Where Is God in Alzheimer’s, Dementia, and the Loss of the Mind?
When We Can No Longer Remember God, Does God Still Remember Us?
Theological Abstract
Alzheimer’s disease and other forms of dementia present a profound theological challenge because they progressively impair memory, language, reasoning, self-awareness, recognition, and the ability to express faith. If human identity is located primarily in consciousness or rational cognition, dementia can appear to diminish not merely mental function but personhood itself. A biblical theology of dementia therefore requires a more adequate theological anthropology—one that recognizes the distinction and relationship between body, soul/spirit, and mind within the unity of the human person.
Scripture does not reduce the human being to the functioning mind or brain, nor does it treat the body as an insignificant container for an otherwise complete spiritual self. Human beings are embodied creatures made in the image of God (Gen. 1:26–27), formed from the dust and given life by God (Gen. 2:7), possessing bodily, rational, relational, moral, volitional, and spiritual dimensions. Although Christian theologians continue to debate dichotomous, trichotomous, holistic, and nonreductive understandings of human constitution, the biblical witness provides no basis for equating the whole person with cognitive performance. Consequently, neurological deterioration may profoundly impair the means through which personhood is presently expressed without demonstrating that the person has ceased to exist or has lost God-given dignity.
This distinction has direct implications for dementia. The believer’s relationship with God ultimately rests not upon uninterrupted memory, intellectual competence, or the continuing ability to articulate faith, but upon the initiating, sustaining, and preserving grace of God. God knows His people when they can no longer adequately know themselves (Ps. 139:1–16); the Holy Spirit ministers in human weakness when words and conscious prayer fail (Rom. 8:26–27); Christ preserves those who belong to Him (John 10:27–29); and nothing within the created order can separate the believer from the love of God in Christ (Rom. 8:35–39).
Dementia should neither be minimized nor romanticized. It represents genuine bodily and neurological deterioration within a fallen creation and brings profound suffering to individuals, families, and caregivers. Yet it does not erase the image of God, extinguish personhood, or nullify the promises of redemption. Christian hope therefore extends beyond compassionate dementia care to bodily resurrection and the restoration of the whole person. The brain matters because the body matters, but the diseased brain does not exhaust the identity of the person before God. Dementia may progressively take memory, speech, recognition, reasoning, and independence, but it cannot take the believer from Christ.
The person may forget God.
God does not forget the person.
Introduction: When the Mind Begins to Disappear
Few diseases raise questions about human identity as painfully as Alzheimer’s disease and other forms of dementia. Cancer attacks the body. Arthritis limits movement. Heart disease weakens physical strength. But dementia appears to reach into the places we commonly associate with the self—memory, language, recognition, reasoning, personality, and the ability to communicate.
A person who once remembered birthdays and anniversaries may no longer recognize a spouse. A parent may forget the names of his children. A lifelong Christian may eventually become unable to recite Scripture, participate meaningfully in worship, articulate a prayer, or even speak the name of Jesus.
For Christian families, this can produce a frightening theological question:
Where is God when a person appears to be losing his or her mind?
Behind that question are others.
Is someone still the same person when memories disappear?
Is the mind the person?
Does a damaged brain mean that the self is gradually disappearing?
What is the relationship between the brain, mind, body, soul, and spirit?
Does a Christian remain spiritually connected to God when cognitive abilities deteriorate?
What happens when someone can no longer understand the gospel, remember a conversion experience, or consciously pray?
These questions require more than a theology of suffering. They require a theology of the human person. Our understanding of dementia will inevitably be shaped by our understanding of humanity itself. Scripture gives us reason to affirm that our relationship with God ultimately rests not upon the strength of our memory, but upon the faithfulness of God. Dementia may impair our ability to remember God, but it cannot impair God’s ability to know us.
The person with dementia may forget God.
God does not forget the person with dementia.
The Mind Is Not the Whole Person
The questions raised by dementia ultimately force us into one of the oldest questions of Christian anthropology:
What is a human being?
This question becomes especially important when Alzheimer’s disease damages the brain. If the brain is the bodily organ through which we remember our history, recognize our family, communicate our thoughts, make decisions, and express religious belief, what should we conclude when those capacities deteriorate? If consciousness and memory constitute the self, does the self gradually disappear as the brain deteriorates? Much depends upon how we answer that question.
The Modern Turn Toward the Mind
Modern Western thought has increasingly tended to locate personal identity within consciousness. René Descartes famously began his philosophical project with the certainty of the thinking self. Although Cartesian philosophy is considerably more complex than the slogan by which it is commonly remembered, cogito, ergo sum—“I think, therefore I am”—became emblematic of a larger modern tendency to identify the authentic self primarily with the conscious, thinking subject.¹
The consequences for understanding dementia are significant.
