
It's~A~Resonating~World
deMENSCHia
Dementia as de-PERSON-ing
The~Alzheimer's~Conversation belongs in all communities, since this horrible condition destroys the lives of people of all backgrounds. Community connection is an important source of support as those of us in various stages of dementia, or with family or friends with dementia, face the unknown and very threatening future that dementia brings.
This page presents Biblical perspectives on dementia and opens a dementia conversation in the religious community. As I continue on my dementia journey I will post comments based on Biblical, cultural, and other sources that guide Jewish life, and welcome similar input from other communities. You are welcome to submit brief comments on dementia from a religious perspective through the form below.
As if to emphasize the importance of paying attention to Jewish ways of relating to dementia, a "Yiddishized" version of the word Dementia, deMENSCHia, is particularly graphic in describing the
de-PERSON-ing de-MENSCH-ing impact of dementia.
deMENSCHia Jewish Community Dementia Conversation
July 4, 2024 - Parashat Nitzavim - "Therefore Choose Life"
Deuteronomy 30:19 expresses how I relate to my condition of Early-Stage Dementia, and guides me in a decision I'll have to make. In this verse the Torah tells me that it's up to me to choose between four: life, death, blessings, and curses. And then the Torah guides me in this choice to choose life in a way that is fulfilling for myself and for my seed -- for me this is to express what I am feeling and learning from this condition such as at www.MCIandMEE.com, in public talks, etc. At the same time I'm alert to changes in my condition that mean that soon I will not be capable to choose to live a life that is meaningful for me and for my seed, that dementia will take that choose-life capability from me. When I approach that stage I'll make a different choice that the Torah offers me to make, that of choosing death. I am not an observant Jew but yes I'm glad to get Jewish guidance to choose both life and death that are fulfilling for me.
July 7, 2024 - Parashat Chukat - Moses Strikes the Rock
Progressive dementia decreases thought-based, controlled behaviors such as normal conversation and often increases reactive, aggressive behaviors such as coarse language or hitting. In this week's Torah portion of Chukat (Numbers 20:11) Moses displays these dementia-like behaviors: he speaks badly to the Children of Israel, and instead of speaking to the rock as he's told to do Moses hits the rock twice. The result of being with dementia is defined in the next verse: a person's mission in life is ended whether it is completed or not. In this sense Torah relates to dementia behavior as "the end".
July 14, 2024 - Parashat Balak - Bilaam: Unknown Journey and Its Discoveries
This week's portion of Balak describes Bilaam's dementia condition in which unseen and unimaginable forces are at work and prevent him from functioning normally. At the same time dementia is also a release that allows Bilaam to come out with the wonderful declaration "How goodly are thy tents O Jacob thy dwelling places O Israel" -- this Unknown Journey includes very special discoveries along the way. I have the privilege of leading a Torah conversation on parashat Balak including similarities to my own unknown journey with dementia and its discoveries:
This talk references www.MCIJourney.com and I-Have-Now.com.
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July 21, 2024 - Parashat Pinchas - Mt. Abarim as Moses' "Golden Moment"
A Dementia Journey can have a very special "Golden Moment" which is when dementia has released the person's mind enough to allow the person to sense completely new feelings and experiences, and at the same time the person is still lucid and can be fully aware of them. I describe Golden Moments of my dementia journey at www.MCIandMEE.com, and a Golden Moment in Moses' journey is described in Parashat Pinchas at Numbers 27:12. Moses is told to go up Mt. Abarim and from there to view the Promised Land, the place of unimaginable beauty and meaning - this is a Golden Moment of a completely new experience. And then what happens, after Moses' Golden Moment? Verse 13 says that after his Golden Moment Moses' life is over. And how do we know that this is related to Moses' dementia behavior? Verse 14 tells us specifically that this set of events is the result of Moses' dementia behavior described in "Moses Strikes the Rock" above.
July 28, 2024 - Parashat Masei - Dementia as a Continuous Cycle of Starts and Stops
Parashat Masei makes sure that we don't feel the steady flow of life, but rather in over 30 verses repeats the formula "and they started ... and they stopped" in each and every verse. From Numbers 33:5-37 every verse contains this phrase.
There may be many commentaries that explain the reason for this repetition. I don't come to explain it, what I do is feel it very much in my condition. Early-stage dementia still allows the starts, the functioning, the looking ahead. It also allows to see what's coming - the stop, the end, as Aaron's life ends and he dies in the next verse after this series and the Book of Numbers ends after this Parashah. The repetition of starting-stopping, the awareness of life-death, the cut-off that is approaching -- Parashat Masei is telling us a very frightening story, that at the same time can be very enriching. The knowledge of dementia and death can allow us to make more out of the health and life that we have remaining -- if we choose to have it do so.
August 4, 2024 - Parashat Devarim - Don't Let the System Fail You - Prepare Yourselves with Knowing
The Torah warns us that an overloaded system can't work and won't serve the people who need it, and Rashi makes sure that it's clear what we need to do - in the dementia space they are like a chorus of advocates for local/personal care including Doula and Self Doula.
