Martha Ulferts Meyer was a country school teacher before marrying a Minnesota farmer. "Mom coached the six of us with school work and taught Sunday school. After my parents retired, Mom, who always championed the underprivileged, started a chapter of Friendship Ministries in their new church home," says Roze Meyer Bruins, now a hospital chaplain.
"In 1996, when Mom was aware of her Alzheimer's diagnosis, she said, 'You know I have that illness.' I filled in the name for her.
"'I want you to know,' she said, 'that it is nothing to be ashamed about. My grandfather had it too.'
"My mother, the compassionate teacher," Bruins says.
As dementia has affected her mind, body, and spirit, the former teacher has withdrawn into her own little world-moving loved ones to try even harder to reach her.
Bruins' experience has made her passionate about worship for people with dementia. While developing worship services for Evening Star, a pilot worship and activity program for higher-functioning people with dementia at Holland Home in Grand Rapids, Michigan, she brought her mom to services.
"While she dozed at times, a touch, a tactile cue, could bring her back. And with the intentional audio cues of familiar music and prayer, Mom was indeed able to participate. At the close of the service, as I gave each resident a personal benediction, her smile and calm body language gave evidence of not only her need to worship but her joy in worship.
"The Evening Star worship services stoked Mom's worship memory. And that just goes to prove.while Alzheimer's can affect Mom's mind, it cannot touch her soul: Mom belongs to God," Bruins says.
Ask for older adults' insight
Designing meaningful worship for older adults begins with seeking their insights while they're still of sound mind, according to Ramonia L. Lee, minister of congregational life at Inter-Faith Chapel, an ecumenical Protestant congregation located inside a retirement community in Silver Spring, Maryland.
When she and co-pastor Judy Birch surveyed their worshipers, they discovered that people most wanted worship to address aging and later stages, social justice, forgiveness, God's promises, and dealing with pain and suffering.
Inter-Faith Chapel highlights its oldest members during the annual "in praise of age" service. "We only celebrate you if you're 90 years or older. You get a corsage, and we make a fuss over you. One woman even missed a nephew's graduation for this," Lee says.
For this special service, the leader begins the call to worship litany saying, "Smile, people of God! Let the wrinkles of joy baptize your face. Let us celebrate God's presence and each other. It's great to be alive!" The prayer of confession, read in unison, includes these lines: "We yearn for your goodness and great mercy. We confess our inclination to focus on the frailties and losses of life. We ask for your help always to see our possibilities in your love."
At care facilities affiliated with Inter-Faith Chapel, Lee asked groups of nursing home residents to share their favorite Bible stories, hymns, and worship elements.
They told her: "If I didn't have my faith, I don't know how I would live." "We've come this far by faith, leaning on the Lord, trusting in the Lord." "Faith carries me, sustains me. When I'm down, it picks me up."
"Several residents said, 'Thank you for asking us. No one has asked us about worship and our faith.'
"Communion spoke so powerfully to them that we now include it in every worship service-even though I've learned that, in a nursing home, you have to do the entire service in 30 minutes," Lee says.
Create community
"Even though we claim the priesthood of all believers, many congregations are very much clergy-led when it comes to worship. We brought small groups of Inter-Faith Chapel members together for four weeks to write prayers and liturgies," Lee says.
These retirement community members created two dozen prayers and rituals of blessings (scroll down to click on slides) for letting go of grief, driving, or painful memories; entering a nursing home or creating an ethical will; overcoming loneliness, caring for an elderly person, and asking to be a channel of God's grace.
"One lady came in, distraught because her sister was dying. So I gave her a prayer for a peaceful death to share with her family," Lee says.
When health issues force a Chapel member to move into a care facility, Lee and Birch go to the person's new home to bless it. They bring flowers from the chapel altar and say, "These flowers were part of our worship. They let you know you are part of us, even though you weren't there." They light a Christ candle and say, "We are connecting to you even though you are no longer on our campus. You are loved as much here as you were loved in the retirement community."
Lee says this blessing ritual takes only 20 or 30 minutes but has a profound influence on the resident. "And we walk away marveling about being used by God for this ministry," she adds.
Birch and Lee also conduct weekday morning worship services in six assisted living and independent care homes. "Many of these people have been forgotten by their home churches. But we've seen them actually become a congregation and see us as their pastors. They look out for each other and appreciate opportunities to work together. When someone dies, we acknowledge that a member of this congregation has died."
