Ep. 19 - Dementia, Devotion and Spirituality

Elisa Bosley, a licensed non-denominational Chaplin based in Colorado, met with host Attorney Bob Mannor to discuss the lack of faith-based resources for those facing Dementia, Alzheimer's disease or memory loss.

With decades of experience leading worship and bible studies, Elisa founded Spiritualeldercare.com and subsequently her YouTube Channel.

Elisa explains the differences between religious care and spiritual care as well as what those differences can mean for the person with Dementia. The impact of spiritual care revolves around the familiarity and repetition of practice that elders with Dementia can lean into their long-term memory.

Items like songs, scripture, and poems offer opportunities for these individuals to participate in something they know and provide a sense of community and familiarity.

Listen to this interesting and meaningful episode here or find Advice from your Advocates wherever you listen to podcasts.

Transcript

You're listening to
Advice from Your Advocates, a show
where we provide elder law advice
to professionals who work with the elderly
and their families.
Welcome back to Advice
From Your Advocates.
I'm Bob Mannor.
I'm a certified elder law attorney
in the state of Michigan.
And we have a dementia focused practice,
something that we've talked
about quite a bit on this podcast.
And I'm really excited
about today's podcast.
This is something
that I've been looking forward to.
We have Elisa Bosley, who's
a nondenominational Christian chaplain
that has a particular focus
in calling towards
focusing on older adults, especially those
with dementia and their families.
Now if you are interested,
I was just recently
on a podcast called
it was Father Joe Krupp’s podcast on
I'm trying to think of
the name of his podcast,
Quantum Catechesis
is what he calls this podcast,
and so very popular podcast.
If you want to check it out.
I was a guest on that podcast
and we talked about similar issues
as to what
we're going to talk about today.
And so this is a really
an interesting topic
and it's really kind of difficult
sometimes to think about ministering
to those that have some form of dementia
and kind of working with their families.
So Elisa, can you just kind of tell us a
little bit about yourself and what you do?
Sure.
Thank you, Bob, so much for having me
and for the good work that you do.
So I as you said, I'm
a nondenominational, licensed chaplain,
and with a particular
calling to older adults with dementia,
I got involved in this work
because I have actually decades
of experience leading worship
and leading Bible studies
in churches and parachurch settings
kind of everywhere I've lived
and then got very involved
in dementia specific care.
When my father in law developed
Alzheimer's
and we were intimately involved
with his care.
After he passed, I started volunteering
at a memory care
residence close to our home,
and I was really fortunate that
this particular residence had
and has a very strong commitment
to spiritual care
for their residents, which I didn't
realize at the time was unusual.
It's very unusual.
So given my background, I just felt like,
“Oh my goodness, this is now
bringing together everything I love,”
which is worship and looking at scripture
and ministry with people with dementia.
And then I found not only was it
rare to see this kind of service
provided
at elder care residences, excuse me,
but there were
very, very few resources online
that were specific to spiritual care
for people with dementia.
There was a ton of research
on how valuable that kind of care is.
Interesting,
but very little on actually how to do it.
And I'm
also a professional writer and editor,
so I started writing up
all these materials,
you know, using my background
and what I learned about
people with dementia
and created those materials myself
because I couldn't find them
when I was looking for them online.
So that's my background and.
That's amazing.
You know, on a personal note, I'll mention
both of my parents had different
forms of dementia,
and they were both very devout.
And once they started experiencing
these dementias and in very different
ways, very different
symptoms, very
different things that they experienced,
but both of them,
it was very difficult
to have them continue their devotion.
And so I think
that's probably a pretty common scenario
where people
that really would value and appreciate
and get, you know,
get value from having a continuation
of their devotion
are excluded in some way.
Right. Right.
That's very common.
And it's ironic in a lot of ways
because what makes it
what makes spiritual care
so effective often with people with
dementia is the familiarity,
The repetition.
Yes, of these forms that they have
literally grown up practicing.
You know, especially in that generation
of our elders, that they went to
church every Sunday.
