A key challenge for people living with dementia, their loved ones and the church is belonging.

Dementia is a major form of disability[1] with 55 million people living with dementia in the world today,[2] which is more than twice the population of Australia and New Zealand combined.[3] For some Western countries, dementia is the most common cause of death for women.[4]

While dementia’s prevalence and mortality rates are significant another critical issue is that dementia does not diminish a person’s spiritual needs.[5] Sadly, people living with dementia often face serious barriers belonging in a church and often ‘drop out.’[6] However, there is strong support for the importance of church engagement for people living with dementia.[7] Dementia can also limit or stop carers from attending church, so a dementia-friendly church service also cares for them.[8]

This article explores seven key principles for conducting effective church services for people living with dementia. It also provides a sample service, ‘Jesus Loves Me’ (JLM), a church service that applies these principles and has been refined over ten years of continuous use. JLM can be downloaded from from my Linkedin profile, please go here to request a copy: https://www.linkedin.com/in/rev-ben-boland-b4572a108/ - being able to refer to JLM as you read this article is recommended.

Theology of Effective Church Services for People Living with Dementia.

Today many churches run multiple services, with an early morning ‘traditional’ service for older people, mid-morning for families and evening service for youth common. This has led to the critique that multiple services segregate the church. Therefore, the question needs to be addressed: Does JLM further splinter the church or does JLM facilitate hospitality and belonging with people impacted by dementia? 

An answer requires defining two key theological terms: people and church. A Christian understanding of people rests on the Imago Dei - i.e. all people bear God’s image and are thus immutably valuable.[9] This value cannot be tarnished by dementia.[10]

If people living with dementia bear the Imago Dei, do they have a place in the church? Yes! The church universal is God’s people.[11] Yet too often the local church is not a friendly space for people living with dementia and their loved ones.[12] This is true for many people living with ‘disability’.[13] Which has contributed to a plethora of works exploring and advocating for churches to prioritise hospitality and become places of belonging, particularly for people living with disability.[14]

JLM’s theological foundation is that people living with dementia bear the Imago Dei and are a critical, if neglected part of the church.

Why JLM?

When I started as a chaplain in a denominational organisation, the standard church service was a traditional service from that denomination. This was generally acceptable for people from that denomination, but often strange or confronting for people from other traditions, of which there was a high proportion. This disconnect was acute for people who were living with dementia.

This is where my journey into dementia-friendly services began. I searched the literature on how to conduct church services for people living with dementia. The literature on effective dementia communication highlighted the value of factors such as childhood memories, repetition and providing multiple cues. I then sought out printed church materials from the first half of the 20th century to learn what font and style were used. I asked older people (~85+) about the music and liturgical style of their childhood - from mass, church and Sunday school. Then I surveyed what songs they remembered from childhood. This work deliberately targeted people from diverse traditions, denominations, and childhood locations. It was a synthesis of this data that led to the production of JLM. For more than a decade it has been continually improved through weekly use. This improvement came from verbal and body language feedback from people living with dementia, consultation with chaplains and reviewing the literature. Interestingly people involved in ministry with older people in the United Kingdom and North America examined JLM and noted that it resonated with the people they are working with also. Finally, people in their sixties often tell me the JLM service fosters a sense of belonging they do not feel in their home church.

Seven principles for effective Church services for people living with dementia

A review of the literature regarding dementia-friendly church services highlights seven key features of a dementia-friendly church: booklet, music, scripture/preaching, prayer, length, timing and cues. It is these seven features that form the basis of the JLM resource and are outlined here below.

1.     Booklet

There is significant value in using a service guide for dementia-friendly churches.[15] Dill proposes using devotional service booklets based on a Montessori approach to dementia.[16] Since the use of service and prayer books is ancient (e.g. Missal and Book of Common Prayer), from a practical perspective, booklets have significant value, particularly where the congregation come from diverse denominations. For example, praying the Lord’s Prayer aloud is well supported in the literature.[17] However, there are numerous translations of the Lord’s Prayer. A printed version that people can follow along with is therefore helpful.