They created a portable worship center for each facility. Everything necessary for a service-a cross, communion cup and platter, altar cloth, napkins, candle sticks, drip protectors, candles, Communion wafers, grape juice, 12 prepared monthly bulletins, and one memorial service template-fits into a wheeled clear plastic bin.
Lee shared these experiences at a regional conference she organized on aging and worship. "Light on a Gray Area: A Symposium on Worship and Older Adults" trained 120 clergy and lay leaders in metro Washington, DC.
Tap into deep memory
"I encouraged symposium participants not to discount someone who is 'impaired.' It's a myth that there's no need to feed their spirit. They can respond. Our question is 'what can we do to trigger that response?'" Lee says.
"They can seem lost and locked inside. Then you start singing 'Jesus Loves Me' or 'Amazing Grace,' or we recite the 23rd Psalm or Lord's Prayer-and watch them come out from where they are and join in. And, for a moment, they are there with you," Lee says.
That makes perfect sense to Philip Lucasse. "One of the last things I could do with my mother was sing hymns together, even after she could no longer converse with us," says Lucasse, a Holland Home board member and retired college education professor who co-wrote the Evening Star worship activity curriculum.
"With dementia people, the last thing into the brain-speech, intricate thinking-is the first thing out. They slowly regress to childhood. You can't teach anything new. Instead you have to touch and revisit what they already know," Lucasse says.
Roze Meyer Bruins followed this principle while writing and testing Evening Star worship services. "My mom's worship memory includes important church rituals: faithful church attendance, a love for scripture and hymn singing, and a holy respect for the Lord's Supper," she says.
The Evening Star committee developed and tested 17 worship and activity modules, based on familiar Bible stories and themes such as Christmas, Easter, praise psalms, and communion. They hope to make the series available to others by year's end.
A few days after hearing a Bible story during worship, the activity staff reminds residents about what they learned-such as how the story of Daniel and the lions' den reminds us that God keeps his promises to protect us. They do simple activities and sing the same songs to revisit what residents learned. Handouts posted on the dementia unit bulletin board recount the week's worship service and activity details, so friends and family have songs and ideas to enrich their visits.
"In worship for anyone, whether or not they have dementia, the heart of the matter is interaction," Lucasse concludes.
Learn More
Check out free or low-cost resources for including older adult issues
in preaching, music (scroll down to "When Eyes That We Once Knew as Keen "), and special events.
If your youth group, fellowship group, church council (or whoever!) feels called to minister to people in nursing homes, then check out these books: Soulful Aging: Ministry Through the States of Adulthood, Young Children and Worship (good for reaching people with dementia), and Building a Ministry for Homebound and Nursing-Home Residents.
The United Methodist Church has gathered resources for ministry with and for older adults, including videos, online articles, books, newsletters, and seminars, as has the United Church of Canada, the Reformed Church in America, the Presbyterian Church (USA), and the Church of England.
In the United Kingdom, the Candlelight Group has developed a multisensory prayer service for Christians with dementia.
Start a Discussion
Reflect on how to include and minister to the oldest members of your congregation:
- Ramonia Lee says that working with older Christians reminds her how important it is to "pour something in, because there will be a time when that within you-scripture, hymns, liturgical responses-will have to spring up." What are you pouring in to yourself? How are you passing on this message to other members in your congregation?
- How often does your church challenge older adults to step up and give leadership, share values, and tell how faith has carried them along? Do you capture their testimonies in print or electronically?
- How many of your church members are in nursing homes? How does your church remember them in worship or worship with them?
- In what ways do your sermons, prayers, liturgies, church education, or church outreach address the needs of older adults? Do you involve older adults in these efforts?
- What are the similarities and differences in designing meaningful worship for young children, people with mental impairments, and aging adults?
Share Your Wisdom
- Have you figured out effective ways to cooperate with other churches in ministering to nursing home residents in your community-regardless of whether these residents belong to your congregation?
- Have you volunteered to share your expertise in aging issues with churches that think they're not equipped to help elderly Christians?
- Which books, videos, training events, or other resources have helped your lay leaders learn more about doing ministry with and for older adults?
- What are your best insights on how to attract and retain lay leaders and pastors with a gift for ministering to older adults, including those with memory loss?