Second Forgetting: Remembering the Power of the Gospel during Alzheimer's Disease

Second Forgetting: Remembering the Power of the Gospel during Alzheimer's Disease

by Benjamin T. Mast

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Product Details

ISBN-13: 9780310513872
Publisher: Zondervan
Publication date: 09/23/2014
Pages: 192
Sales rank: 223,556
Product dimensions: 7.90(w) x 5.20(h) x 0.40(d)
Age Range: 18 Years

About the Author

Dr. Benjamin Mast, Ph.D, is a licensed clinical psychologist, Associate Professor in Psychological & Brain Sciences and Geriatric Medicine at the University of Louisville, and an elder at Sojourn Community Church, Louisville, Kentucky.

Read an Excerpt

Second Forgetting

Remembering the Power of the Gospel During Alzheimer's Disease


By Benjamin T. Mast

ZONDERVAN

Copyright © 2014 Benjamin T. Mast
All rights reserved.
ISBN: 978-0-310-51387-2



CHAPTER 1

WHAT IS THE SECOND FORGETTING?


Lewis has been retired for just a year and a half. He worked in home construction and then as a handyman for decades. Because he loves golf and travel, he worked past age sixty-five so he could save up enough money to be able to visit golf courses along the coast. He and his wife, Ann, had just visited one course in North Carolina and had a wonderful time. The weather was perfect, Lewis had more birdies than bogies, and they ended each day with a glass of wine on the beach. It was everything they had hoped retirement would be—until Ann noticed something that made her uneasy.

Lewis had always had a habit of recounting his successes on the course—a powerful drive or a long putt that almost dropped. In all honesty, Ann wasn't usually interested. They all seemed similar, so she often gave the appearance of listening while her attention was elsewhere, whether a magazine or the sunset. But she will never forget this night because there was something in the way he told the story that caught her attention.

On the last hole Lewis had teed off, hoping to hit the green. As he told the story, he knew he'd hit the ball well and saw it soar over a small hill toward the green. As he walked over that hill he was surprised to find the ball sitting mere inches from the flag. His heart had thumped as he realized he had almost hit his first hole in one. Back at the hotel, his excitement was apparent, and Ann knew she'd be hearing about this for quite some time. Sure enough, he talked about it as they got dressed for dinner and brought it up again at dinner and even mentioned it to their waiter. He was proud, and she understood this was part of the enjoyment of the game for him, so his talking about it over and over made sense.

But as they sat on the beach at sunset, he told the story again. She couldn't say exactly how, but there was something slightly different in the way he told it, almost as if he didn't realize he had already told her the whole story several times. Her heart rate quickened. She knew Lewis's mom had suffered with Alzheimer's, for she and Lewis had spent countless hours taking care of her in her later years when she had become unable to care for herself. Lewis's mom had developed the habit of repeating herself early on, and this only stopped when she became unable to speak much at all. As Ann recalled those days, she began to feel overwhelmed. Was Lewis heading down the same road? Ann couldn't help but focus on this repetition as Lewis finished his story again, but she eventually talked herself out of jumping to conclusions. She remained quiet and just listened.

Eventually Ann thought about other things, and they continued their journey with great enjoyment—until a month later when she became concerned again. Lewis had arranged to meet with some friends in a nearby city. He and a friend golfed in the afternoon and met up with their wives for dinner. Ann noticed that he was unusually quiet during dinner and seemed to have trouble deciding what to order. Then he leaned over to Ann and said, "I'm going to the men's room. Can you order me something good?" He gave her a quick smile and a kiss on the cheek before departing. Lewis had always been particular about his food, so this struck her as odd, but it didn't raise her concern until Lewis's friend spoke.

"Ann, I feel a bit awkward asking this, but we've been friends for a long time, and ... well ... how's Lewis doing?"

Ann's heart jumped, and once again she found herself becoming overwhelmed with a growing fear of what might be coming. "What do you mean?"

"Well, it's probably nothing, but he seems different. I know we haven't seen you in a while, but Lewis just seems more quiet than usual, and when we golfed today, a couple of times I could have sworn he was getting stuck on certain words. On one hole he asked me to bring him 'that club'; I knew he needed his putter because he was on the green, but it struck me as strange. I know he's not as young as he used to be, and I don't want to pick on him, but his mother had dementia or something, and I couldn't help but notice that he seemed a little foggy. When we got back to the clubhouse, he was a little confused about where to go. Again, I'm not sure, it was a new course for him, but it's just not like him ... you know?"

