How To Fight When Your Mind is Failing

Article by John Piper

If you read your Bible in the morning and see an encouraging promise of God’s help, but then, ten minutes after you have put the Bible away, you have no memory of what that promise was, your battle for hope and holiness will be seriously compromised. This happens to most of us from time to time — no matter our age — but for those of us who are in our seventies, the problem is more acute. What’s to be done?

Matter of Life and Death

You may not feel with me how urgent and serious this is. So let me remind you that there is a holiness (a “sanctification”) without which we don’t get to heaven. “Strive for the holiness without which no one will see the Lord” (Hebrews 12:14). John puts it like this: “We know that we have passed out of death into life, because we love the brethren. He who does not love abides in death” (1 John 3:14). And Paul says, “If you are living according to the flesh, you must die; but if by the Spirit you are putting to death the deeds of the body, you will live” (Romans 8:13).

So, practical holiness, which includes love for people and mortification of the body’s sinful bent, is not marginal. Hebrews and John and Paul say it’s a matter of life and death.

Besides the New Testament estimation of holiness as a necessary mark of spiritual life (old or young), there is the plain biblical fact that practical holiness is how God is glorified and people are loved and joy is sustained. We do good deeds, Jesus said, that people may see them “and give glory to our Father in heaven” (Matthew 5:16). And Paul made clear that such love is the radiance of holiness (1 Thessalonians 3:12–13). And Nehemiah added that the joy of the Lord is our strength and should mark the holy day (Nehemiah 8:9–10).

“Practical holiness, which includes love for people and mortification of the body’s sinful bent, is not marginal.”

In sum, holiness is the path to final salvation, glorifyingGod, loving people, and experiencing joy. This means that if this is harder as we get older, we need serious spiritual help, not theologies that minimize the importance of holiness.

Stockpiled Faith Is No Substitute for War

But perhaps you have the notion of sanctification that the longer a person has walked with the Lord, the less vulnerable that person is to sin. Perhaps you see sixty years of spiritual discipline as stockpiling faith so that the fight for faith is not as crucial as it once was. Or perhaps your view of sanctification is that it happens subconsciously so that the loss of conscious memory is not a liability.

There is some truth in each of those three notions.

1. Long familiarity with Jesus in sweet fellowship habituates the heart to his reality and presence (Philippians 3:10).

2. And there is a sense in which faith does grow with exercise over time (2 Thessalonians 1:3).

3. And it is true that the subconscious is altered by God’s word and prayer and persevering obedience. “Out of the abundance of the heart [subconscious] the mouth speaks” (Matthew 12:34).

However, no length of fellowship with Jesus, no degree of growth in faith, no subconscious renewal of the inner person ever replaces the need for conscious, daily acts of the mind and the heart recalling and embracing and believing the promises of God in fighting for hope and holiness. Listen to Paul as he comes to the end of his life:

I am already being poured out as a drink offering, and the time of my departure has come. I have fought the good fight, I have finished the race, I have kept the faith. (2 Timothy 4:6–7)

Wouldn’t you agree that those last three clauses imply “right up to the end”? “I have fought the good fight, fighting right up to the end. I have finished the race, running hard right up to the end. I have kept the faith, holding fast, right up to the end.” Paul does not give us the impression that his long familiarity with Jesus, or his ongoing growth in faith, or the depth of his subconscious renewal in Christ diminish his need to fight and run and hold on.

Sanctification Through Conscious Faith

I think the main reason for this is that God intends for us to live in consciousreliance on Christ. While it is true that a huge percentage of our daily acts are instinctive — with little or no extended premeditation on the word of God as our guide, or the promises of God as our conscious motive — nevertheless, God’s ideal for us is not that we become increasingly oblivious of his presence, and increasingly unconscious of his word while our sanctified subconscious completely takes over. That would make us increasingly robot-like, and strip our behavior of conscious volition to trust Christ and glorify God. Our experienced, personal relationship with the Lord would vanish.