In terms of formatting, an A4 booklet with a large font[18] is most effective (I recommend 18 point). Dill proposes Arial as the font,[19] while Rodgers suggest Arial or Times New Roman (TNR).[20]  TNR was the font used in the 1920s-1950s church resources, and so, on the principle of drawing from what is familiar from long-term memory, it is used in JLM. Indeed, resources from this period typically used headings in bold red text, and bold black text for components of the service which everyone was expected to say aloud. So JLM uses TNR and with red bold headings, black text and bold black for corporate reading, which has proved effective.

Further advantages of a printed service are that both liturgy and lyrics are printed so people do not have to go between a hymn book and a service booklet.[21] The lyrics are printed in full, rather than using ‘repeat chorus’ to make it easier for people to follow. The hymn writer’s name and reference details are not included in the booklet as this can distract some people living with dementia.

To help people navigate JLM, each item is numbered, and each page has a coloured ‘ribbon’ printed down the side.[22] So, the service leader can say ‘We are now going to sing Amazing Grace,’ ‘On the page with the green ribbon,’ ‘At point three.’[23] The added value of the ribbons is that the service leader can visually check from the front if people are on the right page and help as required. The colour of the ribbons was chosen to maximise engagement with people who are colour-blind.

Finally, the topic of booklets raises the question of why not use a projector and screen? The problem with a projector and screen is people living with macular degeneration a common issue for older people, makes reading from a screen challenging.[24] In addition, I often have people want to take the booklet home to read and use as a private devotional tool, which is only possible with a ‘hard copy.’

2.     Music

We can draw on the discipline of music therapy to understand how it can be positive for those experiencing dementia. The selection of the music in JLM is based on research about which music was most memorable for people whose childhood was before the 1950’s. The power of music for people living with dementia generally is well attested in the literature.[25] The value of hymns from childhood specifically is also well documented.[26] A question asked about JLM has been: Is singing the same songs not just repetitious but boring and thus ineffective? The answer is no. Repetition is a core tool for ministry with people living with dementia.[27] This is partially because even people living with advanced dementia can and do learn.[28] Regarding music in liturgy specifically, Crouch and Holland Home argue that two-thirds of the songs should be the same for each service.[29] However, JLM repeats the same songs each service, this has proven to be the most effective strategy.

Finally, Holland Home recommends using only the first verse and chorus of songs in a service.[30] However, my experience is that some people take longer than a verse and chorus to fully engage with the hymn, and as the chorus repeats, the confidence in the congregational singing increases. For this reason, I advocate singing multiple verses. Finally, as many hymns have a large number of verses, and some people find following a song across multiple pages challenging, JLM has what fits only on one page.

3.     Scripture and preaching

One of the underlying principles of any church service is “to spread the word.” This can take many forms such as preaching or the reading of a biblical text. Bible reading and sermons have been a key component of church services for as long as the church, has existed. In this respect, Goldsmith’s proposal that a dementia-friendly church service should have ‘no sermon’ is historically challenging. However, Goldsmith argues that a sermon is typically long and complex. Certainly, long and complex is not best practice in terms of communication with people with dementia.[31] Furthermore, Goldsmith argues for brief talks, so the problem appears to be definitional rather than fundamental.[32] Indeed, there is strong support in the literature for bible reading and a sermon as a core component of a dementia-friendly church service.[33] Thankfully, there are numerous books which provide sermons and devotions suitable for people living with dementia.[34]

Those who have looked at the JLM service will have noticed there is no bible reading or sermon included. The reason for this is flexibility rather than omission. Specifically, it allows the Bible reading and sermon to occur where the service leader feels it fits most appropriately in the service. For example, if the Scripture reading is about grace, next to point 3, ‘Amazing Grace’ is ideal. If the reading is about prayer, then point 8, ‘The Lord’s Prayer’ would be a better place.

Finally, it is helpful to cover some basics about public speaking in the context of ministry with older people. As with all communication, it is not what is said but what is heard that is important. Ministry with older people and people living with dementia typically includes people with hearing and vision impairment and people who will need extra time to process information. Actively learning to speak slowly, clearly and using pauses is critical. Ensuring your mouth is visible with good lighting, trimmed facial hair (if applicable) and not having your hands in front of your mouth when you speak are all important, particularly for people who lip read. Using large slow gestures is also helpful for people who may find small gestures hard to follow.