Unfortunately, she did. She had been debating with herself about whether to push Lewis to talk to his doctor, but at this moment, the debate ended. A few days later she asked him—then pleaded with him—to make an appointment.

Ann's talk with Lewis hadn't gone well. She'd been uncertain about what to say and when to say it, and when she finally brought up the subject, he downplayed his forgetfulness and dismissed her concerns. But she was worried, so she continued to press him. Eventually he became angry and shouted at her, speaking words that she hadn't heard him speak in decades.

Three months later, they walked into the doctor's exam room together. Lewis and the doctor discussed the weather, their golf games, and other matters until Ann couldn't stand it any longer. Was Lewis going to say anything about his memory? Was the doctor going to get down to business? She finally broke in with a list of things that she had observed that concerned her—the repetition of stories, the forgetfulness of events and conversations, his difficulty thinking of the words, and his trouble with directions.

Soon the doctor began testing. He asked Lewis some questions, which to Ann seemed much too easy. The doctor asked about the date, the day of the week, and the year. Lewis got these correct, though Ann was surprised to see him struggle a little. When the doctor pointed to his wristwatch and asked Lewis what it was called, Lewis hesitated and the room grew unusually quiet. Five seconds seemed like five minutes. Finally, Lewis said, "This is silly kid's stuff." He couldn't remember what a watch was called. A short time later the doctor asked him to recall three words he had been instructed to remember earlier in the exam. He couldn't even remember one of them. Tears welled up in Ann's eyes, but she pushed them back so her husband wouldn't see.

Lewis was clearly having difficulty remembering things, and as it turned out, it was caused by Alzheimer's, a frightening disease characterized by progressively worsening memory. His forgetting had grown increasingly obvious—once Alzheimer's grabs hold, the forgetting is unmistakable and sometimes terrifying.

The initial forgetting of Alzheimer's is a subtle, gradual onset, getting steadily worse over time. It signals that something might be wrong and causes family members like Ann to be concerned. Doctors and other healthcare professionals focus much of their effort on evaluating this form of forgetting to determine whether a person has Alzheimer's disease or another condition of aging. The Alzheimer's Association estimates that over $200 billion are spent annually on Alzheimer's care.

As Lewis and Ann listened to the doctor deliver the Alzheimer's diagnosis, a second forgetting began to creep in. This second forgetting took hold as they considered the magnitude of what they were facing.


The Second Forgetting

We are all imperfect and broken. We forget the Lord, even in the best of health. This is what I call "the second forgetting." The first forgetting is experienced by the person with Alzheimer's, but the second forgetting reflects a spiritual forgetting experienced not only by the person with Alzheimer's, but more broadly by their family, friends, and even the church who seeks to care for them.

To understand such second forgetting we need to consider a story about an entire community that was prone to forget. The story is much older than Lewis and Ann, but it shares some similarity with theirs. The story is about the people of Israel in the Old Testament who, like Lewis and Ann, were prone to forget the Lord.

God had made a promise to a man named Abraham, a promise to make him a great nation, to give the people of Israel a Promised Land of rest, and to be with them always (Genesis 12, 17). But after several generations, they found themselves enslaved and subjected to oppressive forced labor in a foreign land (Exodus 1). They groaned under their suffering and saw no hope of rescue or deliverance. The promises God made to Abraham were far from their minds, and to them it must have seemed they had no hope.

But God heard his people groaning and delivered this message:

I am the Lord. I appeared to Abraham, to Isaac and to Jacob as God Almighty, but by my name the Lord I did not make myself fully known to them. I also established my covenant with them to give them the land of Canaan, where they resided as foreigners. Moreover, I have heard the groaning of the Israelites, whom the Egyptians are enslaving, and I have remembered my covenant.

