On God, Disease, and Dying

Cancer, dementia and aging:

I must be getting older: I am writing about things I never used to write about. That is because I and my peers are experiencing things we never used to experience. So a quick moral lesson to begin with: if you are young and healthy, never take it for granted. Soon enough things can change.

In a few days it will be two years since my wife passed. And increasingly my friends and colleagues are struggling with health issues, and a number have already passed away. Just the other day I got this email: ‘Just wanted to let you know that *** is in *** Hospital in ICU. The cancer has spread quite rapidly to her lungs, liver and spine. The doctors say she has only days left. Very sad that it is in the same week as Averil’s passing.’

Wow, another one! Upon reading that, there were more tears. I said to myself: ‘I HATE death – and I hate sin that causes death.’ And when I rather angrily told God that I hate death, this verse immediately sprang to mind “‘Where, O death, is your victory? Where, O death, is your sting?’ The sting of death is sin, and the power of sin is the law. But thanks be to God! He gives us the victory through our Lord Jesus Christ” (1 Corinthians 15:55-57).

As I was praying for this gal and her family, I immediately thought that she will soon be hanging around with my wife, free of suffering. But still, all this misery, pain and death is so horrible. One day it will be no more, but for now, it really sucks.

My wife’s aggressive cancer had also spread everywhere, including tumours in her brain. Near the end, her mental facilities were wearing down. That was the hardest part for me and I recently wrote about it: https://billmuehlenberg.com/2025/05/24/disease-christ-and-eternity/

I pray daily for folks that I know who are struggling with cancer. And I pray daily for folks that I know who are struggling with dementia and related disorders of the mind. And since most of these folks are married couples, there is a dual prayer that needs to be prayed: one for the sufferer, and one for the spouse looking after the sufferer. Both are on such hardcore journeys.

And it has not just been my own friends and personal acquaintances that I know are struggling in these areas. A year or two ago I wrote about Elisabeth Elliot and all the trials she went through, including the deaths of two of her three husbands. Many know of Jim Elliot and how he and four other missionaries were martyred in the jungles of Peru. As I wrote a few years back:

“But Elisabeth went on to marry two more times, with her second husband losing a lengthy battle with cancer, and her third husband at times being much too critical, domineering and harsh with her. And for her final 15 years or so Elisabeth went through even more suffering and hardship, this time battling Alzheimer’s and dementia.” https://billmuehlenberg.com/2023/09/21/three-top-books-on-elisabeth-elliot/

And around the same time, I stumbled upon a 2020 movie being shown on television that also really moved me. The Father, starring Anthony Hopkins, is about an elderly man who is struggling with dementia and how it affects his relationships with others, including family members. It really is a superb film. See more on it here: https://billmuehlenberg.com/2023/10/09/crisis-christ-and-comfort/

Dementia and truth telling

Let me focus further on the matter of dementia and other brain disorders. And I will tie it in with something else I have written about lately. I recently did a piece on the Ninth Commandment, and if it is ever right to keep the truth from others. I focused on ruses and deception in wartime, but one friend sent in this comment, looking at another area where this can apply:

Thanks Bill for that very comprehensive summary. I think today I have engaged in many deceptions to my wife. On the bare face of that statement, many would hail me down. But my wife has dementia, a position she refused to accept for a long time. She would often ask why she is where she is (in a dementia unit in a place of care). To tell her the truth I would have to say that she has been diagnosed with dementia. That would cause her undue grief and anxiety, something to be avoided with dementia patients. She would ask when we could go home and I would tell her soon, knowing full well that was not true. But again the truth would cause her anxiety and do her no good at all….

I thanked him for his comment and said that I just recently had come upon an article discussing the very same matters. Back in 2019 Denis Haack wrote a piece titled “Random reflections on lying”. It began this way:

“I’d like to move next February,” my mother told me. She looked me in the eye intently and repeated herself. “I’m going to move next February. A friend and I have been looking at places when we go out for walks and I’ve found a house I like. It has a big kitchen which is good so I can do more cooking.”