4.     Prayers

A key component of a dementia-friendly church service is prayer. As previously noted, using the Lord’s prayer is very well supported as a helpful tool for use in dementia-friendly church services.[35] However, other prayers are also appropriate in this context[36] with best practice being prayers with simple language and short sentences.[37]

5.     Length

A common issue for many Christians is the length of church services. The length of services designed to be inclusive of older people and those with dementia is a challenging question not simply due to attention span but also to continence issues. The literature proposes a range of times: 15-20 minutes,[38] 15-25 minutes,[39] 30 minutes[40] and 45-60 minutes.[41] Thus, there is strong evidence for a ‘shorter’ service[42] but diversity about best length. A compounding challenge is that in many care homes it can take over 30 minutes for people to be assisted to gather. Two practical ways to help prevent boredom and agitation while waiting for the service to start are to have music played during this time and have volunteers to sit with people while they wait. So, how long should a service be? Perhaps the most practical answer is as long as it is engaging for the congregation! Gauging length can be achieved by feedback (body language and verbal) and the best service leaders have the ability to condense as needed.

6.     Timing

The time of the day is a significant factor in terms of conducting a church service for people living with dementia. Generally, a morning service is best.[43] Specifically, mid-morning is often ideal for three reasons. First, traditionally many church services were ‘early’ morning (e.g. 8:00am & 9:00am) but this needs to weighed up against the fact that many older people find the temperature of early mornings challenging, particularly during the colder months. Second, particularly when an older person needs assistance with activities of daily living, they will struggle to be able to attend an early morning church service. Finally, most older people and people living with dementia are most alert mid-morning.[44] My experience has been that a 10:00am or 10:30am service is best, as any later time tends to run into lunch.

While church is traditionally a Sunday event,[45] there are two significant reasons why another day may be better for a dementia-friendly service. The first is that in many care homes, there is less staff working on a Sunday so fewer people to help bring people to church.  Second, as most church services also run on a Sunday morning, it can be hard to have enough people available to run a service in a care home.

7.     Cues

Dementia impacts situational awareness.[46] In care home and respite centre settings, this is complicated by the fact that church services are typically held in a multipurpose room.[47] A major theme in the research regarding dementia-friendly church services is the value of providing people living with dementia multiple cues, specifically to help them worship,[48] for example; a cross,[49] ‘worship table’[50] and robes/clerical collar.[51] So, using cues is best practice in a dementia-friendly church particularly in multipurpose spaces.

Future direction

As research continues and different generations grow older, dementia friendly church services will change. For example, the Billy Graham crusades and introduction of choruses to churches, will change the musical style.

Conclusion

Spiritual care of people living with dementia is critical, so churches must learn to

effectively love these people. While this care should not be limited to service style, part of facilitating belonging for people living with dementia and their loved ones is running an effective church service. Not simply because church services are important but also as a way of communicating they are loved, valuable and belong. This article has outlined seven principles of effective church services for people living with dementia and noted how they apply to JLM, a proven service for people living with dementia.

Ben Boland is a visiting lecturer at Brisbane School of Theology and Mary Andrews College. He has served as an older persons’ chaplain for over fifteen year, and is passionate about Gospel ministry with older people and people living with dementia. His next book, “Priceless People: Loving older people and people living with dementia”, will be released by Christian Focus Publication in mid 2025.

[1] Christine Bryden, “A Spiritual Journey into the I-Thou Relationship: A Personal Reflection on Living with Dementia,” in Still Waters Run Deep: Theological Reflections on Dementia, Faithfulness and Peaceable Presence, ed. John Swinton and Elizabeth MacKinlay (Milton Park: Routledge, 2024), 7, 12; Joyphen Henry, “Introduction: Dementia has No Boundaries” in Dementia and the Church: A Practical Guide, ed. Carol S. Ighofose et al, (Sydney: Dr Carol S. Ighofose, Joyphen Herry et al, 2023), 17; World Health Organisation, “Dementia,” 2023, https://www.who.int/news-room/fact-sheets/detail/dementia.

[2] World Health Organisation, “Dementia,” 2023.

