Church’s familiar routine may comfort Alzheimer’s patient

I'm an LPN and specialize in Alzheimer's. I have been doing this for more than 25 years, and have headed Alzheimer care units. One of the things we strive for is some sense of normalcy. These people lose their short-term memory at first. But many have strong, vivid memories of years ago.

Going to church every Sunday is probably one of the few things Blanche actually remembers, and it most likely brings her a sense of comfort. Most of the parishioners probably have known her for years. This isn't walking through a mall full of strangers; it is enjoying fellowship with old friends. I'm sure they are not "gawking."

Nursing homes are often frightening to Alzheimer's patients – full of strange sounds and people. Church, however, is full of beloved hymns and friends.

Unfortunately, there will come a time when her disease will progress to the point that these trips will become stressful for her, and possibly that her behavior will become too difficult for church. But until that time comes, I hope this dear friend continues to do such a wonderful thing for this woman. I only hope that I have such caring friends in my later years. – Jennifer in Carthage, Mo.

Dear Jennifer: I would like to thank you and the many readers who urged me to change my answer to that letter. Some pointed out that Blanche had elicited the promise when she was a "different person," far different from the woman she is today.

However, I am torn.

While I think it's brutal for older people who suffer from dementia to be treated as pariahs and isolated (and many are), and clearly this friend is well-meaning, I also feel strongly that a person's wishes stated in advance should be respected. Blanche may have wanted to be remembered as the person she was, and entrusted her friend to carry out her wishes "after she reached a certain point."