By William C. Goertz

Praying Together with Those in Advanced Dementia

Is such a title possible? How can someone pray together with an individual whose mental capabilities have deteriorated to such an extent that the person cannot even recognize family members, much less remember prayers? I have heard family members repeatedly say, ''Don't bother; he doesn't remember anything. It's a waste of time.''

Prayer is not a waste of time. Praying with those in advanced dementia is possible at any time. What is desirable is to have a connection between the people praying. Is that possible for those in advanced dementia?

I became acquainted with the son of a nursing home resident whom I visited on a weekly basis. We started to talk about Ann, and he mentioned that she is now in advanced dementia and that to make contact with her was impossible.

However, this observation contradicted my experience with her. We would meet several times a week, and we became very friendly. Through the years I could see her mental capabilities slipping, but even in her final weeks of life, we still could pray together. I would start by saying and making the Sign of the Cross. Ann would attempt to imitate me by raising her hand to make the Sign of the Cross, but it would only move a few inches.

When I started to say the Lord's Prayer, I could see Ann's lips moving and saying the prayer. They would stop but again she would try to continue with me. At the end of the prayer, again she tried to make the Sign of the Cross with me but only moved her arm slightly.

I Still Did My Ritual

There were days that I could not connect with Ann. She acted as if she were unaware of her surroundings, but I still did my ritual with her. Ann would slip into this state of being for a period; but then again I was able to make contact with her. This toggling between unresponsiveness to awareness occurred approximately 50 percent of the time. Was she aware of praying when we interacted together? I do not know. I am neither a psychologist nor a gerontologist, but I do know, by her actions and the expression on her face, that it seemed to give her comfort and peace of mind.

Another example deals with Jim. I knew him for several years and saw him slowly lose his mental abilities. When I tried to talk with him, he would answer in sentences that were foreign to our conversation. I had the custom of praying with him during my visits in the home. We would begin with the Sign of the Cross and say the Lord's Prayer. Most days Jim would try to make the Sign of the Cross, but while I was saying the Lord's Prayer, he would start talking to himself. At the end of the prayer, again he would try to make the Sign of the Cross.

Making Connection

One day I was in the hallway, and we began to pray. This time, he said most the Lord's Prayer loudly and clearly. The nurse down the hallway came over in utter shock and was amazed that Jim was so alert and could pray in that fashion. This happened because he usually did not connect with those around him, but we usually did connect when we prayed.

Betty was always in the wheelchair and seemed to be asleep all the time, but when I approached her and asked whether she would like to attend the community's rosary, she would immediately say, ''Yes.'' Her intention was good, but physically she would fall asleep again.

It was the same for Holy Communion. I asked her whether she would like to receive, and she would immediately respond by saying, ''Yes.'' She would also occasionally say, ''I want to receive Holy Communion,'' and, of course, I would administer the Eucharist to her. Even though she was classified as being in advanced dementia, her whole being was still devoted to Christ, and she wanted to be as close to Him as possible.

'This is My Friend'

James was similar in that he was also deeply religious, confined to the wheelchair, could hardly speak and was classified as being in advanced dementia. When I approached him and he became aware of my presence, he would intently look at me. When I asked him whether he wanted to pray, he would nod in consent.

James began by attempting to imitate me in making the Sign of the Cross, but his hand would move only a few inches. He then tried to say the Our Father with me. I could see his lips moving and forming some of the words, but he would pause between the phrases. After a second or two, he would resume saying the prayer. He also wanted to receive Holy Communion.

Another interesting observation dealt with a comment that James made one day. The hospice worker was singing to him when I came into the dayroom. I said hello to him, and he whispered to the hospice worker, ''This is my friend.'' I saw only him twice a week for a few minutes, but he still considered me his friend. It takes very little to give a lot of comfort to those in need.

There were days when Ann and Jim were not responsive, but on other days they were quite alert. Other residents were never responsive. Yet regardless of their state of mental awareness, prayer was always beneficial to them. This was especially true for Betty and James who were deeply religious. Even the thought of praying raised their spirits.

As a result, I believe that these observations have implications for the family, friends, staff and representatives of the Church. By making the Sign of the Cross slowly and distinctly, and by saying familiar prayers, such as the Our Father, the Hail Mary and the Glory Be, contact can at times be made with those who are in the final stages of dementia -- especially with those who have a firm spiritual background.

Patience and understanding are key terms. It is not for their own personal gain that family members pray with their beloved ones but for the individuals themselves. TP

DR. GOERTZ, D.MIN., has been in the nursing-home, adult-day-care and assisted-living ministry for over 25 years. To further his work he has earned a Doctor of Ministry degree from Barry University.