[3] Australian Bureau of Statistics, “National, state and territory population,” 2023, https://www.abs.gov.au/statistics/people/population/national-state-and-territory-population/latest-release; Stats New Zealand, “National population estimates: At 30 June 2023,” 2023, https://www.stats.govt.nz/information-releases/national-population-estimates-at-30-june-2023/#:~:text=Key%20facts,resident%20population%20was%20provisionally%205%2C223%2C100.

[4] Dementia Australia, “Dementia Statistics,” 2023, https://www.dementia.org.au/statistics; Office of National Statistics, “Death registration summary statistics, England and Wales: 2022,” 2022, https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathregistrationsummarystatisticsenglandandwales/2022#:~:text=For%20females%2C%20dementia%20and%20Alzheimer's,both%20increases%20compared%20with%202021.

[5] Benjamin Mast, Second Forgetting: Remembering the Power of the Gospel During Alzheimer’s Disease (Grand Rapids: Zondervan, 2014); Ben R. Boland, “Should Urban Mission Include a Focus on Older People?” Australian Journal of Mission Studies, 18 (1) (2024): 51-55; David Jolley et al. “Spirituality and Faith in Dementia,” Dementia 9, no. 3 (2010): 311–325. doi.org/10.1177/1471301210370645; Deborah Barr, et al. Keeping Love Alive as the Memories Fade: The Five Love Languages and the Alzheimer’s Journey (Chicago: Northfield Publishing, 2016); John Dunlop, Finding Grace in the Face of Dementia (Wheaton: Crossway, 2017); John Swinton, Living in the Memories of God (London: SCM Press 2012); Parmaprabha Dalby, et al. “The Lived Experience of Spirituality and Dementia in Older People Living with Mild to Moderate Dementia,” Dementia 11, no. 1 (2012): 75–94, doi.org/10.1177/1471301211416608, 75; Mark Wormell, Coming to Christ in Dementia (Sydney: Mountain Stream Media, 2015); Stanley Hauerwas et al. Growing Old in Christ (Grand Rapids: Eerdmans, 2023).

[6] Bryden, “A Spiritual Journey into the I-Thou relationship,” 10; Fayron Epps et al. “Dementia‐friendly Faith Village Worship Services to Support African American Families: Research Protocol,” Research in Nursing & Health, 42, no. 3 (2019): 189–197, doi.org/10.1002/nur.21940, 189; Pat Otwell, Guide to Ministering to Alzheimer’s Patients and Their Families (New York: Routledge, 2007), 4-5; Patrick Coghan, Creating ‘Church’ at Home: For Older People Living with Dementia (Buxhall: Kevin Mayhew, 2016), 5; Renate Ysseldyk et al. “Abide with Me: Religious Group Identification among Older Adults Promotes Health and Well-being by Maintaining Multiple Group Memberships,” Aging & Mental Health 17, no. 7 (2013): 869–879, doi.org/10.1080/13607863.2013.799120, 871.

[7] Carol S. Ighofose et al. “Dementia and the Church: A Practical Guide,” in Dementia and the Church: A practical guide, ed. Carol S. Ighofose et al, (Sydney: Dr Carol S. Ighofose, et al, 2023), 28; Linda Beuscher and Victoria Grando, “Using Spirituality to Cope with Early-Stage Alzheimer’s Disease,” Western Journal of Nursing Research, 31, no. 5 (2009): 583–598. doi.org/10.1177/0193945909332776, 591; Rosalie E. Hudson, “God’s Faithfulness and Dementia: Christian Theology in Context,” in Still Waters Run Deep: Theological Reflections on Dementia, Faithfulness and Peaceable Presence, ed. John Swinton and Elizabeth MacKinlay (Milton Park: Routledge, 2024), 59.

[8] Fayron Epps and Ishan C. Williams “The Importance of Religiosity to the Well-Being of African American Older Adults Living With Dementia,” Journal of Applied Gerontology, 39, no. 5 (2020): 509–518, doi.org/10.1177/0733464818820773, 514; Mairi R. Finlay, “Righteousness in the Land of Forgetfulness,” J Relig Health. 54, no. 1 (2015): 279-86. doi: 0.1007/s10943-013-9813-z. PMID: 24477459; PMCID: PMC4289938, 285.

