A Delicate Subject⤒🔗

The word “and” was deliberately chosen in the title of this article. I could also have said “at”: elderly people with dementia at the Supper. That is precisely the issue that will be discussed in this article.

This topic was presented to the editors from within a group of office-bearers. For various reasons it is not an easy theme to write about.

There is, first of all, the fact that this is mainly about the administration and celebration of the Lord’s Supper in a nursing home, possibly in a seniors home.

As far as I am aware of the situation, there is at this point no single pattern or rule that is followed in our churches. There are various possibilities for arranging the Lord’s Supper celebration in a care home.

It should be paramount that the brothers and sisters themselves, as well as the congregation, will give preference to the actual participation of these older members of the Lord’s Supper in the church itself. With all that follows, this preference is to be stated first.

In the Home←⤒🔗

However, there are people who due to age and defects cannot leave the seniors’ home where they were given a room and where they receive loving care. With regard to church services, there is often the possibility to be connected to one’s own local church on Sundays via modern means of communication. That gives a feeling of familiarity. There may also be homes where church services are held, organized either by the pastoral worker of the home or by local church councils according to their turn.

Obviously, no single resident can be compelled to go to such a service when he or she prefers to be connected to their own church in their own room. All kinds of factors can play a role here. If at all possible, it would be advisable — based on the community ideal of the home — to experience the communal church service at least from time to time. It is quite conceivable, however, that there are so many justified objections to this that some residents prefer to stay in their room and wish to be connected to their own church. No senior can be forced at this point. In the home itself there should be the freedom for the residents to make their own choices. Such a decision needs to be respected by the staff and management of the home. I know that unfortunately this is not always the case. Sometimes it may happen that people are considered to be unwilling or obstinate when they prefer their own church service and to listen to it in their own room. That is both deplorable and wrong.

No Common Rule←⤒🔗

Now I will pay attention to the Lord’s Supper in such homes. This is arranged differently from place to place. The purpose of this article is by no means to prescribe one single policy as the only correct one. When a church council has established a good arrangement—sometimes after difficult external and internal consultations—it is not my task to criticize this here in this article. I do believe that consultation with classis and church councils deserves recommendation. Even then there can be a difference from one place to another. One should always take the local situation into account (as it has developed and sometimes came about after various difficulties).

I know that there are places where “our” church council, on a rotation basis, organizes the celebration of the Lord’s Supper once a year. This church council then has its own responsibility for the entire service. The church council will also admit members of other churches as guests to the Supper table, just as its own members may celebrate the Supper as guests when another church council is responsible for the celebration. “Our” church council will accept as guests all those who have admission to the Lord’s Supper in their own church. Although this is not the only way to arrange this celebration in care homes, it seems to me a proper way.

These are exceptional situations. There are members of the congregation who can no longer go to their own local church and yet appreciate the opportunity to celebrate the Lord’s Supper together. This opportunity should be given as much as possible. If there is no sense of community among the residents, or among the churches who founded and maintain the home, the Lord’s Supper can also be served to the individual church member in his or her room by their own church council. It seems desirable to me that at least one family member and an elder are present in order to express the idea of ​​community.

I have written down a few thoughts about these matters, which are by no means intended as an exclusive regulation. They serve as a guide within the framework of the provisions of Article 63 of the Church Order.¹

Seniors with Dementia←⤒🔗

The title of this article is about elderly people with dementia. Will church councils admit them to the Lord’s Supper or serve the symbols of bread and wine to them? There are differences in the degrees of dementia. There are people who can still think and speak reasonably well. There are also people who are — as it is sometimes said — living in an almost vegetative state. I don’t like to use this expression. The reader will understand that I am referring to the most severe form of dementia. Between these two there is an entire range of possibilities.           

Let me also add that it is a delicate subject. An author does not write his thoughts on paper without proper emotions. You feel in your heart how difficult these things can be for family members. For many years we, as her children, have visited our mother who suffered  serious dementia. Sometimes there were still moments or flashes of consciousness. I will never forget that at one time, she was very restless during a church service in the nursing home. I had moved her to the church hall myself and sat next to her. I understood her turmoil somewhat. It was a church service in which things were not familiar to her. The guest minister was rather modern in the presentation of his sermon and in the choice of songs. When he gave the blessing with the words of Numbers 6, my mother said, “Now it is good.” At that moment there was recognition.

I believe that with regard to our subject we have to move between these two extremes: on the one hand, taking it for granted that the Lord’s Supper should be administered to such people, and on the other, the obviousness of not doing this. The well-known text from 1 Corinthians 11:28-29 (about self-examination) was not written for this situation in the first place, although we do not need to disregard it entirely.

From what I wrote earlier, it may be clear that we cannot determine exactly the reach of comprehension of a demented elderly person. We need to be careful not to pass a quick judgment on this. In addition, people with dementia are sometimes rather sensitive to certain actions (call them rituals if you like). They are therefore sometimes more encouraged and comforted by these actions than by words. I think this should be taken into account in our consideration.

There is another aspect to this issue: that celebrating the Supper requires action. There is an active element to it, even though we spoke about “the Supper being administered.” Whoever celebrates the Lord’s Supper needs to be able to do that activity to a certain extent. When someone is totally passive, and he or she cannot drink the cup in any way, it is actually not possible for him or her to celebrate the Supper. Something similar can be said about using the bread. Then a limit has been reached where we need to stop. Where there is a perception of a total physical and psychological inability, we should not pretend that this limit is not there for us.

I would therefore be cautious about offering the Lord’s Supper to people with dementia. Out of respect for the sacred character of the sacrament, and for the brother or sister who should not be compelled, I would be careful not to cross a line that we should not cross.

Here I can only give some hints. This is not a matter where a certain rule would be applicable to all and every situation. Love and respect, compassion, and at the same time a degree of reticence, coupled with prayer for wisdom, will pave the way.

In closing I wish to emphasize that the visual value carries extra meaning in these situations, more than the spoken word.

Let us ask ourselves whether we can hold back a member of the congregation from the Holy Supper, when the Lord does not make it physically and psychologically impossible for him or her. In general, we will pray with seniors who have dementia — with them, and not just for them. Perhaps this consideration, too, can help us, as office-bearers, to arrive at a good decision when we are in doubt.