The Role of the Faith Community Nurse in Fostering Spirituality in those with Alzheimer's Disease

International Journal of Faith Community Nursing Volume 1 | Issue 3 October 2015 The Role of the Faith Community Nurse in Fostering Spirituality in those with Alzheimer's Disease Verna Carson PHD, PMH/CNS-BC C & V Senior Care Follow this and additional works at: http://digitalcommons.wku.edu/ijfcn Part of the Family Practice Nursing Commons, Other Nursing Commons, Other Religion Commons, Psychiatric and Mental Health Nursing Commons, Psychological Phenomena and Processes Commons, Public Health Commons, and the Public Health and Community Nursing Commons Recommended Citation Carson, Verna PHD, PMH/CNS-BC (2015) "The Role of the Faith Community Nurse in Fostering Spirituality in those with Alzheimer's Disease," International Journal of Faith Community Nursing: Vol. 1: Iss. 3, Article 3. Available at: http://digitalcommons.wku.edu/ijfcn/vol1/iss3/3 This Article is brought to you for free and open access by TopSCHOLAR®. It has been accepted for inclusion in International Journal of Faith Community Nursing by an authorized administrator of TopSCHOLAR®. For more information, please contact . Article 3 Carson: Fostering Spirituality in those with Alzheimer's Disease THE ROLE OF THE FAITH COMMUNITY NURSE IN FOSTERING SPIRITUALITY IN THOSE WITH ALZHEIMER’S DISEASE Alzheimer’s disease (AD) strips individuals of so much that define who they are – their memories are gradually erased as if the “delete all” command on a computer was selected. It is easy to believe that the “loss of self” also means a “loss of soul as well” (Carson, Vanderhorst, & Koenig, 2015, p.87). However, we enter this world as spiritual beings and we leave this world in the same way. The ability to experience the Almighty definitely changes as the disease progresses but that ability to do so continues. Faith Community Nurses possess a unique opportunity to foster this connection in those with Alzheimer’s as well as their caregivers who are members of the faith community in which the nurse provides service. Those individuals with Alzheimer’s, along with their caregivers, continue to have spiritual needs. For many people with Alzheimer’s religious or spiritual experiences reside in their long-term memories and remain accessible until very late in the disease. Ancient memories of a parent praying with a child or singing hymns to comfort may date back to infancy and so are preserved in the brain well after verbal communication along with short term memory has been destroyed. Religious music continues to be one of the most powerful interventions for reaching those in the late stages of Alzheimer’s. Music is stored in the brain through a complex neural network that preserves music when other areas of the brain are destroyed through AD (Mooney, 2004; Snyder, 2003). This article discusses the many ways that the Faith Community Nurse is able to meet the spiritual needs of those with Alzheimer’s (Carson, Vanderhorst, Koenig, pp.89-91). Published by TopSCHOLAR®, 2015 7 International Journal of Faith Community Nursing, Vol. 1, Iss. 3 [2015], Art. 3 Alzheimer’s alters every dimension of life including the spiritual. The individual’s ability to communicate what is spiritually meaningful begins to diminish along with all other cognitive functions. However this does not mean that caregivers should ignore the issue of spirituality and/or assume that the person with dementia is unable to respond to the spiritual (Beuscher & Beck, 2008, pp. 89-90). As a caregiver it is easy to experience a sense of futility when working with a loved one or with a patient in a facility. It is understandable that caregivers might conclude that it would be futile to even attempt to meet spiritual needs because the person under their care will not understand. Nothing could be further from the truth. Many individuals were exposed to religious beliefs, experiences, and practices beginning in infancy. Perhaps family members said nighttime prayers during this time– a prayer as simple as: “Now I lay me down to sleep, I pray the Lord my soul to keep. If I should die before I wake, I pray the Lord my soul to take.” Perhaps as a child the person with Alzheimer’s heard family members sing religious hymns, or perhaps he/she was exposed to a religious rite such as Baptism and later to First Communion and Confirmation or perhaps the child’s parents dedicated him or her to God. Perhaps the child experienced a Bar Mitzvah or learned prayers in Hebrew, Farsi or another language. These early experiences are imbedded deep within the brain and stored in the individual’s long term memory. The person may not remember the name of their most recent clergy person or what faith tradition they belonged to, but these lapses do not guarantee that the person has forgotten God. Not only do many with Alzheimer’s remember God, but will also respond to long-ago recited prayers and hymns. When the opportunity to actively or passively participate in prayer and singing religious music is offered, many of those with Alzheimer’s readily join in with these activities (Carson, Vanderhorst, & Koenig, pp. 89-90) http://digitalcommons.wku.edu/ijfcn/vol1/iss3/3 8 Carson: Fostering Spirituality in those with Alzheimer's Disease A video clip, embedded within a larger video entitled Memory Bridge shows a vignette of Naomi Feil interacting with Gladys Wilson who has not spoken in two years (www.memorybridge.org). In the video, Naomi, a teacher and consultant on the care of those with Alzheimer’s, moves very close to Gladys and begins to gently touch Gladys’s cheeks –the way a mother would stroke the cheeks of a baby. Naomi draws upon Gladys’s religious history and uses old church hymns to connect with Gladys. Initially, Naomi, while continuing to stroke Gladys’s cheeks, sings the children’s hymn, Jesus Loves Me, this I know, for the Bible tells me so. Although Gladys does not join in the singing, she opens her eyes and focuses intently on Naomi’s eyes; Gladys also begins to clap her hands on the arms of her chair as well as on Naomi’s arms! Although Gladys does not verbally respond her eyes remain fixed on Naomi’s face. Naomi then asks Gladys if she will join Naomi in another song. Naomi begins to sing He’s Got the Whole World in His Hands and when she gets to the second verse, Gladys begins to sing along! It is an incredibly powerful moment when at the end of the song, Naomi asks Gladys if she feels safe and warm, with Jesus and with Naomi – to which Gladys responds yes. This short video clip is a powerful example of how religious music can reach down into the soul of a person and bring forth a response even from someone like Gladys who appears non-verbal and uncommunicative. The religious beliefs, practices, and expressions of faith that are cradled in long term memory can be tapped into long after short-term memories are gone, even during the last stages of Alzheimer’s disease. Profound memory loss is commonly referred to as “loss of self”. However, it never means “loss of s (...truncated)