Moses' wisdom is on full display when he spends four verses in Parashat Devarim Deuteronomy 1:9-12 saying that he as "the system" can't get the job done, and then in verse 13 goes all-in with "havu lachem" power to the people to do what needs doing. Rashi wants to make sure the nuance of "havu lachem" is understood and so clarifies it with "hazminu etzmachem l'davar" prepare yourselves for the matter - don't just take things into your own hands but rather prepare yourselves to handle the things that the system won't be able to handle, and then you can take the responsibility. Beautiful closure comes in verse 14 in which the people accept responsibility for the preparation and then for the action. Wow! A person with early-stage dementia reads this as a road-map for what to do.
The central system is not capable of handling the growing masses of people with dementia, so the act of doula, the act of planning and acting for each person with dementia, is distributed to people who have learned about the condition including the person with dementia themself. As a Jew with early-stage dementia who accepts the responsibilities of it I see Self-Doula as described at Self-Doula.com as my Torah-prescribed way for proceeding with my condition. The Torah has said its part, I accept my part, and as important as those is also verse 14 the support of the community in this terribly difficult and yet incredibly releasing process.
August 11, 2024 - Parashat V'etchanan - The Ten Commandments--Shma Yisrael Reflected in Dementia's MCI--MEE
This week's parashah of V'etchanan shows us that the two cornerstones of the Jewish faith strongly align with two main elements of the dementia condition. Deuteronomy 5:6 tells about that which should be inscribed in stone, embedded in the brain and acted on from there -- the Torah describes the Ten Commandments as the Cognitive and acknowledges at 5:19 that there is risk that this Cognitive side may be reduced or people may become distant from it, there may be MCI Mild Cognitive Impairment. The Torah describes at 6:4 the Shma Yisrael Hear O Israel in completely different terms -- Listen, Unity, Love, Heart, Soul, Energy -- these are terms of feeling and Emotion, of the value and the benefit of MEE Mild Emotional Enhancement. The Ten Commandments and the Shma Yisrael are directly reflected in the dementia characteristics of MCI and MEE www.MCIandMEE.com -- Torah and Judaism has very much to give to and to get from the Dementia condition and the people who have it.
August 18, 2024 - Parashat Ekev - How Torah Expresses the Release that Dementia Brings
There's a part of the Early-Stage Dementia condition that has become very powerful for me lately and that can be summed up in one word: Release. I'm frequently having a (very expanding) feeling of Release of mind and spirit from constraints and boundaries that have long limited them. This feeling is still sprouting but the word Release has been very present for me lately. In a conversation with a group of people who are dying of various conditions it turns out that several of us are feeling this and are even expressing it beautifully in similar ways.
The Torah in parashat Ekev has its own Biblical way of expressing this, in a very striking way and using a metaphor that none of us in the conversation had thought of. Deuteronomy 10:16 conveys God's instruction that the people circumcise the foreskin of their hearts and be no more stiff necked. Wow - this is a very personal way of saying Release and let go of your usual ways. In the spirit of Release I'll ask a question that I otherwise wouldn't dare - if instead of the condition of dementia being a complete curse and we certainly know that much of it is blacker than black as it advances, could this early stage of dementia, this feeling and ability and joy of Release actually be showing us a different way of living that not only has value but is even a way of getting us to a place that otherwise some of us wouldn't be able to get to? I would not even be able to think this thought if I wasn't in a flow of Release from many assumptions I've long lived by.
August 25, 2024 - Parashat Re'eh - Mind and Feelings as Paths to Torah
The first verses of the Torah portion Re'eh tie the Torah's approach to good and bad directly to the mind's black-and-white interpretation of the physical senses, of seeing and hearing. The first word of the first verse of the portion, the portion's name of Re'eh, means "see", and the verse talks about a blessing and a curse. The second verse talks about hearing, and the third verse about not hearing, and also tie them directly to blessing and curse. These verses show that the concepts of blessing and curse are available to the mind, with the ability of the mind to see, hear, and interpret, and provide exact adherence to the performance of the mitzvot. Mindfulness is present here in full force.
Unlike this focus on Mindfulness, the Feelingfulness that characterizes Early-Stage Dementia's impaired cognition/enhanced emotion as described in MCIandMEE.com is almost completely absent from this portion. But where it does appear, in Deuteronomy 12:12, the Torah emphasizes that Feelingfulness is very welcome from any member of the population who feels the Feelingfulness of rejoicing without reference to the Mindfulness of "see" and "hear" and exact performance.
Happily participation in the Torah community and the Jewish people is available also to those of us with dementia of various levels, although the form and level of our participation is different than those of our community who are capable of full Mindfulness.
September 1, 2024 - Parashat Shoftim - Realization of Readiness
As my mind is declining I'm aware that I am getting closer to the "black line" of being demented, and that I've already made the choice not to reach that line. This week's Torah portion of Shoftim at Deuteronomy 20 speaks directly to my feelings. I've made the decision, and now I am feeling that I will soon put it into action -- not an easy feeling at all. So the Torah asks for another person who is about to go out to a difficult action, do you feel incomplete? Do you have a new house, a new vineyard, a new mate, or are otherwise weak in your decision? These questions help me realize my own readiness -- by its nature it will not be easy for me to bring my life to an end, but I realize I feel very fulfilled, I have lived a good life with good years and feel blessed with the many fulfillments my life has, and do not feel lackings as this week's portion asks about. I will bring the ending of my life while I am in this state of fulfillment, and before my condition turns me into something non-functional and non-connected, a place I choose not to go to.