And those forms are hardwired
into their long term memory.
And any amount of dementia care
that you do, you find out pretty quickly
that those are the forms
that you want to try to access anything
that's in that long term memory.
And of course, religious practice
and ritual is full of that.
The songs and the,
you know, the prayers and the scriptures.
And there's so much repetition.
So it's very it's interesting to me.
But the thing is, in a normal church
setting, the amount of stimulation
is generally too much
for people with dementia because of course
they don't have the brain ability
to process that much stimulus.
So it's using those familiar forms,
but simplifying them.
You know, we.
Often talk about music
being one of those things
that folks with dementia often
still can relate to.
Their...
The neural, the neurons,
the connections
still work with regard to the music.
Yeah,
I feel like that sort of ritual is similar
not just music, but all, all forms
of, of ritual and religious, you know,
rituals would be similar to that, though
those connections still exist.
Music is you're absolutely right.
Music is, I would have to say,
probably the number
one most connecting form
that I find to be effective
because, you know, you think about it.
I've heard this said from music
therapists, The heartbeat is our first
experience of music.
The rhythm, it goes back that far.
Interesting.
Music, it's also one of my favorite things
in research about dementia.
They have discovered that the brain center
that's responsible for music memory
is largely, completely untouched
throughout the entire course of dementia.
Right? Right. It's mind blowing.
It's just mind blowing.
And so again, those songs and I'm sure,
you know, there's songs
that come into your mind unbidden
sometimes you don't want them to
and you can't get them out of your head.
But those old hymns and spiritual songs
and gospel music,
those are deeply embedded
in that long term memory
and they're full of truth and comfort
and beauty.
So you know better than, in my opinion,
singing some, you know,
jingle for a product
which also might get stuck in your head.
Yes. Accessing these hymns
which have that added
benefit of comfort and peace and truth, is
so valuable.
And I imagine so
sometimes
and this is not true in every case,
and it's probably a minority of cases,
but there are some times where we worry
about in the long term care industry,
they call them behavior. And behaviors
are somebody that's being verbally abusive
or acting out physically.
And my in my imagination,
this could be very helpful
in addressing behaviors.
Am I on the right track?
Oh, definitely, yes, absolutely.
In fact, I think music for sure.
But even the my experience has been
that the religious, the church services
that I provide, the benefits
extend way beyond
even that hour that I'm there.
You know, that there's a lasting...
it's not that they're going
to remember what I said
or the prayers or anything,
but that sense of peace and connection
can last for quite a long time.
And again, there's research that
it's what's
called procedural
and emotional religious activity.
It's a fancy term for, you know,
these forms we've been talking about,
that those have more lasting
beneficial effects
than other engaging things like bingo or,
you know, whatever trivia games.
Those are all fine and good
and have their place.
But that those long faith
based, long term faith based
practices have an even longer
lasting benefit for people with dementia.
You know, and probably going down
a bit of a controversial road here.
But I feel like that's one of those things
like religion has been
it's not as acceptable
in in very generic society
and anything that's going to be,
you know, very broadly construed,
we're we're going to invite anyone in.
We try to avoid religion.
And I feel like in this particular
case, that's a real
that's really not
ideal because this is something
that could provide some really
positive comfort and quality of life
for those folks that would
benefit from it. Right.
I'm so glad you brought that up.
Yeah, that's a really,
really important point because I think
it's important to distinguish
between religious care and spiritual care.
So I'm an unapologetically, I'm
a Christian chaplain.
That's my background. That's what I do.
But chaplains are, by definition,
nondenominational.
That means if I have and I do
of course, have elders
that aren’t part of my particular faith
religion, but they still are part
of another faith tradition.
It's my job to help them
get that spiritual care that they need.
Religious care is specific
to a particular religion.
Spiritual care is a human need
and a human right.
It's a human right
because it gets at the dignity
and the purpose
of every single human being.
And of course, there are those faith
based rituals across faith traditions.
And it's really important for myself
or anyone who wants to provide
this kind of care to find the specific
forms and
rituals for that resident
that they're working with.