If thinking constitutes being, what happens when thinking becomes impaired?
If personal identity resides primarily in autobiographical memory, what happens when those memories disappear?
If the self is essentially consciousness, what happens when consciousness becomes profoundly impaired?
The danger is that neurological deterioration can gradually be interpreted as ontological deterioration: as the capacities of the mind disappear, we begin to imagine that the person is disappearing as well. Craig Carter traces an important strand of modern thought in which the authentic self becomes increasingly identified with consciousness rather than with the embodied human person.² Marc Cortez similarly describes modernity as involving a decisive “turn toward the self,” a development that inevitably affected theological reflection upon human nature.³ Dementia exposes the inadequacy of reducing personhood to such categories. A person with advanced Alzheimer’s may lose many of the characteristics modernity associates with autonomous personhood: rational independence, autobiographical memory, verbal communication, deliberative reasoning, and sustained self-consciousness.
But Christianity asks a more fundamental question.
Not merely:
What can this person still think?
But:
What has God created this person to be?
Biblical Anthropology Is Larger Than the Mind
Scripture does not provide a modern scientific description of human psychology or neurobiology. Nor does it use anthropological terminology with the precision of a contemporary medical textbook. Instead, Scripture speaks about human beings through overlapping terms such as body, flesh, soul, spirit, heart, and mind.
In the Old Testament, important anthropological terms include nefesh, commonly translated “soul” or “life”; basar, “flesh”; ruah, “spirit” or “breath”; and leb, “heart.” These terms describe dimensions of human existence without necessarily dividing the human person into completely independent compartments.⁴
Genesis 2:7 is particularly important:
“And the LORD God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living being.”
The text does not portray the body as an irrelevant container into which the real person is temporarily placed. God forms the human being from the earth. God gives the human being life. The result is a living human person. Hans Schwarz emphasizes that nefesh frequently refers to the living person rather than merely to a separable component possessed by that person. In discussing Genesis 2:7, he writes that the human being “does not have a nefesh (soul or psyche), but is one and lives as one.”⁵
The point should not be pressed into a complete denial of every distinction between material and immaterial dimensions of human existence. Rather, it demonstrates how difficult it is to force biblical anthropology into modern categories. Scripture regularly speaks of the person holistically.
The same complexity appears in the biblical use of “heart.” Modern Western culture commonly distinguishes sharply between the heart as the center of emotion and the brain or mind as the center of rational thought. Biblical terminology is not so neatly divided. Schwarz notes that leb encompasses bodily, emotional, intellectual, and intentional dimensions and “functions in all dimensions of human existence.”⁶ The biblical “heart” can think, understand, desire, choose, rejoice, rebel, and respond to God. This matters enormously for dementia.
The Bible does not identify the whole person with the functioning intellect.
Reason is important.
Memory is important.
Consciousness is important.
The brain is extraordinarily important.
But none of these alone exhausts what Scripture means by a human person.
The Distinction and Relationship Between Body, Soul/Spirit, and Mind
The New Testament gives further reason to resist reducing the person to cognition. Jesus distinguishes between body and soul:
“And do not fear those who kill the body but cannot kill the soul. But rather fear Him who is able to destroy both soul and body in hell.” —Matthew 10:28
Paul can speak of the human person in terms of “body and spirit” (1 Cor. 7:34), while elsewhere he refers to “spirit, soul, and body” (1 Thess. 5:23). He also speaks of the nous, or mind, as associated with understanding, thought, intention, and moral orientation (Rom. 7:23; 12:2; Eph. 4:23). These passages have contributed to longstanding Christian debates over human constitution. Some theologians have understood humanity dichotomously, distinguishing the material body from the immaterial soul or spirit. Others have advocated a trichotomous understanding, distinguishing body, soul, and spirit.
More recently, some Christian biblical scholars, theologians, philosophers, and neuropsychologists have proposed holistic or nonreductive physicalist understandings that emphasize the profound unity of embodied human existence. Brad Strawn, for example, describes contemporary proposals including nonreductive physicalism, the constitution view, and emergent dualism as attempts to take modern neuroscience seriously without simply reducing human persons to neurological mechanisms.⁷
We need not settle that larger debate in order to establish the point essential to dementia.
The mind is not synonymous with the whole person.
Scripture does not say:
You are your memory.
It does not say:
You are your intelligence.
It does not say:
You are your capacity for rational thought.
And it certainly does not say:
When your brain can no longer perform these functions normally, you cease to be a person.
The biblical language is richer.
We are embodied creatures.
We are rational creatures.
We are relational creatures.
We possess emotional, moral, volitional, and spiritual dimensions.