September 8, 2024 - Parashat Ki Tetze - Going Out: Release שחרור
This week's portion of Ki Tetze lists one law after another law, what must be done or what must not be done in many situations. My mind couldn't find even one verse in the portion that it could connect with in its own way, so I stopped looking for how to relate to this portion. Then I opened it again to the start at Deuteronomy 21:10 and the words of the first verse were like magic in describing exactly how I feel with my early-stage dementia condition: "When you go out from where you're used to being, and things that were normal become very difficult for you, and you face very different challenges than you have ever known before, then if you go into your innermost authentic self you will find there how to make them a beautiful part of you". May we each be blessed in our challenges and in how we take them with us.
כִּי-תֵצֵא לַמִּלְחָמָה, עַל-אֹיְבֶיךָ; וּנְתָנוֹ יְהוָה אֱלֹהֶיךָ, בְּיָדֶךָ--וְשָׁבִיתָ שִׁבְיוֹ
September 15, 2024 - Parashat Ki Tavo - Serving God Through the Guts
The study of the Bible is generally considered to be a very mind-intense activity, with reading / analyzing / mindful intention being key elements of learning the Bible and serving God. This serves mind-oriented people very well, but not feeling-oriented people or people whose condition has shifted their ability to relate to the world from mind to feeling as described at Feelingfulness.com. This week's portion of Ki Tavo opens the Bible and its observance to the feelings and the guts. Deuteronomy 26:16 says that for those living the now "On this day" rather than a broad cognitive view of the world, the learning and the doing of the Bible is through the heart and the soul rather than through the mind "On this day the Lord your God commands you to do the rules and the ordinances, and to observe and to do them fully with your heart and with your soul". What a beautiful belief does Torah provide that allows each person to understand the Bible and to act on it from the place that the person is at.
הַיּוֹם הַזֶּה, יְה-וָה אֱלֹ-הֶיךָ מְצַוְּךָ לַעֲשׂוֹת אֶת-הַחֻקִּים הָאֵלֶּה--וְאֶת-הַמִּשְׁפָּטִים; וְשָׁמַרְתָּ וְעָשִׂיתָ אוֹתָם, בְּכָל-לְבָבְךָ וּבְכָל-נַפְשֶׁךָ
September 22, 2024 - Parashat Nitzavim - Better Together: Living with Good with Dying with Bad
When the Bible wants to list things, it simply lists them. When it wants to show that things are connected with each other and are part of a greater whole it puts the Hebrew word "et" meaning "with" between them. This week's portion of Nitzavim at Deuteronomy 30:15 does not just list Living and Good and Dying and Bad as separate things that happen, but rather it uses "et" between them to say that we should take together Living with Good with Dying with Bad as one unit in which the together makes each of these parts more whole in loving God and walking in God's ways. As described at I-Have-Now.com having the condition of dementia brings these parts together in a very immediate way in how this person lives his or her life in this moment. The beautiful place this "with" creates for the person is fuller than if the Torah had listed out living, good, dying, and bad as four separate actions without the together that makes life richer, and is even more present for a person facing dementia.
רְאֵה נָתַתִּי לְפָנֶיךָ הַיּוֹם אֶת-הַחַיִּים וְאֶת-הַטּוֹב וְאֶת-הַמָּוֶת וְאֶת-הָרָע
September 29, 2024 - Parashat Ha'azinu - Not Standard-Straight but Water-Flowing
Most communication happens in order to make a point, to convey information, to express an idea - a straightforward way of achieving a straightforward result. One thing that characterizes dementia behavior is that communication is not clear, it is often difficult to understand what a person with dementia is trying to say, words and ideas may be mixed together like water that is spread around but does not provide specific meaning to a specific person. The highly unusual second verse of this week's portion of Ha'azinu at Deuteronomy 32:2 tells us that God knows to communicate in this same way: "Let my teaching fall like rain and my words descend like dew, like showers on new grass, like abundant rain on tender plants." The verse repeats and emphasizes that God's communication, God's teaching, does not come as a standard-straight conveying of information, but rather as various forms of water that fall on different beings in different ways. A person trying to understand what a person with dementia is trying to say may very well feel that the communication is coming out as a mixture of rain and dew and showers and abundant rain. Could it be that the Torah is telling us that within our frustration that dementia communication is difficult and challenging to understand, we are also intended to see the holy in it, that like God's teaching and communication is not bone-dry and well-defined but rather like various forms of water so too we should take dementia communication as flowing, as different forms of water, as giving us an opportunity to relate differently and in so doing find nourishment as do the new grass and the tender plants from the way that God communicates like water?
October 13, 2024 - The Day After Yom Kippur
When we read Kol Nidre from the mind, it starts the Yom Kippur prayers as a formal, legalistic statement of Release from commitments or obligations:
... may (our commitments) all be permitted, forgiven, eradicated and nullified, and may they not be valid or exist any longer. Our vows shall no longer be vows, and our prohibitions shall no longer be prohibited, and our oaths are no longer oaths.
When we feel Kol Nidre in the guts as a moment of complete openness, it becomes a Release from our usual way of viewing life, of relating to living and dying. Here is a "Kol Nidre Moment" that happened three days before Yom Kippur:
Yesterday I went to the Funeral Home to make arrangements for my cremation, to go from body to ashes. Even though I knew I would go through this station on my Dementia Journey, actually doing it, being there, talking about the details, and going by things like the Display Room for caskets and Scattering Tubes was different than just thinking about it. It left me rather shaken and stomach churning.