No length of fellowship with Jesus ever replaces the daily acts of the mind and heart to believe God’s promises.

In other words, God’s will for us is not merely that we increase in the subconscious renewal of the inner person, but also that we live increasingly in mindful reliance on his revealed word. He does not intend that we ever outgrow the need to hear his word, and by trusting it consciously, get victory over temptation and get motivation for love.

Paul said that Christian love for all the saints was owing to our hope laid up for us in heaven (Colossians 1:4–5). And he said that his aim was that we love people “from a sincere faith” (1 Timothy 1:5). He had been told by the Lord Jesus, in his commissioning, that people “are sanctified by faith in me” (Acts 26:18).

Two Examples of Sanctification by Conscious Faith

I think these texts point to a way of life in which conscious hope and conscious faith in the promises of God are the daily means by which the luring promises of sin are negated by the power of the superior promises of God. I think Paul is pointing to the fact that acts of practical love are unleashed by conscious faith in the promised care and reward of God.

An example from Hebrews: “Keep your life free from love of money, and be content with what you have, for he has said, ‘I will never leave you nor forsake you’” (Hebrews 13:5). Would you not agree that the writer is calling us to a way of life that is joyfully conscious of the promise, “I will never leave you nor forsake you”? And that he intends for that conscious faith to keep us free, day by day, from the love of money? Another example from the teaching of Jesus:

“When you give a feast, invite the poor, the crippled, the lame, the blind, and you will be blessed, because they cannot repay you. For you will be repaid at the resurrection of the just.” (Luke 14:13–14)

Here is a directive and a promise, a path of holiness and a motive of happiness. Invite people to dinner who cannot repay you. If your old, selfish nature objects that it’s not worth it, defeat that sinful thought by faith in this promise: “You will be repaid at the resurrection of the just.” Doesn’t Jesus mean that we should pursue such difficult acts of holiness by means of conscious reliance on specific promises?

How Can I Fight When My Memory Fails?

This brings us back to the problem of senility. One of the effects of the “wasting away of our outer nature” (2 Corinthians 4:16) is that short-term memory weakens. The mind simply will not hold on to things like it used to. This is why all Medicare checkups at the doctor require the nurse to test your memory loss by telling you three words (chair, banana, tree), and then asking you one minute later (after you have drawn a clock and proved you can still tell time) if you can remember the three words.

“We do not know what small miracles God might work for us if we just ask him.”

So what am I to do if I read my Bible in the morning, spot a promise that I know will be of great help in sustaining my faith at a moment of testing later in the day, but when the Bible reading is over, I have no recollection of the promise? How am I to defeat temptation by faith in God’s promise if I can’t remember the needed promise?

1. Do not underestimate what God might do when you ask him for help.

Ask the Lord — be urgent and sincere — to strengthen your memory of his promises. I know this sounds naïve in the face of real, physical brain deterioration. But I do not think we should be so fatalistic that we think God would not give us some help. We do not know what small miracles he might work for us. God was not happy with King Asa when he was old and neglected to ask the Lord for help but only sought help from physicians.

In the thirty-ninth year of his reign Asa was diseased in his feet, and his disease became severe. Yet even in his disease he did not seek the Lord, but sought help from physicians. And Asa slept with his fathers, dying in the forty-first year of his reign. (2 Chronicles 16:12–13)

By all means, seek help from physicians, exercise, eat right, do your crossword puzzle, play Sudoku, and get lots of sleep. But don’t be a practical atheist and neglect to ask God to do what only he can do. God does not promise escape from aging and senility. In fact, he says it will come (Romans 8:23; 2 Corinthians 4:16). But who knows what help he may give in the process! We have not because we ask not (James 4:2). Ask him.

2. Work even harder at memorizing God’s promises.

Disability demands greater effort. If we stop doing things because they get harder with age, we will stop living long before we are dead. Disabled people have always had to work harder to do what non-disabled people do. And we admire them for it. Senility is a disability. Are we just going to give in? No. We work harder to make up for the disability.