And most importantly, we exist in relationship to the God who created us.
Veli-Matti Kärkkäinen argues that Christian anthropology must understand the human person fundamentally in relation to God.⁸ Theological anthropology therefore cannot begin and end with neurological function.
The question “What is a human being?” cannot finally be answered merely by describing what happens inside the brain.
Neither a Brain Alone nor a Soul Trapped in a Body
An important qualification is necessary.
Rejecting the reduction of the person to the brain does not require Christians to diminish the importance of the body. Christian thought has sometimes been influenced by ideas that portray the body as little more than a temporary container for the soul—as though salvation ultimately means liberation of the real, immaterial person from physical existence. But the biblical story does not end with souls escaping bodies. It ends with resurrection.
Paul does not describe the believer’s ultimate hope as permanent disembodied existence. He speaks of “the redemption of our body” (Rom. 8:23), and 1 Corinthians 15 places bodily resurrection at the center of Christian eschatological hope.
Paul declares:
“For this corruptible must put on incorruption, and this mortal must put on immortality.”
—1 Corinthians 15:53
The body therefore matters.
The brain matters.
Neurology matters.
Damage to the brain can profoundly alter how a person thinks, remembers, communicates, experiences emotion, recognizes others, and interacts with the world. Christian theology should never minimize those physical realities. But neither should we make the opposite error and conclude that the physical processes of the brain exhaust everything that can be said about the human person.
Joel Green observes that developments in neuroscience have intensified the debate over traditional understandings of body and soul. He describes contemporary neuroscience and neurophilosophy as raising substantial challenges for Christian anthropology, particularly regarding consciousness, human freedom, personal identity, and traditional understandings of the soul.⁹
The appropriate Christian response is therefore neither to deny neuroscience nor to allow neuroscience to become an exhaustive anthropology. The human person is neither a brain alone nor a soul imprisoned in an irrelevant body. The Christian doctrine of humanity requires us to consider the distinction and relationship between body, soul/spirit, and mind within the unity of the human person.
Dementia Damages the Brain—But Does It Destroy the Person?
This brings the theological problem into sharper focus. Alzheimer’s disease damages the brain. As that damage progresses, memory may disappear. Language may become fragmented. Reasoning may deteriorate. Personality may change. Recognition may fail. Eventually, even the ability to communicate conscious thought may disappear. These losses are real and devastating. But we must distinguish between damage to the means through which the person presently expresses himself or herself and the conclusion that the person no longer exists.
John Swinton draws an important distinction when he writes: “There is a world of difference between an apparent dissolution of a human being and the actual dissolution of that person.”¹⁰ That distinction becomes particularly important in advanced dementia. Suppose a Christian woman can no longer say her husband’s name. Has her husband ceased to be her husband? No. Suppose she can no longer remember her children. Have they ceased to be her children? No. Suppose she can no longer remember her baptism. Has her baptism therefore ceased to have occurred? No. Suppose she can no longer articulate the gospel she believed for sixty years. Has Christ therefore forgotten her? That conclusion does not follow either.
The relationships remain objectively real even when one person loses the cognitive ability to recognize them. This gives us an important theological analogy for our relationship with God.
The Person Exists Before God
Christian anthropology grounds personal identity somewhere deeper than self-consciousness. Our identity does not originate with our ability to think about ourselves. It originates with God. David asks:
“What is man that You are mindful of him,
And the son of man that You visit him?”
—Psalm 8:4
Notice the direction of the question. Human significance is connected not merely with humanity’s ability to contemplate God but with God’s mindfulness of humanity. Psalm 139 makes the point even more personally:
“O LORD, You have searched me and known me.”
—Psalm 139:1
Before the psalmist describes his own thoughts, words, movements, or actions, he begins with God’s knowledge. God knows me. That theological order becomes enormously important when dementia destroys a person’s ability to say: I know myself.
Christian anthropology therefore offers something far deeper than cogito ergo sum—“I think, therefore I am.” It enables us to say: God created me. God knows me. My existence and identity before Him therefore do not depend upon my ability to maintain conscious awareness of myself.
Created in the Image of God
This brings us to the doctrine of the imago Dei.
Genesis declares:
“Then God said, ‘Let Us make man in Our image, according to Our likeness.’”
—Genesis 1:26
And:
“So God created man in His own image; in the image of God He created him; male and female He created them.”
—Genesis 1:27
The text does not say that humanity bears God’s image only through rational intelligence. Nor does it say that those possessing greater intellectual abilities bear more of God’s image than others. Schwarz specifically cautions against attempting to isolate particular human functions as though one of them alone constitutes the image of God. He concludes concerning Genesis that “the whole person is created in God’s image.”¹¹ That has profound implications for dementia. If rational intelligence constituted the image of God, then the image would diminish as cognitive ability diminished. If autobiographical memory constituted the image of God, then Alzheimer’s disease could gradually erase it. If self-consciousness constituted the image of God, then those with profound cognitive disabilities would possess less human dignity than those with exceptional intellectual abilities. But Scripture provides no basis for such a hierarchy of human worth.