Already as I left for a walk this morning I felt completely different, I felt that I am already ashes that are still in body form! What an incredible RELEASE! I can relate to myself as having already gone through all this, and my body has to catch up! I'm already ashes and everyone else is already ashes, we are all already ashes (or dust or smoke or dirt or whatever) just still in human form! I felt exhilarated and asked someone to take my picture - my first photo as ashes still in human form!
Every word and every act on Yom Kippur is different when expressed from this deMENSCHia feeling.
October 21, 2024 - Parashat Bereshit - The Serpent Named Dementia
The world was going along fine without the serpent that appears in Parashat Bereshit chapter 3, and in fact the Torah had spent the first two chapters of Bereshit describing what a paradise the world was before the serpent appeared. And now appears this most subtle and most insidious and most destructive of how life was before it arrived -- this same description applies to the serpent and to dementia. And the result is the same for both as summarized in the words of verse 18: thorns and thistles will grow in all aspects of your life. Adam and Eve didn't ask for the slithering snake to appear, it invaded their lives and made their lives terribly difficult, and once the decree was given there was no going back from it as described in verse 24. The serpent of dementia throws us out of the beauty of life and to a terrible place that we can't escape.
October 27, 2024 - Parashat Noah - The Can't-Win Caregiver's Curse
This week's portion is named after Noah and tells of the many legendary things he did. As with dementia though, at a certain point Noah was unable to take care of himself and his sons were forced to be his Caregivers, and like what happens with dementia Noah's response to his Caregivers was unbalanced rebuke even though they did the very best they could under the circumstances.
In Genesis 9:21-26 Noah becomes disabled because of wine he drank, and was unable to take care or dress himself. One of his sons found him and the other two tried to be his Caregivers in as respectful a way as possible. As dementia Caregivers are very familiar, Noah not only didn't show gratitude, he lashed out at one of his sons for a situation which Noah himself had created. This is a curse that Caregivers often face and is an unbearable burden -- despite their best efforts in incredibly difficult situations the patient (who in many cases is like Noah the Caregiver's parent) displays nothing but anger, criticism, and hostility. Like Noah the patient may be a respected and responsible member of the community, but the state of disability serves as the curse of huge, unappreciated effort and care on the part of the Caregivers.
November 3, 2024 - Parashat Lech Lecha - Leave the World You Came From
The opening of this week's portion Lech Lecha at Genesis 12:1 is incredibly clear and dramatic - leave everything you know and discover a new place to be in. As a person with Early-Stage Dementia I am doing exactly this, not as an inner-impulse or outside instruction but as a result of this condition. My "get thee out" is happening in any case, so what is left for me is to find the new place to be in. And this beautiful new place will not be an external place but a place that is authentically me, A Demented World ADementedWorld.com which I can only create when I release myself from my physical surroundings, from the place I consider home, and even from my family. This process of dementia is directing me on the path that this week's portion is instructing, and while I am still lucid I have an opportunity to walk on this path in fulfillment of the Torah's guidance.
לֶךְ-לְךָ מֵאַרְצְךָ וּמִמּוֹלַדְתְּךָ וּמִבֵּית אָבִיךָ, אֶל-הָאָרֶץ, אֲשֶׁר אַרְאֶךָּ
November 10, 2024 - Parashat Vayera - A Person Dissolving Like a Pillar of Salt
Why was Lot's wife turned into a pillar of salt? There are plenty of ways to punish a person who has done wrong, and her being turned into a pillar of salt has a far different message than wrong and punishment. This week's portion of Vayera in Genesis 19:26 is an illustration of dementia. Lot is told not to look back, but Lot's wife receives no such instruction. She has done nothing wrong and therefore what happens to her has no connection to punishment - in fact she is simply living life with her husband. What happens to her is that she goes from living life like a person to living life like a pillar of salt. What does this mean? A pillar of salt stands strong and tall and seemingly for much time, but salt dissolves slowly over time, losing its identity and losing its essence, and this is the terribly painful loss as family and friends watch a person with Alzheimer's/dementia dissolve slowly, losing their entity and who they are in a horrible process which can take a very long time - a person dissolving like a pillar of salt. By telling this story the Torah is saying I recognize you, I feel what you are going through, there is no explanation that can be given but I am with you.
While Lot's wife's fate is similar to that of a vast number of Alzheimer's/dementia victims, there is one huge difference which is certainly in our hands -- Lot's wife's name is not even mentioned in the Torah, and we have the opportunity to remember and to memorialize and to continue to love the victims of this dread condition who we were so close to.
November 17, 2024 - Parashat Chayei Sarah - A Taste of the Repetition of Dementia
This week's parashah includes a sequence that, while it may make sense in order to tell a story, gives us a taste of one of the many very difficult challenges faced by the Caregiver of a person with dementia. These challenges present themselves in many ways such as the physical care and hygiene of the patient, severe personality swings which frequently result in a spouse being treated like an enemy, the financial burden of providing outside or resident care for the patient, and many others. One of the most immediate challenges is dealing with the patient directly. Memory loss, language impairment, over-reaction or non-responsiveness, and other interpersonal issues can make dealing with a dementia patient essentially impossible and create an enormous amount of stress for the Caregiver.