So, if you once repeated a promise to yourself ten times in the morning and could remember it easily all during the day in any situation, you might need to repeat it twenty or thirty times to achieve the same effect. This will change over time. Know yourself. I could run eight-minute miles when I was in my thirties. Today I can only run twelve-minute miles. (Which most people would not call running!) It takes longer. It hurts more. It leaves me more tired. All because I am forty years older. So why do it? Same reason I’ve run for fifty years. I don’t want to be depressed, I don’t want to be fat, and I don’t want to be dead (yet).

It’s the same with memorizing promises. Once upon a time, I memorized a verse every morning from four different places in the Bible. Today, alongside constant review of large portions once memorized, I focus on one word from the Lord to carry with me through the day, and I must work two or three times as hard to make that word stick. I want that word with me all day, especially for use against temptation, and to motivate hard obedience.

3. Spite the devil with your smartphone.

When the memory simply will not hold on to the promises you want with you during the day, spite the devil and dementia with pieces of paper and iPhone reminders. I am totally serious. When you find the promise in the morning that you want to enjoy all day, write it on a little piece of paper and put it in your pocket. Take it out and read it again and again during the day, especially in the hour of trial.

I am part of the first wave of baby boomers who got in on the era of mobile devices soon enough to take them with us into senility. So, take your smartphone, push the button, and say to Siri or Bixby, “Remind me at 10:00am that I should cast all my cares on God because he cares for me.” Then do the same for as many times during the day you find helpful.

“If we stop doing things because they get harder with age, we will stop living long before we are dead.

If you have the mindset that this kind of spiritual warfare is superfluous, and that God somehow automatically makes up for our increasing weakness apart from the fight of faith, you are not paying attention, either to aging Christians or to the word of God. He comes. And he helps. But he does it in and through our resolves and efforts of faith. “We always pray for you, that our God may fulfill every resolve for good and every work of faith by his power” (2 Thessalonians 1:11). It is God’s gift. But we act the miracle by “resolves” and “work.”

4. Let a companion become your eyes and memory.

Stay close to caring members of the body of Christ. The senile member cannot say to the strong, “I have no need of you.” The non-reading eye, with glaucoma and macular degeneration, cannot say to the members with reading mouths, “I have no need of you.” Nor can those with good eyes say, “I have this gift for myself alone.”

When the eyes and the memory of one member go, the other members pick up the missing strategy of spiritual war. If I cannot remind myself of the promises of God, I will need you to remind me. With aging, it is truer than ever that we must “exhort one another every day, as long as it is called ‘today,’ that none of you may be hardened by the deceitfulness of sin” (Hebrews 3:13).

Let’s Be God’s Voice for Each Other

Until the day we die, sanctification remains a divine work through human means. It began that way. It ends that way. The means might change as our weaknesses increase. But sanctification never ceases to be a divine summons to fight the good fight, finish the race, and keep the faith.

Even in the last hours, it is a summons to the body of Christ to lean down close to the ashen face and say with a loud voice:

Even to your old age I am he,
   and to gray hairs I will carry you.
I have made, and I will bear;
   I will carry and will save. (Isaiah 46:4)

Posted at: https://www.desiringgod.org/articles/how-to-fight-when-your-mind-is-failing?fbclid=IwAR0ErNr3kIM20S32szaFWRARTFnKI1oNg3DlDnQUVN2Wo7qfE224PeCiXEE

Loving Our Neighbors with Dementia

Article by Kathryn Butler

A loved one drifting through the shadows of dementia clutches your wrist and implores you to find her husband. She no longer recognizes you, or remembers the laughter and tenderness you’ve shared. She can’t comprehend the steady erosion of her memories, the parts of herself that have crumbled away.

And she doesn’t remember that the husband she adores died decades ago.

What should you say? The last time she heard the truth, she howled and cried, reliving her grief as if for the first time. Then, after an hour of sobbing, she forgot the entire conversation and asked for her husband again.

