Spiritual perspectives on the person with dementia: identity and personhood

F. Brian Allen and Peter G. Coleman

in Dementia

Published on behalf of Oxford University Press

Published in print December 2005 | ISBN: 9780198566151
Published online February 2013 | e-ISBN: 9780191754418 | DOI:

Series: International Perspectives in Philosophy & Psychiatry

Spiritual perspectives on the person with dementia: identity and personhood

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In this chapter we consider contributions from spiritual and theological perspectives to the meaning of personal identity in the face of dementia. In contemporary health and social care literature there has been a growing interest in spirituality and stress has been laid on identifying and meeting the spiritual needs of people, particularly those with mental health problems, learning disabilities, and ill health in later life. Definitions of spirituality are elusive as are concepts of mind, meaning, and personhood—not least in the case of people with dementia.

Spirituality is often described both as being about the intangible and immaterial aspects of life as well as being closely associated with a sense of meaning and purpose. It is particular to each person and yet, by virtue of its essential nature to all human beings, is shared with others. Some would say that spirituality is intuitive or even innate and, therefore, not easily susceptible to rational explication. Whilst it is sometimes described as being distinct from religion, arguably spirituality is essential to religion. One definition claims, people of all ages share basic human needs that include love (the giving and receiving of affection), faith (someone or something to believe in), hope (something to look forward to), peace (finding a measure of stability and tranquillity) and worship (a sense of awe and the attribution of value or ‘worth’ to whomever or whatever is deemed to merit it). (Jewell 1999, p. 10)

Some of the circumstances of older age give a particular focus to these needs and values. Other definitions emphasize connectivity. Spirituality is an intra, inter and transpersonal experience that is shaped and directed by the experiences of individuals and the communities within which they live out their lives. (Swinton 2001, p. 20)

Spirituality could be described as that which is essential to our humanity, embraces the desire for meaning and purpose, and has personal, social, and transcendent dimensions. The word ‘spirit’ comes from the Latin for breath and its equivalent in Hebrew and Greek, amongst other languages, similarly denotes that which is fundamental to life. To talk of spirituality, then, is to attempt to put into words things intimate and immanent as well as things other and transcendent.

Spending time with people with dementia and their carers inevitably poses some basic questions about ourselves. Who am I and what is to become of me? What is the meaning and purpose of our lives? Such are the existential questions and dilemmas with which we are faced and which are often seen as funda mental to recent spiritual discourse. Historically, this discourse has taken place within the frameworks of faith traditions, where faith is both the means and the end of the spiritual quest. Clearly history bears witness to how religious faith, as the politics of spirituality, has not lived up to the ideals it has promulgated; fundamental concepts have been lost or diluted in practice. In a secular and post-modern environment, such history is often used as reason to cease taking underlying concepts seriously. Furthermore, post-Enlightenment philosophies have often rejected the premises of religious thought. That beliefs about who we are and what is to become of us can no longer be responded to in religious terms with any reasonable legitimacy or integrity is a notion we wish to challenge.

The apparent renewal of interest in spirituality can be seen as indicative of a positive regard for the identity and personhood of people with dementia. We suggest it also reflects a sense of something essential that is missing from current theory and practice, which goes beyond specific considerations about people with dementia. Without understating the effects of dementia on either those diagnosed or their carers, it appears that people with dementia are showing us something of ultimate concern about the nature of personhood and creation. This is, perhaps, reflected in part by the recent focus on the personhood of people with dementia (Kitwood 1997).

The way in which terms such as ‘individual’ and ‘person’ have been employed in both philosophical and religious thought over the centuries is being explored today, perhaps not so much to discover what has hitherto remained mysterious or unknown, but more in an attempt to recover that which has been lost in modern and post-modern thought, or indeed not developed adequately to sustain its case in the contemporary world of ideas.

Chapter.  8013 words. 

Subjects: Psychiatry

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