The portion of Chayei Sarah gives us a small taste of one of these interpersonal challenges, that of repetition. A dementia patient may repeat either an action or a verbal expression for what seems to be an endless period. The weekly portion presents this in a very limited way, but three appearances of the same phrase start to give the reader a feel for this condition. In Genesis chapter 24 Abraham sends his servant to find a wife for his son Isaac. The standard by which the servant evaluates the appropriateness of a woman is if, in addition to giving the servant water to drink, she also brings water for the servant's camels. Verse 14 uses this phrase to establish the offer of giving water to the camels as the standard, verse 20 describes her actually giving water to the camels, and verse 46 recounts that she gave water to the camels. Even these three times of saying the same thing are prominent and give a taste of what repetitive expression feels like, and from this point we can begin to imagine what it would be like to face seemingly endless repetition of a phrase or action. For the Caretaker of a dementia patient this is not to imagine, but rather is the daily reality, challenge, and frequently crushing situation that care-taking requires.
November 24, 2024 - Parashat Toldot - When a Parent Doesn't Recognize His/Her Own Child
Dementia leads to a virtually complete disconnect from surroundings - the patient no longer has any connection with their surroundings. One of the most tragic results of dementia is when a parent no longer recognizes or connects with their own child. In this situation the parent has lost all aspects of their relationship with the child and does not recognize the child in any way. Perhaps even more tragic, the child knows the result of the parent's dementia and is aware of all the experiences and connections and love between parent and child that is lost.
Genesis chapter 27 in this week's portion of Toldot describes this situation in Isaac's connection with his son Esau. The Torah starts out by saying that Isaac could not see Esau and had lost visual connection with him. Rather than leaving the story at the single broken connection of visual, the Torah lists a whole set of ways in which Isaac was disconnected from Esau. The Torah specifies that Isaac loved Esau's cooking, but does not recognize that the meal he is given was not cooked by Esau. Esau's brother speaks to Isaac but Isaac does not clearly recognize that the voice is not that of Esau but rather Esau's brother Jacob. Then Isaac touches the person he is speaking with and does not sense that the animal skins he is touching is not the skin of his son Esau. Finally, Isaac smells the person with him and again does not recognize how disconnected he is from recognizing his son Esau.
Disconnect of sight, taste, sound, touch, and smell - the Torah is telling us of the terrible fate of so many parents and their children today, of the horrible distance that dementia creates even within the closest of families.
December 1, 2024 - Parashat Vayetze - Functional and Non-Functional Parts of Life
As Early-Stage Dementia takes hold, the patient more and more distinguishes between two parts of life. This week's portion of Vayetze strikingly illustrates a person facing these different conditions of their life, and how the patient relates to each.
The first part of life is that part of the patient's life that remains relatively "regular". In this part of life the patient continues to function and flow, carrying out activities similarly to before the condition. Even as the patient's dementia develops this part of life is marked as a good place to be, as a marker for measuring possible changes and decline that come with the dementia.
The second part of life is that which has been affected by dementia. In this part of life the patient's ability to carry out what used to be normal tasks is reduced, and are done with difficulty or requiring more time and focus than previously. Some tasks even become impossible for the patient to perform, and must be carried out by other people or at least with the assistance of others. The dementia patient very much feels the difficulty or impossibility of this part of life.
Genesis 28:12 illustrates the first part of life. This verse describes angels going up and down a ladder, a flow of life in which things sometimes go up and sometimes go down, and which has a regular flow to it like the ongoing up-down of the angels. Jacob recognizes the value of this situation, and in verse 18 places a stone to mark this good place in life so he'll be able to relate to it as much as possible.
A few verses later in Genesis 29:8 a much more difficult situation is described. A boulder covers the mouth of the well that's used to water the flock. One shepherd can't roll the rock away, this only happens when several shepherds are present. Even when Jacob comes to push the boulder away he is not alone, he has family around him to guide and encourage him. Through a series of events we see the conflict, non-achievement of goals, and terrible lack of understanding that this leads to, as it does in many cases as dementia develops.
In a few short verses Jacob demonstrates the two parts of a dementia sufferer's life, that of normalcy and that of great difficulty, and that the sufferer must deal with both.
December 8, 2024 - Parashat Vayishlach - Give a Place to Pace
From its very start at Genesis 32:4 Parashat Vayishlach is about people going from here to there, in this verse Jacob sends his servants to his brother Esau. Repeatedly in this portion the way people go, what they have with them, and what they are to say when they get to their destination are specified. All of these aspects of going from one place to another are described as important.
Genesis 33:14 defines that pace is important because many factors affect the pace in which a person functions. This verse is the instruction for someone else to proceed and not be delayed: "Please, my lord, go ahead of your servant. We will follow slowly, at a pace that is comfortable for the livestock and the children. I will meet you at Seir". Perhaps it is obvious that the faster should go ahead of the slower but in this verse it needs to be expressed.
A person with Alzheimer's/Dementia also functions at a slower-than-usual pace. Perhaps here also it may be obvious that a person who is having difficulty walking or completing a task requires special consideration, and here also it may need to be expressed. This card that the Alzheimer's Association provides is the modern equivalent of Genesis 33:14:
What we learn from Parashat Vayishlach speaks directly to the consideration, patience, and processes we should have in relating to people with Alzheimer's/Dementia.