Therefore, say to the Israelites: "I am the Lord, and I will bring you out from under the yoke of the Egyptians. I will free you from being slaves to them, and I will redeem you with an outstretched arm and with mighty acts of judgment. I will take you as my own people, and I will be your God. Then you will know that I am the Lord your God, who brought you out from under the yoke of the Egyptians. And I will bring you to the land I swore with uplifted hand to give to Abraham, to Isaac and to Jacob. I will give it to you as a possession. I am the LORD." (Exodus 6:2–8)


In the midst of their suffering, God had heard the groaning of his people and remembered and reaffirmed his promises—to deliver them, be with them, and bring them into the Promised Land. Suffering is a part of this world. It was present during the ancient days of Israel, and it will be present until the Lord brings full restoration. While his people wait, they cry out to God. When God's children groan, God remembers his promise and responds.

Even so, because their suffering was so great, the people of Israel did not listen to the great promises of God. Although they didn't listen and remember, God followed through on his promises. He heard their groans and took clear steps to rescue them, and these steps were not subtle (see the story of the plagues in Exodus 7 – 11). Finally, Pharaoh relented and the Israelites were set free, only to be chased again when Pharaoh changed his mind. But God rescued the Israelites by parting the Red Sea.

After their deliverance, they celebrated with song:

The Lord is my strength and my defense;
he has become my salvation.
He is my God, and I will praise him,
my father's God, and I will exalt him
Who among the gods
is like you, Lord?
Who is like you—
majestic in holiness,
awesome in glory,
working wonders? ...
In your unfailing love you will lead
the people you have redeemed.
In your strength you will guide them
to your holy dwelling.
(Exodus 15:2, 11, 13)


It was a truly unforgettable moment. God remembered his promise, reminded his people of that promise, and miraculously delivered them. It seems that all this would forever be etched in the minds of the Israelites with the faithfulness of God. How could they ever doubt God or complain about his provision again? Certainly, they would never forget!

Yet it only took three days for Israel to forget what God had done. They grumbled against God and doubted his provision because they couldn't find water. Despite their grumbling, God was gracious and took care of their needs—providing water to drink, and eventually manna and quail to eat.

So a cycle emerges. It starts with God promising to be among his people, to care for them, and to deliver them to the home he has promised. Next, the Israelites face difficulties and suffering, and they forget God and doubt these promises. They groan under the weight of their suffering. God hears them and remembers his promises, and finally, God delivers them (although not always as soon as they would like), continuing to be faithful to what he has promised. This is sometimes followed by a period of rejoicing, but eventually new difficulties emerge and a new cycle begins. With each new difficulty they forget his faithfulness and begin to groan and grumble.

The fact that we rejoice in God's goodness one minute and grumble against him in the next reflects the brokenness of our memory and our ongoing struggle with sin. God knows our need for reminders. He asked Moses to bottle up some manna as a reminder for future generations (Exodus 16:32). Later, God tells Moses to record their victory in battle "as something to be remembered" and pass it on to Joshua, the leader of the next generation. God knows the tendency of his people to forget him and his faithfulness. He encourages them to retain reminders so that this remembrance can be passed down to encourage the faith of his people and to bring them the assurance of his presence when they are suffering.

This cycle was on full display when they were eventually led to the brink of the Promised Land. God had brought them through so much and had now delivered them to the land he had promised them. He had never failed to deliver on his promises, and this seemed to be the culmination. God showed them the land and told them to take it. But instead of remembering his promises and faithfulness in the past, they only saw a new threat. Instead of trusting God's promises and responding in faith, they became fearful and decided to check it out for themselves. They sent out ten spies. Most of them returned with reports of how powerful the people in the land appeared and how easily they could defeat the Israelites. Only two spies dissented, trusting in God and remembering his faithfulness in the past and his promises for the future.

When we are faced with threats, where do our minds go? Do we focus on the magnitude of the threat or on the remembrance of God's past faithfulness and his promises for the future? When we focus on the threat, we begin to forget. That's what Israel did, and that's what God's people have been doing for thousands of years since. The people resumed their grumbling, saying that God had only led them there to die. Despite God's previous rescue and grace-filled care, they seemed to forget and refused to believe in his goodness and faithfulness. Functionally, they forgot the Lord, and wandering in the wilderness soon followed.