I'll give a quick shout out to Coral
Health.
I have a partnership with Coral Health
because they they're a content provider
across the faith spectrum,
so I provide Christian content for them.
But their whole thing is, you know,
we want to provide this.
And as you say, it's valuable for anybody
who has a faith
background of any faith
or even no faith, right.
That this content that's from a rabbi
or from an imam or whatever
it may be, a priest, any kind of clergy
that gets at that root
need for a connection with Divine
and with the ineffable
and that human dignity.
That's part of everyone.
Yes, absolutely.
That's really fantastic.
So let's get into this a little bit.
Tell me a little bit more about, you know,
how does this work?
So what what is this?
What's unique about it?
How do you do things differently?
Okay, so, I have found well,
first of all,
my calling is to bring church,
as it were, into the long
term care communities where I've worked.
So it's a wonderful thing for churches
to try to become more dementia friendly.
That's a really a different topic
and different than what I do.
But boy, really worth
exploring. Absolutely.
What I do is, is
bring it in to the building
because so often these elders are not able
to get out to their places of worship
anymore for whatever reason, whether it's
too stimulating or they're physically
compromised or whatever it may be.
The family members
don't have the resources to get them to
their place of worship, but they miss it.
They really, really miss it.
So I bring it in and the materials
that I've created are to really encourage
anyone to bring that service
into where these elders live.
So, you know,
I gather people up for a Sunday service.
I invite everyone and anyone.
I always tell you, you know,
people will say, Well, I'm Catholic.
Are you Catholic?
I was like, Well, no, I'm not.
But this is for anyone.
If you don't like it, you can leave.
It's fine.
Jews, Muslims, Buddhists,
I've had them all come.
So again, my forms are
mostly Christian
form, but I try to incorporate elements
like poetry or readings
or whatever it is so that everyone
can have some connection point.
And again, the music is huge
because a lot of people know
a lot of these songs,
no matter what their background is.
The main things I would say that
make it different
are one, slower pace.
Okay.
So if people ask me, what's the
what's the one thing that I should know
about really interacting
well with people with dementia?
And the first thing I say is “slow down,
slow down,” Because people with dementia
need extra time to process
whatever you're saying,
whatever you're doing,
whatever sensory input there may be.
So I think, you know, as I'm talking to
you, I'm like, this is way too fast.
But if I'm in a church service,
I consciously slow my speech down.
And then there are
the familiar repetition
through every church service that I do.
So I actually use the same lineup
of songs every single week
so that, you know, we have
songbooks that we can use or not
or not use.
You know,
they're like point type or whatever.
And but it's page
one, page two, page three, page four.
We're not skipping around, right,
because it simplifies it.
The forms like the Lord's Prayer,
the Our Father, the Psalm ,
the Lord is my shepherd.
And I think a key, key aspect
that makes it valuable and
dignity giving to people with dementia
is that it's interactive.
I feel really, really strongly
and any professional in dementia care
will tell you that engaging
the people is important
as opposed
as opposed to just talking at them.
Yeah.
So I have what I call like a it's
I basically call it an interactive homily.
It's not a sermon.
I do not just talk at them.
There are questions based on
whatever the theme for the day is.
So yesterday the theme was change
and we talked about,
well, you know,
what sorts of things change in life?
And then I wait and see what they say
and we go back and forth and
and whatever they say,
I will affirm it and try to draw out more.
And so they feel like
they're participating.
They don't feel like it.
They actually are participating.
And again,
I feel like that's a matter of dignity.
These people are valuable
and they have always been valuable
and they remain valuable.
Their cognition has nothing to do with it.
So those forms, the speed, the pacing,
the repetition,
the familiarity and again, the music,
probably
half of the hour that I spend in a church
service.
Is music.
Nice, Yeah,
I had an experience a couple of years ago.
I was at a
legal conference
and the keynote was an Anglican monk
and he spoke
and this is very,
you know, this was fascinating to me.
Part of it was the experience of it,
but part of it was looking around
at the rest of the audience.