As she searches your face now, should you tell her the truth and watch the agony wash over her? Or should you spare her the pain and fib that he’s gone out to the store?

Dignity or Happiness?

Such heartbreaking dilemmas inspired a recent article in The New Yorker by award-winning writer Larissa MacFarquar. In her challenging piece, MacFarquar explores the practice of “therapeutic lying,” a controversial approach in dementia care that favors deception over dragging people discombobulated and frightened into a reality they can’t understand.

MacFarquar guides us through memory care centers that feature 1930s décor, fake bus stops, and artificial simulations of the beach, all intended to mirror the realities of people locked within their distant memories. Proponents of such simulated environments argue that familiar details, even if fabricated, comfort dementia sufferers, and soothe the confusion and agitation that arise when their sharpest memories don’t align with their surroundings. Critics question the impact of systematic deception on the hearts and minds of caregivers and dementia sufferers alike.

Throughout her sensitive investigation, MacFarquar posits a quandary: Should we be blisteringly honest with dementia sufferers in the name of dignity and truth, even if the facts devastate them? Or should we lie and collude with their delusions, diminishing their personhood, but keeping them blissfully unaware? “What is more important,” she asks, “dignity or happiness?”

MacFarquar’s question reflects deep empathy for people with dementia and captures the agitation, fear, and confusion that so often afflict them. But it also presupposes stark dichotomies between dignity and happiness, truth and compassion. The question strands caregivers between two unnerving and opposed choices, neither of which seems to wholly manifest love for our neighbor (Matt. 22:39).

The gospel offers an alternative approach.

Loving a Person

Personhood doesn’t decay with our cognitive abilities, but resides in our immutable worth as image bearers of God (Gen. 1:26), a value no disease or calamity can degrade. And the central tenet in care for anyone, stricken with dementia or not, should be love, as God loves us in Christ (Mark 12:30–31; John 3:16; 13:34–35). In Christ, dignity and compassion unfurl as branches of the same vine, each a vital offshoot.

Christian love doesn’t subscribe to blanket policies of harsh fact or rampant falsehood, but rather seeks to build “others up according to their needs” (Eph. 4:29). It views each person as Christ sees him: cherished, unique in the world, worthy of time and sacrifice, with a specific role in God’s story.

Artificial environments with fake bus stops hardly embody this love. Such prescribed, imposed realities ignore the unique stories, memories, and experiences that enrich a life and the varied needs each person harbors in a given moment. Systematic deception discounts the fluctuating course of dementia, when moments of lucidity break through the fog, and when tactics that soothe in one moment can agitate in the next.

According to the U.K.’s Mental Health Foundation, this neglect for individual experience can actually worsen distress and confusion among dementia sufferers. Fabricated environments, the Foundation argues, thrust people into out-of-context scenarios that don’t always align with their own memories and realities.

The resulting disconnect can deepen anxiety among dementia sufferers, and even more concerning, erode crucial relationships. As the foundation reports, “A person living with dementia may start to feel suspicious and lose trust in one or more of their carers if the responses/interactions are inconsistent from one carer to the next, or the body language of the carer suggests something is ‘not quite right.’”

Those with dementia themselves echo these concerns. In one study, people with mild dementia described lying, even if well-intended, as “patronizing” or “demeaning,” and predicted that knowing they were lied to would upset them.

They described their distress as especially profound if the lying occurred within a close, trusting relationship. Such comments warn us that if we routinely lie to those with dementia, even out of compassion, we risk fracturing the fragile bonds tying them to others.

Speaking Truth in Love

None of these dangers should surprise us, given the high standard of truth the Bible upholds (Lev. 19:11; Mark 12:14). But when a woman with severe dementia, for whom the last shreds of working memory have vanished, weeps for her lost husband, should we bluntly retort that her beloved has died?