[9]John Calvin, Institutes of the Christian Religion. Translated by Henry Beveridge, (Peabody: Hendrickson Publishers, 2008), 1.15.3; John, I. Packer, Concise Theology: A guide to the Historic Christians Beliefs (Carol Stream: Tyndale House Publishers, 199), 71-73; Wayne Grudem, Systematic Theology: An Introduction to Biblical Doctrine (Nottingham: Inter-Varsity Press, 1994), 442-450.

[10] Ben R. Boland, “Jesus and Dementia,” Luke’s Journal 29(3) (2024): 19-24, ISSN2209-9441.

https://lukesjournalcmdfa.com/2024/11/05/jesus-and-dementia-rev-ben-boland/; Kenneth L. Carder, Ministry with the Forgotten: Dementia Through a Spiritual Lens (Nashville: Abingdon Press, 2019) 61-71; Wayne Grudem, Systematic Theology: An Introduction to Biblical Doctrine (Nottingham: Inter-Varsity Press, 1994), 450.

[11] John Calvin, Institutes of the Christian Religion. Translated by Henry Beveridge, (Peabody: Hendrickson Publishers, 2008), 4.1.2; John, I. Packer, Concise Theology: A guide to the Historic Christians Beliefs (Carol Stream: Tyndale House Publishers, 199), 199-203; Wayne Grudem, Systematic Theology: An Introduction to Biblical Doctrine (Nottingham: Inter-Varsity Press, 1994), 853.

[12] Bryden, “A Spiritual Journey into the I-Thou relationship,” 10; Fayron Epps et al. “Dementia‐friendly Faith Village Worship Services to Support African American Families: Research Protocol,” Research in Nursing & Health, 42, no. 3 (2019): 189–197, doi.org/10.1002/nur.21940, 189; Pat Otwell, Guide to Ministering to Alzheimer’s Patients and Their Families (New York: Routledge, 2007), 4-5; Patrick Coghan, Creating ‘Church’ at Home: For Older People Living with Dementia (Buxhall: Kevin Mayhew, 2016), 5; Renate Ysseldyk et al. “Abide with Me: Religious Group Identification among Older Adults Promotes Health and Well-being by Maintaining Multiple Group Memberships,” Aging & Mental Health 17, no. 7 (2013): 869–879, doi.org/10.1080/13607863.2013.799120, 871.

[13] Amy Jacober, Redefining Perfect: The interplay between Theology and Disability (Eugene: Cascade Books, 2017), 2; Brian Brock, Wondrously Wounded: Theology, Disability and the Body of Christ (Wayco: Baylor University Press: 2019), 1; Erin Raffety, From Inclusion to Justice: Disability, ministry and congregational Leadership (Waco: Baylor University Press, 2022), 3.

[14] Amos Yong, The Bible, Disability, and the Church: A New Vision of the People of God (Grand Rapids: William B. Eerdmans Publishing Company, 2011); Thomas E. Reynolds, Vulnerable Communion: A Theology of Disability and Hospitality (Grand Rapids: BrazosPress, 2008); William C. Gaventa, Disability and Spirituality: Recovering Wholeness (Waco: Baylor University Press, 2018).

[15] Kenneth L. Carder, Ministry with the Forgotten: Dementia Through a Spiritual Lens (Nashville: Abingdon Press, 2019); Lindsay Pelloquin and Jaye Keightley, Celebrating the Seasons in Residential Care Homes: A Service for Every Week of the Year (Rugby: Paul Thomas Group, 2022), 4; Robin Dill, “Devotions in the Respite Care Setting,” in Dementia-Friendly Worship; A Multifaith Handbook for Chaplains, Clergy and Faith Communities, ed. Lynda Everman & Don Wendoft (London: Jessica Kingsley Publishers, 2019), 141.

[16] Dill, Devotions in the Respite Care Setting, 142.

[17] Pelloquin and Keightley, Celebrating the Seasons in Residential Care Homes, 5; Trevor Adams, Developing Dementia-friendly Churches (Cambridge: Grove Books 2018), 23; Wayne Crouch, Dementia-Specific Christian Worship Service Handbook (Melbourne: PASCOP – Meaningful Aging, 2016), 13.

