The theology of forgetting: How dementia deepens our understanding of human dignity – America Magazine

Report on Dementia Care, Human Dignity, and Alignment with Sustainable Development Goals

1.0 Global Health Challenge and the Imperative for Well-being (SDG 3)

The global incidence of dementia is projected to triple by 2050, affecting an estimated 153 million people. This escalating health crisis presents a significant challenge to achieving Sustainable Development Goal 3: Good Health and Well-being. The situation necessitates a comprehensive response that extends beyond medical intervention to include pastoral and theological frameworks affirming human dignity irrespective of cognitive function. A critical pastoral imperative has emerged for institutions to address the spiritual and existential well-being of individuals experiencing memory loss.

2.0 Reducing Inequalities by Upholding Inherent Human Dignity (SDG 10)

Societal and institutional responses to dementia often reflect and perpetuate inequalities, which contravenes the principles of Sustainable Development Goal 10: Reduced Inequalities. A prevalent cultural perspective, rooted in Enlightenment philosophy, equates personhood with rational thought, thereby diminishing the perceived value of individuals with cognitive decline. This view contributes to their marginalization and exclusion.

• Challenge to Inherent Dignity: The view of dementia as a complete loss of self leads to quality-of-life judgments based on cognitive capacity, undermining the principle of inherent and inviolable human dignity.
• Institutional Barriers: Many institutional practices, including religious education and sacramental preparation, are structured around cognitive understanding and memorization, implicitly excluding those with memory loss.
• Social Exclusion: Individuals with dementia are frequently discouraged from full participation in community life, not through deliberate policy but as a consequence of discomfort and a lack of familiarity with their condition.

An alternative framework, grounded in the concept of imago Dei, asserts that human dignity is not contingent on ability or memory. Adopting this framework is essential for reducing inequalities and ensuring the inclusion of persons with disabilities.

3.0 Developing Inclusive and Supportive Communities (SDG 11)

The development of “dementia-friendly” theology and pastoral practices is a direct contribution to Sustainable Development Goal 11: Sustainable Cities and Communities, which calls for inclusive and safe environments for all. This involves a shift from intellectual-based engagement to embodied and communal participation.

1. Embodied Cognition and Memory: Recent neuroscience confirms that identity and memory reside throughout the body, not solely in the brain. Individuals with advanced dementia often retain muscle memory, emotional responses, and spiritual receptivity. Practices that engage these faculties, such as the tactile use of a rosary, can provide comfort and connection.
2. Communal Remembrance: The concept of memory can be understood as a communal act (zikkaron) rather than solely an individual one. The community is called to remember on behalf of those who cannot, fostering an inclusive environment where participation is embodied rather than cognitive.
3. Practical Accommodations: Institutions can pioneer inclusive practices to ensure full participation. Recommended actions include:
   • Implementing simplified liturgies that emphasize ritual and sensory experience over verbal explanation.
   • Creating prayer stations that use sensory objects like textured fabrics, scented oils, and smooth stones.
   • Providing spiritual care that is responsive to the individual’s present state, rather than cognitive expectations.

4.0 Institutional Responsibility and Justice (SDG 16)

Addressing the dementia crisis requires institutions to serve as pillars of justice and inclusion, aligning with Sustainable Development Goal 16: Peace, Justice and Strong Institutions. The church and other community organizations have a responsibility to lead in developing both theological understanding and practical, just responses.

• Advocacy and Policy: Institutions must advocate for just policies that protect the rights and dignity of individuals with dementia and support their families and caregivers.
• Training and Education: There is a need for specialized training for clergy, staff, and community leaders in dementia care to foster competent and compassionate support.
• Support for Caregivers: Providing robust support for caregivers is a crucial function, as every act of caregiving affirms the principle of human dignity over utility.
• Inclusive Governance: Institutions must actively reform practices that create barriers, ensuring that individuals with dementia are not treated as problems to be solved but as persons to be loved and integrated into the community. God’s mercy is not bound by human limitations, and institutional policies should reflect this principle of unconditional inclusion.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being
   • The article’s central theme is dementia, a significant global health issue. It highlights the growing prevalence of the disease, stating that “Dementia cases worldwide are projected to triple by 2050, affecting 153 million people.” This directly connects to the goal of ensuring healthy lives and promoting well-being for all ages, with a focus on non-communicable diseases and mental health.
2. SDG 10: Reduced Inequalities
   • The article addresses the social exclusion and discrimination faced by individuals with dementia. It points out that society often bases human worth on cognitive capacity, leading to the marginalization of those with memory loss. The text critiques how we “frequently discourage those with dementia from full participation in parish life” and calls for affirming their “inherent and inviolable” dignity, which aligns with the goal of reducing inequalities and promoting the social inclusion of persons with disabilities.
3. SDG 11: Sustainable Cities and Communities
   • The article advocates for creating inclusive environments for people with dementia. The call to develop “‘dementia-friendly theology’—pastoral practices that do not require intact memory” and create “inclusive liturgies” speaks directly to making communities and human settlements inclusive and accessible for persons with disabilities. While the context is religious communities (parishes), the principle applies to the broader goal of accessible public and community spaces.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Under SDG 3: Good Health and Well-being
   • Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. The article’s focus on dementia, a progressive neurological disorder, and the call for pastoral care and support systems directly relate to promoting the well-being of individuals affected by this non-communicable disease.
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services. The article’s call for “training clergy in dementia care, creating inclusive liturgies, supporting caregivers and advocating for just policies” implies the need for a comprehensive support system that is a key component of universal health coverage for those with dementia.
2. Under SDG 10: Reduced Inequalities
   • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, disability, or other status. The article’s core argument is for the full inclusion of people with dementia in community life, challenging the “discomfort and unfamiliarity” that leads to their exclusion from religious and social participation.
   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory policies and practices. The text critiques pastoral practices that “implicitly contradict” the teaching of inherent dignity and advocates for new practices that ensure people with cognitive decline are not marginalized.
3. Under SDG 11: Sustainable Cities and Communities
   • Target 11.7: By 2030, provide universal access to safe, inclusive and accessible, green and public spaces, in particular for women and children, older persons and persons with disabilities. The article’s promotion of “dementia-friendly” parishes with “simplified liturgies” and “prayer stations using sensory objects” is a direct application of this target, aiming to make community spaces accessible and inclusive for people with cognitive disabilities.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicators for SDG 3
   • Prevalence of Dementia: The article provides a direct quantitative indicator of the health challenge: “Dementia cases worldwide are projected to triple by 2050, affecting 153 million people.” This statistic can be used to track the prevalence of the disease, which is relevant to monitoring progress on non-communicable diseases (Target 3.4).
2. Indicators for SDG 10
   • Rate of Participation in Community Life: The article implies an indicator by highlighting the problem of people with dementia being discouraged from “full participation in parish life.” Progress towards Target 10.2 could be measured by the rate of participation of persons with dementia in community, social, and religious activities.
3. Indicators for SDG 11
   • Adoption of Inclusive Practices: The article suggests concrete measures for creating inclusive spaces. An indicator for Target 11.7 could be the proportion of community centers or parishes that have implemented “dementia-friendly” practices, such as “simplified liturgies,” “prayer stations using sensory objects,” and specialized spiritual care programs mentioned in the text.

4. Summary Table of SDGs, Targets, and Indicators

Source: americamagazine.org