The person with advanced dementia remains a creature made by God and living before God. Human dignity does not rise with intelligence. It does not fall with memory. It does not disappear with language. It is not measured by an IQ score, neurological examination, ability to live independently, or ability to recognize one’s family. Kenneth Carder’s theological treatment of dementia challenges approaches that effectively locate spirituality and personhood primarily in rational cognitive capacities.¹² When cognition is treated as the principal measure of the person, cognitive impairment can easily be mistaken for spiritual disappearance.
A Christian anthropology grounded in God’s creative and relational action allows us to say something different. The mind can deteriorate without the person becoming less valuable. The brain can become diseased without the person becoming less human. Memory can disappear without the image of God disappearing. And the ability to think consciously about God can diminish without God ceasing to know the person.
Dementia Belongs to a Fallen World
Christian hope does not require us to minimize the devastation of dementia.
Alzheimer’s disease is not good.
Confusion is not good.
The inability to recognize one’s spouse is not good.
The gradual loss of speech, independence, mobility, and memory is not something Christians need to romanticize in order to defend the goodness of God. Scripture, however, places suffering within the larger biblical story of creation, fall, redemption, and restoration. Humanity was created for life with God, but sin brought corruption and death into human experience (Gen. 3; Rom. 5:12). Paul describes creation itself as subjected to corruption and waiting for liberation (Rom. 8:20–23). Benjamin Mast approaches Alzheimer’s within this larger Christian story. Present deterioration must be understood against the hope of redemption and restoration rather than treated as the final definition of the person.¹³ That distinction matters.
Christian hope does not say dementia is insignificant.
It says dementia is not final.
It does not tell grieving families that they should not mourn.
Jesus Himself wept in the presence of death (John 11:35).
Christian hope says instead that disease does not receive the final word.
God Knows Us When We No Longer Know Ourselves
Perhaps the most important theological reversal in thinking about dementia is this:
We naturally ask whether the person with dementia still knows God.
Scripture directs our attention toward something even more fundamental:
God knows the person.
Psalm 139 describes God’s knowledge of us as preceding and exceeding our knowledge of ourselves:
“O LORD, You have searched me and known me.
You know my sitting down and my rising up;
You understand my thought afar off.”
—Psalm 139:1–2
God’s knowledge reaches farther than human self-awareness.
Before we formulate a thought, God knows it.
Before we speak, God knows what we intend to say (Ps. 139:4).
Before we were born, God knew us (Ps. 139:13–16).
The theological significance for dementia is profound.
If God’s relationship with His people depended upon their uninterrupted ability to remember Him, advanced dementia would present an enormous spiritual problem. But Scripture consistently portrays God as the One who knows, seeks, preserves, and holds His people. Mast emphasizes that both salvation and continuing faith ultimately depend upon divine grace rather than autonomous human faithfulness. He writes, “both our salvation and ongoing faith are the result of the work of God, rather than our own faithfulness.”¹⁴
Alzheimer’s may eventually make it impossible for family members to understand what their loved one is thinking, feeling, or attempting to communicate.
But God is not limited by those barriers.
Family members may eventually say:
I don’t know if she understands me anymore.
I don’t know what he is thinking.
I don’t know if she recognizes me.
I don’t know whether he understands when I pray.
Those statements may all be painfully true.
But the Christian can add another statement:
God knows.
What If Someone Can No Longer Pray?
Dementia may eventually rob a person of the ability to formulate sentences. Someone who prayed faithfully for decades may reach a point where coherent verbal prayer is impossible. Has prayer therefore ended? Romans 8 gives a remarkable answer:
“Likewise the Spirit also helps in our weaknesses. For we do not know what we should pray for as we ought, but the Spirit Himself makes intercession for us.”
—Romans 8:26
Paul’s statement does not specifically concern dementia, but its theological principle has profound significance for believers whose neurological condition makes verbal prayer difficult or impossible. Prayer has never depended entirely upon our ability to find the correct words. The Holy Spirit ministers in human weakness. Mast draws attention to Paul’s declaration that the Spirit intercedes even through “wordless groans.”¹⁵ God’s access to the believer is not dependent upon the believer’s ability to produce coherent language. That means a Christian lying silently in a dementia-care facility is not spiritually abandoned simply because words are gone.
Speech may fail.
Memory may fail.
Concentration may fail.