[18] Colette Bachand-Wood, Do this Remembering Me: The Spiritual Care of those with Alzheimer’s and Dementia (New York: Morehouse Publishing, 2016), 73.

[19] Dill, Devotions in the Respite Care Setting, 142.

[20] Jade Rodgers, Dementia and the Church: Creating a Dementia Friendly Church (Maryborough: JADMA Publishing. 2023), 70.

[21] Malcom Goldsmith, In a Strange Land…People with Dementia and the Local Church (Southwell: 4M Publications, 2004), 152.

[22] Bachand-Wood recommends using different colored pages, Do this Remembering Me, 103.

[23] Short sentences are part of good communication in the midst of dementia; Bernie McCarthy, Hearing the Person with Dementia: Person-Centred Approaches to Communication for Families and Caregivers (London: Jessica Kingsley Publishers, 2011), 65.

[24] Sandra Gordon, The Aging Eye (New York: Simon and Schster, 2001), 107-121.

[25] Kirsty Beilharz, Music Remembers Me: Connection and Wellbeing in Dementia (Sydney: HammondCare, 2019); Richard L. Morgan and David J. Fettermann, “That All May Worship,” in Dementia-Friendly Worship; A Multifaith Handbook for Chaplains, Clergy and Faith Communities, ed. Lynda Everman & Don Wendoft (London: Jessica Kingsley Publishers, 2019), 145; Robin Rio, Connecting Through Music with People with Dementia: A Guide for Caregivers (London: Jessica Kingsley Publishers, 2009), 19; Susan H. McFadden, Dementia-Friendly Communities: Why we Need Them and How We Can Create Them (London: Jessica Kingsley Publishers, 2021), 191.

[26] Beuscher and Grando, “Using Spirituality to Cope with Early-Stage Alzheimer’s Disease,” 591; Richard Behers, Spiritual Care for People Living with Dementia Using Multisensory Interventions; A Practical Guide for Chaplains. (London: Jessica Kingsley Publishers 2018), 103; Warren, A. Kinghorn, “‘I am still with you’: Dementia and the Christian wayfarer,” in Still Waters Run Deep: Theological Reflections on Dementia, Faithfulness and Peaceable Presence, ed. John Swinton and Elizabeth MacKinlay (Milton Park: Routledge, 2024).

[27] Karen S. Dumey, “Dementia-Friendly Congregational Worship,” in Dementia-Friendly Worship: A Multifaith Handbook for Chaplains, Clergy and Faith Communities, ed. Lynda Everman & Don Wendoft (London: Jessica Kingsley Publishers, 2019), 230; Kathy F. Berry, “Nurturing the Spirit through Worship,” in Dementia-Friendly Worship; A Multifaith Handbook for Chaplains, Clergy and Faith Communities, ed. Lynda Everman & Don Wendoft (London: Jessica Kingsley Publishers, 2019), 117.

[28] Elias, Ingebrand, et al. “A Person Living with Dementia Learning to Navigate an iPad: A Case Study,” Disability and Rehabilitation: Assistive Technology, 17, no. 5 (2022): 570–579, doi.org/10.1080/17483107.2020.1800117; Megan L. Malone and Cameron J. “Montessori-Based Dementia Programming Reg: Providing tools for engagement,” Dementia: The International Journal of Social Research and Practice., 6, no. 1 (2007): 150–157, doi.org/10.1177/1471301207079099, 151; Quinn, J. and Blandon, C. (2020). Lifelong Learning and Dementia: A Posthumanist Perspective. (London: Springer International Publishing, 2017). 

[29] Holland Home, Handbook for Worship; Christian Worship Experiences for Persons with Dementia (Online: Holland Home, 2005), 7; Crouch, Dementia-Specific Christian Worship Service Handbook, 9.

[30] Home, Handbook for Worship, 8.

[31] McCarthy, Hearing the Person with Dementia, 65; Otwell, Guide to Ministering to Alzheimer’s Patients and their Families, 77; Rodgers, Dementia and the Church, 27.

[32] Goldsmith, In a Strange Land, 192.

[33] Kenneth L. Carder, and Norma S. Sessions, “Worship With Rather Than For,” in Dementia-Friendly Worship; A Multifaith Handbook for Chaplains, Clergy and Faith Communities, ed. Lynda Everman & Don Wendoft (London: Jessica Kingsley Publishers, 2019), 133-134.