December 15, 2024 - Parashat Vayeishev - A Torah Handbook on Dementia
From its beginning until its last word Parashat Vayeishev tells us many things about relating to people with dementia, or with dementia-like behavior that is an indicator of a related condition. The first time Joseph is mentioned in Genesis 37:2 he is specifically referred to as a "boy" indicating limited development, and the next verse further emphasizes his special condition in how his father related to him differently than to his brothers. Going through the stories told in Parashat Vayeishev brings us to Genesis 40:23 the last word of the parasha which is "vayishkechehu", a seemingly redundant and vague word meaning "and he forgot him". It's as if the Torah is telling us that Joseph forgot the Chief Baker -- a forgetfulness that is a common and important characteristic of dementia and dementia-like behavior. Did Joseph have dementia? The Torah goes out of its way to present to us Joseph's dementia-like condition, and the lack of MRI machines in those days may have prevented the Torah from providing his full diagnosis.
Let's briefly go through a few of the lessons that the Torah is giving us related to Joseph's condition:
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Genesis 37:5-11 tells of dementia-like hallucinations that Joseph had, and how his brothers hated him for being different while his father wanted to better understand what was going on with Joseph. The brothers' reaction (and to the degree to which a community reacts in a similar distancing way to a person with dementia) did not lead to any good for anybody.
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Genesis 37:15-17 shows that with special guidance Joseph was able to reach his goal
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In Genesis 37:21-22 Reuben serves as Joseph's Caregiver, parallel to the difference a Caregiver makes in the life of a person with dementia
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Genesis 37:24 and following screams to us the importance of how a community relates to its members with dementia. The community of Joseph's brothers throws him out and ignores him, and the result is much grief for all involved. The community of the Midianites in Genesis 37:28 served as a transition in Joseph's life, strengthening him from where he was before and guiding him to what he could achieve. Finally, Genesis 39:1 and following shows us how Joseph was able to flourish in a sensitive, understanding, and supportive community, and achieve his full potential.
How a community is aware of, understands, and relates to the special condition has a huge impact both on the person and on the community. Parashat Vayeishev as a Handbook on dementia teaches us much that is of great value for us to learn and to put into place.
December 22, 2024 - Parashat Miketz - A Virtual Journey Into Dementia
This week's Torah portion of Miketz is an invitation for people who do not have dementia to take a virtual journey and to get a sense of what having dementia feels like. It does this by having several of the people in the portion be in dementia-like situations, and describing the situations and how the person feels.
This starts with the very first verse, in Genesis 41:1. Pharaoh is dreaming -- the Hebrew uses the present-continual tense, not the past tense, to tell us this condition is ever-present for a person with dementia. It is not a sometimes-thing, it is a continual presence and challenge for the person and for those around the person. Verses 8 and following describe the distress this causes.
A recurring mode throughout the portion is the mix of reality and unreality that a person experiences, of a person's life being affected by forces that are not understood or visible - as with dementia. The people of Egypt had their produce taken for seven years without knowing why, and then suffering an unexpected famine. In Genesis 42:7 the stage is set for another not-understandable and difficult example of life, that Joseph recognized his brothers but they did not recognize him, and he was rough with them. In Genesis 42:27 they have another bad and unexplainable experience, that their money was in their sacks, in 43:33 the brothers saw that Joseph inexplicably knew the order of their birth, and in 44:12 they experienced the shocking reality that the goblet was found in Benjamin's sack.
A long string of difficult, unexplainable, challenging, and frightening experiences - so it is with the portion of Miketz and so it is with dementia. And tragically - just like Miketz, a word that means "at the end", there is no going back from dementia, it is a path to the end.
December 29, 2024 - Parashat Vayigash - The Approach Makes the Difference
This week's portion of Vayigash is a crescendo. Two weeks ago in the portion of Vayeishev, Joseph's unusual behavior and life showed that he was "dancing to different music" that only he heard and which may well have been a form of dementia. Last week's portion of Miketz played that music for people who hadn't heard it before, with a virtual journey into dementia.
Vayigash pulls these two together in the magnificent three words that begin this portion at Genesis 44:18: "Judah approached him". The Torah doesn't use standard language such as "Judah came into him" which would mean Judah moving closer to Joseph physically. Rather, "Judah approached him" means that Judah adapted himself to Joseph's way of being, Judah listened for and danced to the music that Joseph heard and danced to, Judah related to Joseph on Joseph's terms instead of on Judah's terms.
And the result of Judah's action is incredibly moving: Genesis 45:1 tells us that Joseph could not restrain himself and wept openly, the hardness that had characterized Joseph's relationship to his brothers up to now was completely broken by Judah's approaching him. This is the pinnacle of Joseph's story, and it resulted from Judah being aware of and connecting with Joseph according to where Joseph was at. The message of Vayigash for the Jewish community is loud and clear: raise awareness of dementia in its various forms within the community and relate to members of the community who have dementia with "approach" just as Judah did to Joseph.
January 5, 2025 - Parashat Vayechi - A Persistent Condition
Since the portion of Vayeishev the Torah has been telling us about Joseph - who he was, what his life was like, and what he did. As we have seen from the beginning of the story of Joseph, the Torah provides indicators that Joseph had Early-Stage Dementia or a dementia-like condition. With Vayechi being the last portion describing Joseph's life, and the portion in which he dies, we see the last indicators of his condition. In fact it's remarkable the level of detail the Torah provides in order to express Joseph's condition.