But God has not failed.
The God who searches the heart does not require an intact vocabulary before He can minister to one of His children.
What If They Forget Jesus?
For Christian families, this may be the most troubling question of all. What happens if a lifelong believer eventually forgets the name of Jesus?
What if he no longer remembers the gospel?
What if she no longer remembers being baptized?
What if the person can no longer explain what he believes?
We should begin by recognizing what salvation is not.
Salvation is not maintained by repeatedly passing a theological examination. A believer is not justified because he successfully remembers the facts of his conversion every morning. We are saved by grace through faith because of the saving work of Christ (Eph. 2:8–9). Scripture describes salvation from beginning to end as the work of God:
“Whom He predestined, these He also called; whom He called, these He also justified; and whom He justified, these He also glorified.”
—Romans 8:30
Mast emphasizes this divine initiative when considering Alzheimer’s and faith. If salvation and perseverance ultimately rest upon God’s gracious action, cognitive deterioration cannot reverse the work of Christ simply because the believer can no longer articulate what he once believed.¹⁶ Jesus gives similar assurance concerning His sheep:
“And I give them eternal life, and they shall never perish; neither shall anyone snatch them out of My hand.”
—John 10:28
Notice where the security lies. Not in the strength of the sheep.
In the hand of the Shepherd.
A believer may lose the ability to remember Christ without Christ losing His ability to hold the believer.
Nothing—Including Dementia—Can Separate Us from Christ
Romans 8 reaches its climax with one of Scripture’s strongest declarations of Christian assurance:
“For I am persuaded that neither death nor life, nor angels nor principalities nor powers, nor things present nor things to come . . . nor any other created thing, shall be able to separate us from the love of God which is in Christ Jesus our Lord.”
—Romans 8:38–39
Alzheimer’s disease belongs to the created order affected by the fall.
Dementia can separate a person from memories.
It can separate a person from independence.
It can make communication between spouses extraordinarily difficult.
It can obscure familiar faces.
It can remove occupational skills, vocabulary, judgment, and awareness of surroundings.
But it cannot separate the believer from Christ.
Mast summarizes the theological assurance powerfully: “Though Alzheimer’s disease is a frightening and powerful enemy, the promise of God is greater: nothing can separate those who are in Christ from the love and grace of God.”¹⁷ That distinction changes how Christians should think about dementia.
Our assurance is not:
I remember God; therefore God must still have me.
Our assurance is:
God has me; therefore even when my memory fails, I remain His.
Can God Still Reach a Mind Damaged by Dementia?
Another question naturally follows. If Alzheimer’s physically damages the brain, can a person still experience God? John Dunlop cautions against assuming that neurological impairment necessarily indicates spiritual absence. Damage to the brain can alter the outward means through which spiritual awareness is expressed without establishing that God is incapable of ministering to the individual.¹⁸ This distinction is essential.
The brain is part of the physical body and can become diseased. But Christianity does not teach that God is dependent upon a healthy brain before He can know, love, sustain, or reach a human being. We should therefore be cautious about interpreting outward silence as inward spiritual absence.
A person may no longer respond when Scripture is read. That does not prove God is absent.
A person may no longer sing the words of a hymn. That does not prove worship has become meaningless.
A person may stare silently while someone prays. That does not prove the prayer is spiritually irrelevant.
Our inability to observe a response is not evidence of God’s inability to reach the person.
Spiritual Life May Persist Beneath Cognitive Decline
There are also reasons not to assume that all spiritual responsiveness disappears as cognitive abilities deteriorate. Stephen Post observes: “Observers estimate, and my personal experience confirms, that 90 percent of Americans who are diagnosed with dementia pray.”¹⁹ He further notes that “litanies, prayers, and hymns often have a deep emotional significance” for people progressing through dementia.²⁰ This should encourage families and churches not to abandon spiritual ministry merely because someone appears unable to participate as before.
Kathie Erwin similarly writes: “People with Alzheimer’s or dementia, as well as their family members, still have spiritual needs.”²¹ She makes the theological point even more directly: “The soul of a believer is not diminished by mental capacity.”²² That statement captures an important implication of the anthropology developed throughout this article. Cognitive capacity and personhood must not be treated as synonyms. This has practical consequences.
Read Scripture even when you are unsure how much is understood.
Pray with the person even when there is no verbal response.
Sing familiar hymns.
Play worship music that was meaningful earlier in life.
Speak gently about Christ.
Hold a hand when appropriate.
Repeat familiar passages such as Psalm 23.
Say the Lord’s Prayer together if that has been part of the person’s Christian life.
Do not measure the spiritual value of these actions solely by visible response.
The church’s responsibility is not merely to stimulate cognition.
It is to love the person.
