Review of John Swinton, Dementia: Living in the Memories of God (SCM, 2012).
I confess that I approached this book with trepidation. What I feared was a well-meaning but dull account of the symptoms and basic pastoral needs of those with dementia – worthy, but not very interesting. What I found was quite different. This book is a mixture of deep theological accounts of what it means to be human, and important reflections on love and living. All of this is explored and brought to the surface in Swinton’s reflections on dementia. All has repercussions far beyond caring for those with that illness. This is another truly excellent book on the Michael Ramsey Prize shortlist.
Swinton starts with a question of identity. He wants to be loved and cared for, just for who he is. So the question becomes who is he? This is, of course, compounded by issues around dementia, where people lose memories, act differently, fail to recognise loved ones and family members and so on. A common place of dealing with dementia is to suggest that the person has ceased to be themselves. Swinton strongly disagrees. He argues that ‘devastating as dementia undoubtedly is, the human beings experiencing it do not dissolve. They are certainly changed, and there is much suffering and cause for lament. But these people remain tightly held within the memories of God. It is our ideas about what humanness, the nature of the self, and self-fulfilment mean that will have to be dissolved and re-created’ (p. 15).
What follows is a challenging and moving attempt to rethink these categories of humanness, identity and fulfilment. There are insights from philosophy, science, medicine, psychology as well as theology. All are handled carefully and persuasively. Swinton’s chapter on memory is particularly well done. He refuses the simplistic understanding of memory as recollection. Rather memories are constructed in the present, with a historical sense but also a connection to present needs and desires. They are ‘collages or jigsaw puzzles rather than pictures or tape recordings’ (p. 208). Divine memory too has a transformative power in the present. Human memory is one mode of participating in this, but we are all dependant on divine memory to give us truth and identity and hope. To suggest that those with advanced dementia are remembered by God is not, then, a bit of pastoral fluff. Rather it is a statement about a common humanity. Remembering people with dementia, by visiting them, praying for them, treating them with care and attention is a way in which the pastoral task participates in the activity of God.
There is rigour and steel in Swinton’s pastoral theology – this is no well meaning piece of hand-wringing. But it is coupled with a humanity and a pastoral sense that means that all of the careful, deep and detailed argument never forgets that those who suffer with, or alongside, dementia are human beings. This is pastoral theology at its very best. Swinton has done a great service to the church, and to those in need of its care.