Genesis 48:10 says explicitly that Joseph's father Israel had become blind, and that when Joseph brought his two sons to Israel that Israel kissed them and hugged them. In the next verse Israel says that this was seeing his two grandsons just as he had seen Joseph's face - Israel knew which grandson, Ephraim and Menashe, was which. Verse 13 tells in which hand Joseph presented each grandson to Israel, and Verse 14 tells that Israel reversed his hands from the way Joseph presented them - and the Torah explicitly says that he did so intentionally. When Joseph tried to switch Israel's hands to the way Joseph wanted, Verse 19 says explicitly that Israel refused and that Israel said TWICE that he knew what he was doing.
Anyone familiar with a person with dementia will recognize Joseph's response throughout this process -- already starting in Verse 17 Joseph saw this act as bad and it very much bothered him. Even though his father Israel made it clear that his choice was intentional, Joseph was unable to accept someone else's approach or decision - a situation which is common with the condition of dementia.
January 12, 2025 - Parashat Shmot - Moses' Openness
For the purpose of raising Awareness and Conversation about dementia and similar conditions in the community, this week's Torah portion of Exodus shows us Moses' method which we can well learn from.
Problems with language and speaking are a first-line indicator of beginning the development of dementia. There is no indication that Moses had any communication problem during much of his life, and he is referred to as speaking on different occasions. Then in Exodus 4:10, when he was in his 70's, Moses himself begins to emphasize quite openly and clearly the problem he has recently developed with speaking and how it affects him: "And Moses said unto the LORD: Oh Lord, I am not a man of words, neither yesterday or the day before, nor since Thou hast spoken unto Thy servant; for I am slow of speech, and of a slow tongue".
The pattern that we see with Moses is quite common for dementia - in this age range early indicators of dementia begin to appear in limited scope. What is extraordinary here, and what we can learn so much from Moses, is his response to it. He doesn't hide his condition but rather the opposite -- he describes openly and clearly, as a recognized member of the community, the condition he has. In doing this he raises Awareness and Conversation of the condition within the community. Moses' model of relating to his condition is incredibly important -- each person with a dementia-like symptom such as communication problems who finds the strength, courage, and vision to speak about it openly is helping other people and the community as a whole to deal with the huge challenges that the condition brings.
And just to give it further context, Moses' "coming out" about his communication-impairment condition corresponds to a much larger "coming out" that he's about to lead - this week's portion of Exodus describes the start of the process in which the Children of Israel will come out of Egypt. Such is the importance to the community of openness in dealing with personal-impairment conditions such as dementia symptoms.
January 19, 2025 - Parashat Va'eira - Let My People Go - to a Place of Quiet
Among the effects of dementia is limited brain function, so the brain is not capable of accepting and processing as many inputs as previously. This includes many types of inputs, and especially when they arrive at the same time: people talking, music, reading, understanding an environment, facing a decision, taking an action, etc. Such input-overload is overwhelming for people with dementia, who respond to such a situation in different ways to reduce the inputs that are coming in.
The weekly portion of Va'eira well demonstrates input-overload and the need to escape it. The portion begins with some history, then goes through a long list of genealogy, and then the Plagues with the talk around each. Peppered throughout all of this action is the famous phrase "Let my people go that they may serve me". For a person with dementia trying to follow all of these shifting scenes this going-away is a "Godsend" so to speak - reading this is an overload of inputs, please focus on one activity such as serving the Lord, which my mind can handle and I can absorb. This is exactly what a person with dementia feels when dealing with what is going on around them.
This portion further emphasizes this by an addition it makes the first time the phrase Let My People Go is used, in Exodus 7:16: Let my people go that they may serve me in the desert. When there are too many inputs, going to the wilderness - a place with a drastically reduced amount of inputs - is the most effective way to allow the person to function in whatever activity the person chooses.
January 26, 2025 Parashat Bo Egypt/Dementia: Progressive Tragedy
Physical disintegration, darkness, death of what once shone. This week's portion of Bo is the story of what happened in Egypt which is the story of what happens with dementia.
Last week's portion of Va'era described seven plagues, a series of suffering in different forms but following the same repetitive pattern. Such is the progression of dementia - starting out with one or more symptoms, each bringing difficulty and suffering, with the number, severity, and impact of the symptoms accumulating to make the patient's life more and more difficult for the patient and the family. Last week's portion illustrates the development of dementia through the combination of various symptoms and the decline it causes.
This week's portion of Bo starting at Exodus 10:1 shows the culmination of the process, for both the Egyptians and for dementia. The eighth plague of locusts brings the Egyptians close to their breaking point, and for a dementia patient signals the essentially complete loss of physical capabilities. The ninth plague of darkness shows how much the Egyptians were lost even in their own world, and in dementia it is the state of complete loss of mental capability. The tenth plague is death - for the Egyptians the death of the first-born child, and in dementia the death of the patient as the person they used to be.
The remainder of this portion continues this theme with Exodus 12:13 describing the Passover - in Egypt passing over the Jewish houses in order to not harm the inhabitants, and in dementia the opposite: passing over the patients and not providing them with any healing.
The plague of dementia -- a progressive tragedy for everyone involved.