The Ministry of Presence
Dementia also forces Christians to reconsider what ministry means. We often think ministry requires words: teaching, counseling, explaining, reasoning, correcting, or encouraging. But some stages of dementia make these activities increasingly difficult. At that point, ministry may become much simpler.
Sit beside the person.
Hold a hand.
Smile.
Sing.
Read a Psalm.
Pray.
Listen.
Remain.
This kind of ministry reflects something deeply Christian:
“And the Word became flesh and dwelt among us.”
—John 1:14
God did not love humanity from a distance. In Christ, He entered human suffering. Christian caregivers imitate that pattern whenever they choose presence over abandonment. Post describes loving care as capable of functioning as “prosthetics” for losses involving language and cognition.²³ His analogy helps us see how community can continue carrying aspects of human life that an individual can no longer sustain independently.
When the person cannot remember the community, the community remembers the person.
When the person cannot tell his story, others preserve his story.
When the person cannot pray, others pray for him.
When the person cannot sing, others sing beside him.
When the person cannot articulate faith, the church continues to surround him with the words and practices of faith.
Dementia Reveals Something About Love
Imagine a mother who no longer recognizes her daughter. The daughter walks into the room and says, “Mom, it’s me.” Her mother looks confused. Does the daughter stop being her daughter? Of course not. The relationship is not destroyed merely because one participant can no longer remember it. The daughter remembers what the mother cannot.
She remembers the birthdays.
She remembers childhood.
She remembers Christmas mornings.
She remembers conversations.
She remembers sacrifices her mother made.
She remembers being loved.
And because she remembers, she continues loving the mother who has forgotten.
Human love like this gives us a small picture of something far greater about divine grace.
Scripture says:
“The Lord knows those who are His.”
—2 Timothy 2:19
Our deepest security is not that we remember Him perfectly. Our security is that He knows us perfectly. That is why dementia cannot ultimately destroy the Christian’s identity before God. Identity is not preserved by neurological performance. It is preserved by the God who knows His people.
The Person Is Still There
Dementia can change personality, communication, emotional expression, and behavior so dramatically that family members sometimes say, “That’s not the person I knew.” The grief behind such words is understandable. Something has indeed been lost. In many cases, much has been lost. But Christian theology urges us to distinguish between the loss of abilities and the loss of the person.
Swinton’s distinction between the “apparent dissolution” and the “actual dissolution” of the person is especially helpful here.²⁴ Observable characteristics through which we normally recognize another person may deteriorate dramatically without establishing that the person’s fundamental identity before God has disappeared.
Carder similarly directs Christian attention beyond cognitive performance toward the continuing dignity of the individual before God.²⁵
The woman in the dementia unit is not merely a disease.
She is a person.
She has a history.
She has relationships.
She has dignity.
She bears God’s image.
Her brain may be profoundly damaged.
Her mind may no longer function as it once did.
Her ability to express herself may be disappearing.
But none of those facts authorizes us to declare that the person has ceased to exist.
And if she belongs to Christ, she remains His.
Where Is God?
So where is God in Alzheimer’s disease?
He is where He has always been.
He is present when memory begins to fail.
He is present when names disappear.
He is present when familiar rooms become confusing.
He is present when language becomes fragmented.
He is present when prayer becomes silence.
He is present when the person no longer recognizes the Bible in his hands.
He is present when a husband feeds the wife who once cooked his meals.
He is present when a daughter patiently introduces herself to her mother for the tenth time that afternoon.
He is present when a caregiver sits beside someone who can no longer carry on a conversation.
He is present when a familiar hymn produces the faintest smile.
He is present when there appears to be no response at all.
The Shepherd does not abandon His sheep because the sheep can no longer remember the way home.
Jesus described the shepherd who searches for the lost sheep (Luke 15:3–7).
Mast makes the theological application especially appropriate to dementia: “When you fear that your loved one is no longer seeking God, remember that it is God who first sought us.”²⁶ The emphasis is upon divine initiative. The sheep is found because the shepherd searches. That is grace.
The Christian Hope: Resurrection and the Restoration of the Whole Person
Christian hope ultimately reaches beyond better dementia care. We rightly seek compassionate caregivers, good physicians, effective treatments, safe facilities, and meaningful human connection. But Christianity promises something medicine cannot.
Resurrection.
Paul describes believers as waiting for:
“the redemption of our body.”
—Romans 8:23
That phrase is especially important after considering Christian anthropology. Our hope is not simply that an immaterial soul escapes a deteriorating brain. Nor is our hope that human existence ends when neurological function ends. Christian hope concerns the restoration of the whole person.
The brain damaged by Alzheimer’s belongs to the body awaiting redemption.
The body weakened by disease awaits resurrection.