[34] Debbie Barr, Grace for the Unexpected Journey: A 60-day Devotional for Alzheimer’s and Other Dementia Caregivers (Chicago: Moody Publishers, 2018); Coghan, Creating ‘Church’ at Home; Home. Handbook for Worship; Hornback, God still remembers Me: Devotions for Facing Alzheimer’s Disease with Faith (New York: Starry Night Publishing, 2015); Pelloquin and Keightley, Celebrating the Seasons in Residential Care Homes; Scripture Union, Words of Faith: A Bible and Prayer Guide for People with Dementia. ed. Tricia Williams (Queensway: Scripture Union, 2010).

[35] Eileen Shamy, A Guide to the Spiritual Dimension of Care for People with Alzheimer’s Disease and Related Dementia; More than Body, Brian and Breath (London: Jessica Kingsley Publishers, 2023), 109; Elizabeth R. Reinert, “Familiar Hymns, Prayers and Scriptures to Use in a Small Group Setting for Memory-Impaired Adults,” in Dementia-Friendly Worship; A Multifaith Handbook for Chaplains, Clergy and Faith Communities, ed. Lynda Everman & Don Wendoft (London: Jessica Kingsley Publishers, 2019), 169.

[36] Adams, Developing Dementia-friendly Churches, 23.

[37] Louise Morse, “Keeping it Simple,” in Worshiping with Dementia; Meditations, Scriptures and Prayers for Sufferers and Carers, ed. Louise Morse, (Sparkford: Monarch Books, 2010), 27; Otwell, Guide to Ministering to Alzheimer’s Patients and their Families, 77.

[38] Home, Handbook for Worship, 8.

[39] Shamy, A Guide to the Spiritual Dimension of Care for People with Alzheimer’s Disease and Related Dementia, 109.

[40] Dumey, “Dementia-Friendly Congregational Worship,” 230.

[41] Dill, Devotions in the Respite Care Setting, 141.

[42] Mary, M. Cail, Dementia and the Church: Memory Care and Inclusion (Minneapolis: Fortress Press, 2023), 149.

[43] Behers, Spiritual Care for People Living with Dementia Using Multisensory Interventions, 80.

[44] Marco Canevelli, et al. “Sundowning in Dementia: Clinical Relevance, Pathophysiological Determinants, and Therapeutic Approaches,” Frontiers in Medicine, 3 (2016): 73–73. doi.org/10.3389/fmed.2016.00073; Rodgers, Dementia and the Church, 37.

[45] For most denominations.

[46] Gesine Marquardt “Wayfinding for People with Dementia: A Review of the Role of Architectural Design,” HERD, 4, no. 2 (2011): 75–90. Doi: 10.1177/193758671100400207; Lili Liu et al., “Spatial Disorientation in Persons with Early Senile Dementia of the Alzheimer type,” Am J Occup Ther. 45, no. 1 (1991): 67-74. Doi.org/10.5014/ajot.45.1.67; Rebecca Davis and Chatherine Weisbeck, “Creating a Supportive Environment Using Cues for Wayfinding in Dementia,” Journal of Gerontological Nursing, 42, no. 3 (2016): 36–44. doi.org/10.3928/00989134-20160212-07

[47] Finlay, Righteousness in the Land of Forgetfulness, 285; Otwell, Guide to Ministering to Alzheimer’s Patients and their Families, 239; Pelloquin and Keightley, Celebrating the Seasons in Residential Care Homes, 3.

[48] Finlay, Righteousness in the Land of Forgetfulness, 285; Otwell, Guide to Ministering to Alzheimer’s Patients and their Families, 239.

[49] Berry, Nurturing the Spirit through Worship, 116; Home, Handbook for Worship, 13; Morgan, “That All may Worship,” 146.

[50] Home, Handbook for Worship, 13; Crouch, Dementia-Specific Christian Worship Service Handbook, 9.

[51] Morgan and Fetterman, “That all may Worship” 146; Shamy, A Guide to the Spiritual Dimension of Care for People with Alzheimer’s Disease and Related Dementia, 107