Why a church service matters

For many people living in eldercare settings, worshipping in community on Sunday was an inviolate tradition. It simply wouldn’t be Sunday without going to church!

God is faithful to meet elders — like the rest of us — exactly where they’re at. I believe that deep calls to deep (Psalm 42) as the Spirit communes with seniors’ souls in ways we cannot see or even imagine. That’s why I created more than a year’s worth of dementia-friendly worship services (and I’m working on even more!).

Beyond spiritual nourishment, offering a weekly service gives seniors a comforting sense of familiarity, ritual, and fellowship. For people with Alzheimer’s or other dementia in particular, an interactive, slow, and repetitive approach with numerous familiar elements enables everyone to participate at their highest ability level.

How To: The Nuts and Bolts

You can do this

• As the worship leader, you don’t have to be an expert speaker, scholar, or musician; all you need is a simple, repeatable agenda and a commitment to love and encourage every attendee.
• My free worship service agendas probably include more material than you’ll need, so pick and choose what works for you — or create your own.
• My in-person dementia-friendly services last an hour, but that may be too long for your group; 30-40 minutes is just fine. If people look tired, skip elements after the interactive homily and end early.
• Whether or not to use songbooks is up to you. For my eldercare groups, I’ve assembled soft-sided notebooks with lyrics printed in 22-point type, one song per page (see “Hymns” section below). Each page has a large page number and is placed in a plastic page protector. Many people use the books to follow along; others merely hold them.

Before church starts

• If your memory-care community doesn’t have a chapel room, set up chairs as needed. If possible, face away from the door to minimize distractions when visitors enter and leave.
• Leave a couple of inches between each chair to help people to grab the chair arms as they sit down.
• Set up an “altar” – a simple table covered with a pretty cloth works well.
• On the table, I also place electric candles; a heavy, free-standing cross; a Bible; and a chime for the closing blessing (see below under Sound).
• Thirty minutes before the service begins, turn on recorded pipe organ music (I have this organ-music-only album on my phone) as an audible cue. Many memory-care seniors associate this kind of music with entering a church.
• Post signs to alert staff and visitors that this is a sacred space and to please be quiet and respectful.
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• Before church begins, politely ask the staff to avoid interrupting if at all possible. Giving medications can often wait until church is over.
• After you’ve set up the room, go around and invite residents personally. Ask the staff to help bring people as needed.
• Greet people as they arrive and help them to a chair.
• If using, give each person a hymn notebook.

Hymns

• I recommend my free MP3 files of classic hymns because they are specifically arranged as sing-alongs for people living with dementia (slower, shorter, lower key). Load the MP3s on your iPhone or iPod and link to a small speaker. (I use a Sony wireless XB20.)
• If your group prefers a physical hymn book, I recommend using my standard hymnal lineup each week. Proceed in order from page 1 to 2 to 3 to 4, etc.
• Before each hymn, slowly and clearly call out the hymn name and page number: “Let’s sing page 3, ‘We Gather Together’ … page 3, ‘We Gather Together.'”
• If you do skip pages, announce it and give them a little extra time to get to that page. (“We’re going to skip ahead one page, to page 6, ‘Jesus Loves Me’ … skip one page ahead to page 6, ‘Jesus Loves Me.'”) Only skip ahead, not backwards.
• Because the hymns are generally well-known, your group may not need or prefer hymn books; that’s fine too.
• If you have a smart TV, you can use YouTube video versions of my hymns instead of a physical hymnal. I strongly recommend buying YouTube Premium to avoid pesky commercials. You can pick and choose from the alphabetical list of all 86 options.
• Whether you use my standard hymnal or create a playlist, the general idea is to alternate faster/slower and shorter/longer songs. To choose your own lineup of songs, download lyrics here.

During the service

• Always speak slowly.
• If possible, use a hands-free microphone. Keep your tone warm and personal. Make lots of eye contact.
• Move around the room; feel free to help people find the correct hymn page, or to gently touch someone on the shoulder. Remember, you are part of the group, not just the leader. Worship with them!
• Whatever agenda you use, keep certain elements consistent every week, such as an opening prayer, the hymn order, the Lord’s Prayer (Our Father), and the closing blessing.
• If possible, read Bible passages from an actual, traditional-looking Bible. I’ve included biblical texts within my church agendas, but reading from a physical Bible provides another point of recognition and familiarity.

The interactive homily

• This is my favorite part 😇 Say something like, “We’ll come back to singing in a minute, but let’s pause a bit and talk about [theme for the day].”
• For memory-care residents, it’s crucial to make it interactive. Use my homily questions as a guide. Ask the group questions and then wait for answers. People with dementia take longer to process words, so be patient.
• If answers go in a different direction and people are engaging with a particular idea, keep going with that and build on it however you like.
• Repeat and affirm their contributions and thoughts, no matter what they say. “Jim says that peace involves respect! Jim, that’s absolutely true; thanks for sharing that.” “Yes, your kids are the best, Jane! I love that they bring you joy and peace. That’s such a good point — thanks!”
• Handle interruptions or disruptions with patience and grace. If someone wanders through the room, let them! If they want to take your hand during a song, that’s fine, too. I’ve had residents get up and start dancing — how awesome is that?! 💗 Quietly ask for a staff member’s help only when needed to keep things flowing.

When the service is over

• After the closing blessing, turn on the instrumental hymn music again. Then walk around to collect hymn books.
• Give each person a personal greeting or blessing. Shake or clasp their hand gently and thank them for coming. “God bless you, Laura. Thank you for coming.”

Ideas for sensory elements

When leading spiritual events for a group of memory-care residents, it’s wonderful to include as many of the senses as possible.

Sight 

• I wear a Guatemalan stole (a nod to my Latina roots, but choose whatever type suits you) as a visual cue that I’ll be leading the worship time.
• I hang banners every week as visual cues that this space and time are set aside for worship. I have simple ones for “ordinary” seasons and special ones for Advent and Easter. (Check out PraiseBanners.com for nice-looking, affordable banners.

Sound

• People love to sing or listen to songs, so use hymns liberally and often! Even people who don’t consider themselves churchgoers and those who have lost the ability to speak often start mouthing the words to familiar songs such as “When the Saints Go Marching In.” 
• At my Sunday services, we typically sing about 15  hymns (remember, they’re short). 
• I use a small singing bowl during the final benediction, striking it on the word “Lord.”

Scent

• Certain smells immediately evoke memories and rituals. 
• Use incense or essential oils of frankincense and myrrh at Christmastime and Easter. Put a few drops on a handkerchief and walk around, letting each person smell it.
• Use spices, foods, and plants, such as cinnamon, rose, vanilla, and peppermint, to illustrate various themes. On the Sunday near Chinese New Year, for example, I walk around with a scored orange (traditionally eaten during Chinese New Year) for people to inhale the lovely essential oils in the peel.

Touch

• The sense of touch connects people with feelings and concepts. For example, for the Baptism/Water service, I bring in smooth river stones as a tactile example of water’s smoothing, cleansing properties. 
• Other ideas: palm fronds for Palm Sunday; feathers or silk when discussing light or beauty; evergreen branches during the Christmas season (good for touch and scent). Use your imagination!

Taste

• If possible, arrange with the staff to serve a small snack at the end of the service. Simple refreshments, such as cookies or juice and tea, can evoke memories of church social hours.
• Some services lend themselves to taste elements; for example, I distribute strawberry slices for Pentecost.
• In addition to being deeply meaningful for many elders with dementia, communion (the Lord’s Supper) offers evocative tastes through the cracker and juice.

If you have ideas of your own, I’d love to hear them in a comment below.

Peace be with you,