with the Scriptures…”
Maybe you’re thinking, “Well if they’re just going to forget anyways, why should anyone bother to preach the gospel to them?” Diseases like Alzheimer’s force us to humbly recognize our own inadequacies and helplessness. They force us to realize our need for the grace of the gospel and the Spirit of God to regenerate hearts. We know that God is sovereignly at work and that the gospel is the very “power of God for salvation to everyone who believes” (Romans 1:16), but we don’t know exactly how God works out the will and way of his providence. Thus, there is so much that we simply need to trust—not with a blind and baseless trust, but a trust that firmly stands on the Rock and Redeemer God who has revealed his very nature and word to us.
Trust that for those who are children of God, nothing, no person, death or disease, will be able to snatch them out of his hands (John 10:28). Trust that the God who triumphs over death, disease, and the forces of darkness can certainly reach the depths of a wayward soul. He is the one “who is able to do far more abundantly than all that we ask or think” (Eph 3:20). Perhaps God is challenging us to rely not on the surety of medical diagnoses, but rather on his Word and his Spirit which alone can transform and redeem the fallen sinner’s heart.
Alzheimer’s is a tragic disease, one that allows us to witness the brokenness of the curse. It progressively destroys a person’s mind until that person dies. And, where the world’s solutions end with the grief and loss that comes with the experience of this disease, the believer’s experience roots them in eternal life. Believers have hope in Christ’s victory over death and in the relationship he has redeemed us to enjoy. Even now, he sustains his children and cares for them in the midst of their sufferings, and they will one day find their eternal rest in him alone.