The mind whose memories have disappeared belongs to a person whom God still knows.
The person whose speech has vanished remains within the redemptive purposes of God.
Paul describes resurrection in 1 Corinthians 15:
“The body is sown in corruption, it is raised in incorruption.”
—1 Corinthians 15:42
And:
“For this corruptible must put on incorruption, and this mortal must put on immortality.”
—1 Corinthians 15:53
The Christian doctrine of resurrection therefore prevents two opposite errors.
The first is reductionism: the belief that the person is nothing more than present neurological function.
The second is disembodied spiritualism: the belief that the body ultimately does not matter because only the soul is important.
Christian hope rejects both. The body matters because God created it. The soul/spirit matters because human existence cannot be exhausted by neurological description. The mind matters because our capacity to think, remember, love, worship, and relate to others is part of embodied human life. And the whole person matters because the whole person belongs to God.
Mast places the suffering associated with Alzheimer’s within this larger expectation of redemption and restoration.²⁷ The Christian story does not end in neurological deterioration. Revelation describes the culmination of that hope:
“Behold, I make all things new.”
—Revelation 21:5
For the Christian, dementia is devastating. But it is not eternal. There is coming a day when neurological disease will no longer obscure personality. There will be no Alzheimer’s disease.
No dementia.
No confusion.
No forgotten names.
No frightened wandering.
No inability to recognize the people we love.
No caregivers watching someone they love disappear behind the fog of disease.
The God who created the whole person will redeem the whole person. Until then, the church must stand beside those who suffer and remind them—sometimes with words, sometimes with songs, sometimes simply through faithful presence—that they remain persons of immeasurable value before God. And when the person with dementia can no longer remember the promises of God, the people of God can remember those promises for them.
When they can no longer speak their faith, we can speak words of hope beside them.
When they can no longer pray, we can pray.
When they can no longer remember who they are, we can remember.
And beneath all our remembering stands a greater truth:
God remembers.
You may forget where you are.
You may forget the people you love.
You may forget the hymns you once sang.
You may forget the Scriptures you once memorized.
You may even forget the name of Jesus.
But God will never forget you.
Questions for Reflection
Why does dementia challenge our understanding of personal identity more deeply than many illnesses that primarily affect other parts of the body?
In what ways has modern culture encouraged us to identify the self primarily with consciousness, memory, intelligence, independence, or rational thought?
What problems arise if we assume that the functioning mind or brain constitutes the whole person?
How do the biblical concepts of body, soul, spirit, heart, and mind demonstrate the complexity of human nature?
Why is the formulation “the distinction and relationship between body, soul/spirit, and mind within the unity of the human person” more helpful than simply treating a person as either a body or a soul?
What does Genesis 2:7 teach about both the embodied nature of human existence and our dependence upon God for life?
How does the doctrine of the imago Dei challenge the idea that human dignity depends upon intelligence, memory, productivity, independence, or self-consciousness?
If the whole person bears God’s image rather than one particular cognitive faculty, what implications does that have for someone with advanced Alzheimer’s disease?
What is the difference between damage to the brain and destruction of the person? Why is that distinction important for Christian caregiving?
How do Psalm 8 and Psalm 139 shift our attention from our ability to know ourselves toward God’s knowledge of us?
What comfort does Romans 8:26–27 provide when a Christian can no longer formulate or speak a coherent prayer?
If salvation ultimately rests upon God’s saving grace rather than uninterrupted cognitive awareness, how should that affect our understanding of Christians with advanced dementia?
What does Jesus’ promise in John 10:27–29 teach about the security of believers whose mental capacities have severely deteriorated?
How does Romans 8:35–39 address the fear that Alzheimer’s disease might somehow separate a Christian from Christ?
Why should Christians avoid assuming that someone who cannot outwardly respond to prayer, Scripture, or worship is no longer experiencing anything spiritually?
How might familiar hymns, Scripture readings, prayer, touch, and Christian companionship continue to minister to someone whose verbal and cognitive abilities are disappearing?
What does it mean for the church to “remember” a person with dementia when that individual can no longer remember the church?
How does bodily resurrection protect Christian anthropology from both reducing the person to the brain and treating the body as spiritually unimportant?
What does the promise of “the redemption of our body” in Romans 8:23 mean for a believer whose brain has been devastated by neurological disease?
If you someday lose your own memory and ability to articulate your faith, what promises of Scripture would you want your family and church to remember on your behalf?
Scripture Passages Cited or Referenced
Genesis 1:26–27 — Humanity created in the image of God.
Genesis 2:7 — God forms humanity from the dust and gives life.
Genesis 3 — The fall and the entrance of sin, corruption, suffering, and death.
