The Face of Dementia, John Dunlop, MD, Crossway 2017

Review:

Dr. John Dunlop’s new book Finding Grace in The Face of Dementia is certainly not an escapist approach to God’s presence in dementia, i.e., he doesn’t just quote a few Bible verses and expect this will satisfy all the issues that this horrific disease causes. But in his combination of medical understanding and Biblical truth, he offers help and perspective to people coping with the disease. He dedicates the book “to those who seek to love and care for people with dementia in ways that honor God”. ( John Dunlop, Finding Grace in The Face of Dementia, Crossway 2017).

Dunlop is a seasoned geriatrician and he interlaces his very realistic descriptions of the phases of dementia with poignant stories of his patients’ experiences - both as victims of dementia and as caregivers. His portrayals are given to help people know what to expect and how to respond. They are helpful medically, psychologically, socially, and practically. And they are interlaced with his overarching theme that God is present and it is possible to find grace in the face of all the escalating struggles caused by dementia- both for the patients and certainly for the care givers.

One important principle he emphasizes is that although dementia sufferers lose their cognitive abilities over time, the emotional and relational aspects of their personalities remain and are the primary points of connection as the disease progresses. “People with dementia continue to be social beings… One of the greatest gifts is presence, simply spending time with them… People with dementia [also] still have emotion. We must never allow their cognitive impairment to blind us to their emotional needs. They may feel much more than they know, and how they feel may be far more important to them than what they know…People with dementia want to be loved and they want to love others… The fact is, loved ones can never express their love too much (pp. 130, 131).

Theologically Dunlop believes that recognizing dementia patients’ inherent dignity is a way of honoring God in caring for them.  He also roots the suffering of dementia firmly in the biblical purposes of God who works through all sufferings. Medically, he distinguishes between elderly people with a healthy brain or a deteriorating brain. He describes different forms of dementia and how to cope with each one.  Psychologically, he describes, in two different chapters, how it feels to have dementia and to be a care giver. These insights allow readers to see the disease from the inside of both experiences.  Practically, his final chapter on End of Life Issues is extremely helpful and honest in discussing issues surrounding the imminent death of dementia patients.

This book is one of the best books on dementia I have read, along with an earlier book I reviewed: “When Reasoning Are No Longer Works”.  As a caregiver for my husband in his Alzheimer disease, I‘m very grateful for the depth of understanding,  compassion, and practical help given in both books. Dunlop’s book, particularly, weaves the importance of knowing God and relying heavily on God’s resources through Scripture, prayers, and the church, both for the care- givers and the patients.  As a Christian, I have experienced the truth of his words.          

 5 stars.      M.L. Codman-Wilson, Ph.D.    2/26/18

Excerpts

“Dementia is a threat to the basic values of western culture. Society values youth, wit, independence, and control. We are tempted to equate our individual values with our IQs and ability to accomplish things. Dementia will likely threaten both” ( John Dunlop, Finding Grace in The Face of Dementia, Crossway 2017,  p.15).

“God’s love for His people (chesed) reflects His kindness and mercy and also emphasizes God’s loyalty and commitment to their well-being… The amazing thing is that God pours chesed love on those who are in no way loveable. This chesed love should be the model that a caregiver shows a victim of dementia. It is characterized by kindness, faithfulness, and mercy” (p.86).

“Each stage of dementia has unique challenges in providing love and care. From the repeated questions and forgetfulness seen in early stages to the lack of communication and need for total care in the later stages, there is a daily strain. But the good news is that God himself is a caregiver’s caregiver. He will give daily strength, wisdom, love, and patience… When we do things for others in need, Jesus views it as actually done for Him. That is a privilege and may be reward enough. Providing loving care is doing God’s work and that lasts for eternity “ (pp. 87, 97).

“People in advanced stages of dementia stop eating because they are dying; they don’t die because they stop eating… We must also realize that dehydration is a natural part of dying.. We also do well to realize how threating, if not terrifying, aggressive medical care can be to one incapable of understanding the reason for it… We need to think twice about the wisdom of hospitalization or even major outpatient tests before we commit to them” (pp. 173, 174).