Still, this was not the end of God's promise. He always remembers and never fails to deliver. After forty years God led them back to the Promised Land, this time with a warning and another explicit call to remember. In Deuteronomy the Israelites are commanded to remember their wandering in the desert, the way God provided for them with manna, and his promise to deliver them into the Promised Land. In fact, much of the book of Deuteronomy is Moses' remembrance and retelling of the story of the nation of Israel and their trials leading up to the entry into Canaan. When the Israelites were faced with great fear, they heard these words:

You may say to yourselves, "These nations are stronger than we are. How can we drive them out?" But do not be afraid of them; remember well what the LORD your God did to Pharaoh and to all Egypt. You saw with your own eyes the great trials, the signs and wonders, the mighty hand and outstretched arm, with which the LORD your God brought you out. The Lord your God will do the same to all the peoples you now fear. (Deuteronomy 7:17–19)


While they were waiting on his promises, God called them to remember what he had spoken and taught them. He reminded them how to live and love while waiting on his promises, and how they could keep themselves from forgetting. God wants us to remember too, and in his grace he foresees our tendency to forget and instructs us about how to remember.

The story of the Israelites is filled with calls to remember and trust in the Lord despite the threats that surrounded them. It is a repeated call to remember the Lord's faithfulness and promises, but it is also a reminder that God never forgets his promises to us.


Alzheimer's Disease and the Second Forgetting

When we consider the story of God's people in the Old Testament, we may think the Israelites were crazy to forget and grumble. How could they forget the God who led them, rescued them, and provided for them? Why would they ever doubt a God who did such great things for them? Hadn't he promised them the land and to defeat their enemies, and didn't he then command them to take it?


(Continues...)

Excerpted from Second Forgetting by Benjamin T. Mast. Copyright © 2014 Benjamin T. Mast. Excerpted by permission of ZONDERVAN.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Table of Contents

Chapter 1 - Remembering
This introductory chapter will set the stage for the importance of remembering in everyday life with particular attention given to God’s call to remember him, what he has done and what he has prom-ised. The concept of the second forgetting will be introduced and linked to the way we think about the spiritual care of people with Alzheimer’s disease.

Chapter 2 – What is Alzheimer’s disease?
This chapter provides an up to date description of Alzheimer’s disease, including its effects and treatment. Case examples will be incorporated to demonstrate the various ways that Alzheimer’s can manifest itself in daily life. The intention here is to educate readers on the basics of Alzheimer’s disease.

Chapter 3 - Forgetting
The nature of memory problems in Alzheimer’s disease will be described in detail with attention both to problematic areas of remembering and aspects of memory that are generally preserved. This lays the foundation for later chapters which emphasize how to help people with Alzheimer’s respond to God’s call to remember.

Chapter 4 – The Gospel for Those With Alzheimers
The gospel transforms all of life, including the way we think about and care for people with Alz-heimer’s disease. Drawing on Biblical themes of creation, fall, redemption and restoration, this chapter retells the story of Alzheimer’s disease in the context of God’s story. Understanding the person and their struggle with Alzheimer’s disease in this context promotes a loving and honoring approach to a vulnerable, confusing and frightening stage of life.

Chapter 5 – The Gospel for Caregivers
Caring for a loved one with Alzheimer’s disease brings unique challenges that impact whole families. Caregivers often live with feelings of burden, guilt and anger, and struggle with painful questions about God’s presence and plan in their lives. The gospel speaks to their situation with a way to understand their suffering, grace for their limitations, and a renewed hope for restoration. Drawing on scripture and the personal stories of caregivers, this chapter highlights the challenges of caregiving and the way the gospel transforms this part of their story.

Chapter 6 – A Unique Ministry of Mercy
Most churches have some form of mercy and care ministry. This chapter will describe how churches can focus their mercy and care efforts on people with Alzheimer’s disease and their caregivers. At-tention will be given to the unique challenges of caring for these individuals and how these chal-lenges can be addressed by the church.

Chapter 7 – Recalling Stories of Faith
Remembering our stories of faith and their connection to God’s larger story are critical for under-standing the struggles and confusions of daily life. This chapter describes how the rehearsal and retelling of our stories can be connected to what scripture explains about who God is, what he has done and what he has promised. Practical methods for helping people with Alzheimer’s disease re-connect with and rehearse their faith journey (including key relationships and faith milestones) can be used to promote a form of remembering that brings peace, comfort, and reassurance. These include practical life review and reminiscence techniques which will be provided along with specific questions and worksheets that ministry leaders and families can use.