These are all of these very high powered.
This was a conference
of successful attorneys.
It's called the Atticus Group,
which is not just your average attorney,
but very successful growth
oriented attorneys.
And they were all sort of a type.
I mean, typically typeA, very powered.
And the monk spoke
at a extremely slow pace.
And I was looking around to see
if anybody was getting agitated.
Right. No one was. Mm.
I never... I've been
to a lot of these conferences
and everybody has feedback and everybody,
they like this guy, They don't like
this woman, whatever it is,
%.
I was shocked at how everybody loved this
presentation.
Yeah.
And what was interesting about it was then
at the end of the presentation,
he took some questions
and then he spoke in a normal rate.
Oh, interesting.
Very, very intentional.
He was showing us
he was, you know, and it was just
an amazing experience
for everybody in that room.
And there was probably, I'm going to say,
close to attorneys in that room.
And they
you couldn't
nobody got up and went to the bathroom.
Nobody was in the back
talking on their cell phone.
You could have heard a pin drop.
And he spoke at such a slow pace.
Like, I feel like there's some value
in that for all of us
because of the dementia
diagnosis completely.
I mean, I will say this every time.
I am so blessed being in their presence
because, you know,
we often talk in our culture about,
Oh, it's so important to be in the moment.
Be in the moment, right?
And we have to train ourselves to do it.
But people with dementia,
that's all they have is this moment.
They don't have minutes ago,
they don't have minutes from now.
They have right now. And being with them,
I enter into that space with them
and it is such a gift to me.
They become my teachers
and I get the value from that.
Being with it.
It sets me up for the week.
That's amazing.
It's amazing to think about
because it's really hard.
We have our audience is going to be
a pretty broad audience,
but there's a good portion of them
that are going to be working in the long
term care industry
and working with folks that have dementia.
And I always want to,
you know, acknowledge that, that we.
Absolutely.
Learn from
our clients,
from our patients, from our residents
that some of the
agitation of life, some of our anxiety,
some of our depression,
some of our experiences
could be better if we learned
from everyone around us, including those
that can't fully participate
or perceive
everything that's going on around them.
But to learn from that experience
of being in the moment,
I think that's a
that's a fantastic reminder for everyone.
It really is.
And caregivers,
I mean, you know this as well as anyone.
I want to kiss the feet.
You know,
they're amazing, these caregivers.
And they have an intense, intense job.
And I never want to diminish the fact
that the journey with dementia is hard.
It's really hard.
But there is this beauty in it.
If we will see that
and enter into that, it's
not that we're going to get that right
every time or, you know, be
like all Zen about it
every time because it is hard
and there's challenges,
no question about it.
But again, there's these gifts of beauty
and the divine that enter in that
if you're open to that
and you have some tools to meet
that and to interact
with that part of humanity,
part of their personhood,
the blessings are myriad.
And, you know, that can't be understated
how difficult it is.
It is, oh. My goodness.
Incredibly difficult.
And in no way are either of us
implying anything other than that.
And the idea
is to try to find some joy in that.
Exactly. You find some learning in,
you know...
part of the Christian tradition is
that there is value in suffering,
you know,
And I think that there is an importance
to that.
And a lot of people
like a good part of society.
Say suffering is bad
and there's nothing good about it.
Well, okay, but there will be suffering.
That's a truth. That's just right.
There will be suffering.
And so the I think a good part of probably
all religious tradition,
but particularly Christian
religious tradition,
is that there is value in suffering.
And it's not saying, okay,
we should encourage suffering.
It's saying that there's value
that we can get from that.
Well, that there's purpose behind
not pushing away, but entering in.
And I think that's
that's always a challenge.
Of course, we want to avoid suffering.
But, you know, when I
when I have Bible studies or discussions
with elders with dementia
and we talk about suffering,
we talk about hardship, they get it.
I mean, they understand this is real.
You know, I always say, well, “Who here has
had a completely pain free life?”
You know, that always gets a laugh, right?
They understand. But they know.