Psalm 8:4 — God’s mindfulness and care for humanity.
Psalm 23 — Referenced as a familiar passage for ministry to people with dementia.
Psalm 139:1–2 — God searches and knows the person completely.
Psalm 139:4 — God knows our words before they are spoken.
Psalm 139:13–16 — God’s intimate knowledge of the person from the womb.
Matthew 6:9–13 — The Lord’s Prayer, referenced as a familiar pattern of prayer.
Matthew 10:28 — Jesus distinguishes body and soul.
Luke 15:3–7 — The shepherd searches for the lost sheep.
John 1:14 — The Word becomes flesh and dwells among us.
John 10:27–29 — Christ knows, gives eternal life to, and securely holds His sheep.
John 11:35 — Jesus weeps in the presence of death.
Romans 5:12 — Sin and death enter human experience.
Romans 7:23 — Paul’s reference to the mind within his discussion of human existence and sin.
Romans 8:20–23 — Creation’s corruption and hope; the redemption of the body.
Romans 8:26–27 — The Spirit helps believers in weakness and intercedes when words fail.
Romans 8:30 — God’s saving action from calling through glorification.
Romans 8:35–39 — Nothing can separate believers from the love of God in Christ.
Romans 12:2 — The renewal of the mind.
1 Corinthians 7:34 — Paul’s reference to body and spirit.
1 Corinthians 15:42 — The corruptible body raised incorruptible.
1 Corinthians 15:53–54 — The mortal puts on immortality.
Ephesians 2:8–9 — Salvation by grace through faith.
Ephesians 4:23 — Renewal in the spirit of the mind.
1 Thessalonians 5:23 — Paul’s reference to spirit, soul, and body.
2 Timothy 2:19 — “The Lord knows those who are His.”
Revelation 21:5 — God makes all things new.
Footnotes
Craig A. Carter, “The New Gender Gnostics,” Eikon: A Journal for Biblical Anthropology 2, no. 1 (2020): 32–33.
Carter, “New Gender Gnostics,” 32–33.
Marc Cortez, Theological Anthropology: A Guide for the Perplexed, Guides for the Perplexed (London: T&T Clark, 2010), 3–5.
Stanley J. Grenz, Theology for the Community of God (Grand Rapids, MI: William B. Eerdmans Publishing Company, 2000), 158–59.
Hans Schwarz, The Human Being: A Theological Anthropology (Grand Rapids, MI: William B. Eerdmans Publishing Company, 2013), 5–29.
Schwarz, Human Being, 5–29.
Brad D. Strawn, “Neuroscience, Spirituality And,” in Dictionary of Christian Spirituality, ed. Glen G. Scorgie (Grand Rapids, MI: Zondervan, 2011), 636–37.
Veli-Matti Kärkkäinen, Creation and Humanity, vol. 3 of A Constructive Christian Theology for the Pluralistic World (Grand Rapids, MI: William B. Eerdmans Publishing Company, 2015), 240.
Joel B. Green, Body, Soul, and Human Life: The Nature of Humanity in the Bible, Studies in Theological Interpretation (Grand Rapids, MI: Baker Academic, 2008), 16–21.
John Swinton, Dementia: Living in the Memories of God (Grand Rapids, MI: William B. Eerdmans Publishing Company, 2012).
Schwarz, Human Being, 5–29.
Kenneth L. Carder, Ministry with the Forgotten: Dementia through a Spiritual Lens (Nashville: Abingdon Press, 2019).
Benjamin T. Mast, Second Forgetting: Remembering the Power of the Gospel during Alzheimer’s Disease (Grand Rapids, MI: Zondervan, 2014).
Mast, Second Forgetting.
Mast, Second Forgetting. See his discussion of Romans 8:26–27 and the Holy Spirit’s intercession in human weakness.
Mast, Second Forgetting.
Mast, Second Forgetting. See his discussion of Romans 8:35–39 and the believer’s security in the love of Christ.
John Dunlop, Finding Grace in the Face of Dementia (Wheaton, IL: Crossway, 2017).
Stephen G. Post, “Alzheimer’s & Grace,” First Things, no. 142 (2004): 12–14.
Post, “Alzheimer’s & Grace,” 12–14.
Kathie Erwin, “Dementia & Alzheimer’s: Two Words No One Wants to Hear,” in Physical Health and Illness, Christian Counseling Today Theme Collection (American Association of Christian Counselors, 2025), 38–42.
Erwin, “Dementia & Alzheimer’s,” 38–42.
Post, “Alzheimer’s & Grace,” 12–14.
Swinton, Dementia: Living in the Memories of God.
Carder, Ministry with the Forgotten.
Mast, Second Forgetting.
Mast, Second Forgetting.