When we force her into a painful reality she can no longer decipher, do we really embrace her as a unique child of God? Are we speaking the truth in love in such moments, and building her up according to her needs? (Eph. 4:15).

As Sinclair Ferguson so eloquently states, “Truth is always set in the context of love because it is never only a matter of speech and words, but of spirit and motive.” Guiding our loved ones according a Christian ethic requires that we look beyond the words, sift past the factual inaccuracies, and discern the emotions and deep needs driving them.

We must empathize with sufferers, enter their perspective, and walk with them—either toward clarity, or toward calm and comfort.

For those with mild dementia, who understand their cognitive decline and whose false realities upset them, gentle reorientation may usher them back to awareness. Such redirection need not unfold in cold, callous terms, but can take the form of coming alongside him or her: holding a hand, referring back to points in time, or reviewing a photo album until the dwindling memories sharpen into focus. In remembering together, the encounter evolves into a partnership, rather than a corrective measure.

In advanced dementia, however, people can no longer comprehend reality, and demanding they do so risks crushing them with anguish. To respond compassionately, and to acknowledge their dignity in Christ, requires us to enter their world, and to see what they see. Their attempts to comprehend and to communicate must be taken seriously, and respected, just as for anyone else.

Discerning Needs

“Understanding the world they are experiencing does not mean we have to lie about it,” says Dr. John Dunlop, longtime geriatrician and author of the poignant and informative book Finding Grace in the Face of Dementia. “When a patient is asking for and grieving a dead parent, we need to ask ourselves, ‘What is it they are looking for?’ It may well be love and security. We can respond by hugging them and saying, ‘I love you and will take care of you, and I know you love your mom and dad.’”

Kathy Lind, a nurse practitioner with 25 years of experience in geriatrics, agrees that the chief concern in dementia care is neither fact nor fiction, but viewing each person individually, beloved by God, with unique needs in the moment.

“God is present all the time,” she says. “He is present to the patient with dementia who thinks in the past, and to me who is in the present, both on different timelines. . . . Usually, meeting [people with dementia] where they are and responding to the emotion of their distress, is enough to diffuse the anxiety, and I believe we have really communicated.”

Dunlop lived out this principle when his mother, her mind clouded with dementia, repeatedly mistook him for his father. Rather than reply with, “I’m not Dad,” or pretend to be his father, Dunlop learned to respond with, “Lois, I love you.”

His answer emphasized neither truth, nor fiction, but rather acknowledged his mother’s deepest need in that moment—to receive warmth and affection from someone she loved.

Although the ravages of dementia may chisel away memories, stories of who we are remain. Emotions remain. And these lingering joys can anchor those lost in the past. “Despite their confusion about the present,” geriatric psychologist Benjamin Mast writes,  “people can continue to find themselves and reconnect to their faith by rehearsing their story with people who love and care for them. . . . We should try to interact in a way that draws upon their life story, their well-worn behavioral patterns, and those aspects of life that are flavored with emotion.”

Dignity and Compassion

We know that when Christ returns, the synapses of the dementia-stricken mind will be repaired. The brain will heal, the present will snap into relief, and the memories will take their proper place. In the interim, those struggling with dementia need us to reflect their personhood as eternal, not dependent on remembering or forgetting, fact or deception.

They need our respect and love, through care that presumes no dichotomies between dignity and compassion, but rather views each individual as worthy of both.

When we embrace others in such love, we point to the greatest truth of all, to the one whose power and mercy far surpass the jumbled workings of our feeble minds. We point to the one who gave his life for us and who makes all things new: the broken bodies, the sinful hearts, but also the forgotten names and distorted memories, the glimmers of the past tangled with the present.

About the Author: Kathryn Butler (MD, Columbia University College of Physicians and Surgeons) is a trauma and critical care surgeon who recently left clinical practice to homeschool her children. She has written for Desiring God and Christianity Today, and her book on end-of-life care through a Christian lens, Between Life and Death, releases in 2019 (Crossway). She blogs at Oceans Rise.