And it's actually partly,
you know, it's my job to remind
us, you know, I'm with them.
God is with you in this.
This is not the end.
This is not the final story.
We may be walking through
the valley of the shadow of death
in that psalm.
David doesn't say, well,
“Maybe if I walk through the valley.”
Right.
You know, when I walk through the valley
of the Shadow of death, God is with me.
You know, we're not in this alone.
So even though, yeah, that suffering
is real and hard and the elders get it,
they, they want and
they believe in that hope
that God is with them.
There is purpose in just being with God.
Accessing God's presence and strength
and looking forward
in hope to our final destiny
where there will be no more crying
and no more tears and no more pain.
That's according to our
our Christian scriptures.
So yeah, it's,
you know, living in that reality.
So how do we access your services?
What would be the best way?
How do we get more information
about what you do?
How do we bring that
into some of the communities?
Thank you for asking.
So two major avenues.
One, as I said,
I created SpiritualElderCare.com
when I was looking for materials to do
dementia friendly spiritual care
and couldn't find any online.
So I created SpiritualElderCare.com
It has
a lot of information on there.
I kind of laugh because I feel like,
well, I get a little carried away
because I love this stuff so much.
There's more than a year's worth of theme
based worship services.
There's more than a year's worth of weekly
dementia friendly Bible discussions.
Again, it's
meant to be very engaging.
So they're not just talking at a group,
they're interacting
with questions and meditations.
There's more than a hundred free downloads.
All this stuff is free, free,
downloadable, professionally recorded
hymns, which again,
as we've mentioned on this podcast
earlier, music
turned out to be such a huge, huge part
that in this kind of care
that in I think it was ,
Again, I didn't find anything
online in terms of hymns
that were dementia friendly,
which meant that they were slower,
shorter, right in a lower key.
And so I thought, well,
I guess I'm going to create them myself.
So I hired musicians and oh, nice,
very simple recordings.
It's a single male voice, a single female
voice, a simple piano accompaniment.
Anyway, those are all online to download,
so that all that stuff is on my website as
of , thanks to COVID,
I created a YouTube
channel
that was never in my plan to do that.
But now I have those services there,
a shortened
version of the church services,
and then the hymns with lyrics.
Again, very easy to read lyrics again
all up on my YouTube channel, which is
YouTube.com/SpiritualElderCare.
and even the Bible studies are coming.
I'm in the process of
of creating Bible study discussion videos,
which again are intended to for,
let's say,
an activity professional to put them on.
But pause them at certain points
that I tell you to pause the video
to have a discussion with the group.
It's not meant
nothing that I do is meant to be something
that you just plunk people in front of.
It's meant to be interactive and engaging.
So yeah, those are the two big channels,
the written materials
and then the video materials.
So you had mentioned earlier that you have
a partnership with one organization.
If there is a group online
that is listening to this podcast
and there's, you know,
a variety of organizations
probably that this might go out to.
Is there any way that they could find
a way of partnering with you?
Oh, my goodness.
I love to get inquiries from people.
And I do get inquiries, this amazes me, actually.
I get inquiries from all over the world.
Yeah. Nice.
From people saying, “Well,
how do I do this at my place?”
“How do I start?”
I got an email just yesterday from someone, I’m
trying to remember where they were,
who said, “I've never even been
in a Bible study, but I feel like
I want to lead a Bible study
for my memory care residents.”
“How would I start?”
I love getting inquiries like that,
so it's great.
Yes, please
reach out to me through my website.
There's a contact form on there again
with other faith traditions that
that's something you're interested
in. I really do.
I mean, I partnered with Coral Health
because I love their vision
and what they do
and what they're trying to provide
for seniors from any faith tradition.
So definitely would
would check them out as well.
Well, fantastic.
Elisa Bosley,
It has been an excellent conversation.
I really appreciate you coming on.
This is something that I've been looking
very much looking forward to.
So this has been one of my favorite
presentations of Advice
From Your Advocates.
And don't forget to subscribe
and we will see you next time.
Thanks for listening.