Chapter 8 – Helping Others Remember
In addition to rehearsing our stories, there are many other methods that can be employed by care-givers and the church more broadly to promote remembering the Lord and his goodness. This chapter will describe how the essentials of the gospel can be rehearsed and remembered in a meaningful fashion through the combined use of the sacraments (e.g., communion), well-known scripture passages, music and liturgy. Emphasis will be placed on methods that are familiar, easy to incorporate, and which maximize understanding. This chapter will also highlight the ways that ministry leaders mi

What People are Saying About This

From the Publisher

My mother, one the godliest people to ever walk on this earth, died from Alzheimer’s. The debilitating effects of this disease were almost more than we could bear. A book like this would have been worth its weight in gold! I cannot commend highly enough what a gift it will be to families everywhere. — Daniel L. Akin, President, Southeastern Baptist Theological Seminary

Second Forgetting is filled with wisdom and hope and soaked in the compassion, grace, and kindness of God. It is a fascinating book—it is theologically rich and very practical on how to care for those struggling with Alzheimer’s and for their family members. — Justin Holcomb, Episcopal priest, seminary professor, and author of Know the Creeds and Councils and Know the Heretics.

What is a Christian to think when a loved one who has been faithful to God’s commands and steeped in his Word behaves in ways that are strange to family and even to self? Do we fear ourselves that we may lose our memory, our mind, such that all spiritual that we value dissolves into apparent oblivion? Ben Mast has provided us with much-needed perspective and encouragement about the ongoing interaction among God, family, and those who begin to forget. — Dan G. Blazer MD, MPH, Ph D, JP Gibbons Professor of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina

An expert in the field of Alzheimer’s, Mast has woven together the latest research with a gospel-centered orientation and the compassion of a caregiver to produce a biblically informed and practical guide for those in the early stages of the disease and those who love or minister to those afflicted. A welcome and needed resource! — Eric Johnson, Professor of Pastoral Care, The Southern Baptist Theological Seminary, and Director of the Society for Christian Psychology

Second Forgetting isn’t simply scientific theories regarding the brain, Alzheimer’s, and memory loss, but the deep, prayerful, and careful counsel of a pastor. Dr. Mast is not only a seasoned scholar but a soul physician. My hope is that his prescription would lead to a healthier, holier and more hopeful church. Buy this book. — Daniel Montgomery, Pastor of Sojourn Community Church, Louisville, KY, Author of Faithmapping and PROOF: Finding Freedom through the Intoxicating Joy of Irresistible Grace

When memory is compromised we lose touch with connections to people … and also with God. Benjamin Mast takes us into the inside of memory loss and helps us understand from within what it is like to experience such a tragic, disabling disease. Caregivers who read this book will respond more empathically and effectively to people who struggle to remember. — Ronald J. Nydam, Ph.D., D.Min., Professor of Pastoral Care, Calvin Theological Seminary; Author of Adoptees Come of Age: Living Within Two Families

Dr. Mast leads the reader through Second Forgetting to Second Remembering as he reminds us that all people have infinite value and that God remembers each person no matter the circumstances. This book contains a powerful message of hope, written especially for those of the Christian faith, but it also contains eternal truths helpful for individuals of all faiths. This message is a must for those of us dedicated to a better way of communicating and relating to the person with dementia. — Virginia Bell, MSW, co-author of the Best Friends Approach books

We forget … God always remembers. Thank you, Ben, for this profound reminder. — Jolene Brackey, national speaker on Alzheimer's Disease, author of Creating Moments of Joy

Whether newly diagnosed, caring for a loved one with the diagnosis, or ministering as pastor or friend, readers will find themselves returning repeatedly to the gentle wisdom and compassion conveyed in these pages. — Susan H. Mc Fadden, Research Consultant, Fox Valley Memory Project, and John T. Mc Fadden, Memory Care Chaplain, Appleton Health Care Center

One of the greatest fears of growing old is the ever-increasing possibility of developing Alzheimer’s or another dementia, raising the lament, “Who am I if I can’t remember who I am?” Using Scripture and inspiring testimonies of dementia-afflicted people he has known and helped, Dr. Mast shows the reader how to respond to the experience of dementia as God’s beloved children. — Jane M. Thibault, Ph D, Clinical Professor Emerita, Clinical Gerontologist, University of Louisville, School of Medicine

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