February 2, 2025 Parashat B'Shalach Communications Without Words, Feelings With Thoughts
Memory loss is a major indicator of the onset of dementia, and another is difficulty with verbal communications. For a person with dementia verbal difficulty goes both directions -- in terms of expression it is difficulty in finding the correct words and putting them together in a way that another person can understand, and in terms of hearing it is difficulty in converting a stream of incoming words into a meaningful message in addition to the amount and speed of incoming words, disruptive conditions such as the number of speakers and the surrounding noise, etc.
Parashat B'Shalach describes Bnai Yisrael's exodus from Egypt and the immediately following events in a way that can be considered at least dementia-friendly, and can easily be viewed as requiring dementia in order to fully relate to. Why was this done -- perhaps it was to take into account a significant portion of the 600,000 Hebrews who left Egypt who were in a dementia-like condition, even though "dementia" may not have been defined then in exactly the same way as it is now. As we saw in earlier Torah portions Joseph himself had dementia-like symptoms, and these may have been common throughout the people.
The Torah often uses words to describe actions and situations, so it is unusual that this portion that starts at Exodus 13:17 uses non-word non-verbal methods to communicate messages. These include: 13:21 pillars of cloud and fire, 14:19 angel/pillar moving from front to back. 14:21 splitting of the sea, 14:31 fear from the mighty hand, 15:1 singing a song, 15:20 women singing, 15:27 water and palm trees, 16:15 bread, 16:20 worms, 16:24 not rot, 16:35 manna 40 years, 17:6 water from the rock, and 17:11 Moses' hands.
For all of these Torah is using images rather than words, and feelings together with thoughts, in communicating the messages of Parashat B'Shalach. This is certainly a dementia-friendly approach, and was used when all of Israel was together at the Exodus from Egypt.
February 9, 2025 Parashat Yitro The Dementia Decalogue
The giving of the Ten Commandments starting at Exodus 20:1 is one of the most powerful and dramatic passages in the Torah. It speaks to each of us with a series of do-and-don't rules, each of which needs further investigation and analysis to fully grasp. The Torah further emphasizes that these rules are directed toward individuals with the capability of doing such analysis by putting each rule in the singular, each person is to investigate each rule and carry it out.
People with dementia have limited cognitive capability and are not able to relate to the Ten Commandments in the same way. Recognizing this and in order to provide for people with dementia, the Torah provides a version of the Ten Commandments that are less mind-oriented and more feelings-oriented, in a way that people with dementia can relate to. This version comes at Exodus 20:17-22, immediately following the giving of the more commonly-known Ten Commandments. This version is given in the plural so that understanding and performance are a communal activity with mutual support within the group, which is appropriate for people with special ways of relating to the rules, rather than individual cognitive analysis. The rules themselves are different -- they are simple actions that even protect the people they are aimed at from transgressing. Verse 17 tells that Moses came into the cloud, he approached the people with dementia on their own terms. In verse 18 God talks to the group, identifying them as working together to fulfill these rules. Verse 19 eliminates complex acts or need for fine skills in the activity of this group of people. Verse 20 describes the work of this group as being very simple and connected to the land, the building of an alter of earth. Verse 21 further stresses the simple nature of this effort, that if stones are used they should be in their natural condition and not been worked in any way. Finally verse 22 instructs that the alter be built with a ramp rather than steps, so whatever clothes the people using it are wearing (unlike the requirement for special garments) their modesty will be maintained.
A version of the giving of the Ten Commandments for people with dementia -- the Torah is showing the entire Jewish community how it should relate to its members with dementia.
February 16, 2025 Parashat Mishpatim Description of a Dementia Life
Parashat Mishpatim describes in three parts what a life with dementia looks like. The first two parts are a life as we know it, and it is in the third part that Dementia changes a person's life.
The first part of this portion (Exodus 21:1-23:19) is a list of rules and regulations, like all the do's and dont's a young person is taught. The second part (Exodus 23:20-24:9 ) is B'nai Yisrael moving toward the land of Israel, which is like a person learning to live within a group moving toward a particular goal.
Then comes extraordinary verse Exodus 24:10, inserted between the second and third parts of Parashat Mishpatim, which describes the onset of Early-Stage Dementia. With all the horror of Early-Stage Dementia, Torah presents the aspect that this condition serves as a Release for a person to be their authentic self and to achieve clarity about themself and about the world: "And they saw the God of Israel; and there was under His feet the like of a paved work of sapphire stone, and the like of the very heaven for clearness", the stones below and the heavens above become crystal clear. Torah is telling us about Early-Stage Dementia that leads people to throw off the external noise and the external distractions of everyday life as they are unable to process these, and allows people to connect with clarity to their authentic selves. This is exactly my experience with Early-Stage Dementia -- Release is the dominant word and the dominant feeling I am having. For me this is expressed in ways such as feeling what I feel and expressing what I feel, sensitivity to all types of noise and avoiding/leaving noise situations, creating my tombstone CreatingMyTombstone.com which expresses for me and guides me on what it is that I bring to the world, and in other ways.
The third part of Parashat Mishpatim (Exodus 24:11-24:14) describes the elevation that Early-Stage Dementia brings such as from the change in balance between thinking and feeling. This part includes the parashah ending with Advanced-Stage Dementia and the closing of a dementia life -- Exodus 24:15-18 are the horrible devouring fire and the person fading into a cloud which are the end of a dementia life.