 

I had this conversation with Mom about seven months ago. It was on one of her more lucid days. She’s dead now, but at the time lived in the secure memory care unit of a lovely retirement home about five minutes from where Margie and I live. At the time she could only get around with a walker and then only for short distances: from her room to the dining area, or with my help to the commons area. She simply didn’t have the strength to get past the front door of the place with her walker. Going for a walk required me to push her in the wheelchair I had purchased. There is a little kitchenette in her room, to make it feel more like home but the stove is not plugged in. And the facility provides all her meals—health regulations insist even I can’t provide homemade treats for anyone other than my mother.

 

I asked her about the house she’d found and she happily told me about it. And then because I love her I told her lies: That I was delighted she’d be moving into her own house, that February is a fine month for moving in Minnesota, and that it’d be great she’d be in the kitchen more since I’d missed her cooking.

 

We talk about her new house for a while and then she leans forward and her voice drops to a whisper. “Don’t tell anyone I told you this because it’s supposed to be secret,” she said. “All the residents are required to bring refreshments to activities, so I do. My friend and I walk to the grocery store for supplies. And my treats are the most popular, you know. Most just bring store bought stuff, but mine are always homemade, made from scratch.” That’s the way people are, I said, and she should know how proud I am of her. “And then they come by my room and say they want to be my friend, but all they want is more treats, so I send them away.” And so you should, I reply, real friends want more than refreshments even if they are homemade. Most people weren’t raised right. Mom agrees. She asks if I’ll make the arrangements for her to move and I assure her I will. “Don’t forget, now,” she says sternly. I won’t, I say. I promise.

 

It’s been interesting lying regularly, convincingly to the woman who punished me as a boy for not telling the truth.

 

In dementia care, everybody lies. Although some nursing homes have strict rules about being truthful, a recent survey found that close to a hundred per cent of care staff admitted to lying to patients, as did seventy per cent of doctors. In most places… there is no firm policy one way or another, but the rule of thumb among the staff is that compassionate deception is often the wisest course. “I believe that deep down, they know that it is better to lie,” Barry B. Zeltzer, an elder-care administrator, wrote in the American Journal of Alzheimer’s Disease & Other Dementias. “Once the caregiver masters the art of being a good liar and understands that the act of being dishonest is an ethical way of being, he or she can control the patient’s behaviors in a way that promotes security and peace of mind.” Family members and care staff lie all the time, and can’t imagine getting through the day without doing so, but, at the same time, lying makes many of them uncomfortable. To ease this “deception guilt,” lying in dementia care has been given euphemistic names, such as “therapeutic fibbing,” or “brief reassurances,” or “stepping into their reality.”

 

Six months after our conversation about moving, Mom’s dementia had deepened in remarkable ways. When I visited her and asked a simple question she got confused trying to answer and was embarrassed. I told her not to worry and started telling a story of what Margie and I did that week. How I longed for lucid days that required me to lie. To agree to things I know can’t be true, to ask questions about things that never happened, to be happy about things that are nothing more, sadly, than delusions thrown up by her failing memory. To try to enter in love the reality she lives in, even though it is warped and misshapen by the disease that was slowly taking her mind and memory and life.

 

I’ve occasionally been asked how I feel about lying to my mother, and the question always amuses me. I hated the dementia that afflicted her, of course but the lying never bothered me. From a Christian perspective lying is not necessarily forbidden in a fallen world…. https://ransomfellowship.org/article/random-reflections-on-lying/  

Dementia – final thoughts

There are plenty of good books out there on dementia – many written by Christians. Let me mention one which I picked up a few years ago. John Dunlop is a Christian doctor who has worked with geriatrics for many years. And his own parents had dementia. His book, Finding Grace in the Face of Dementia (Crossway, 2017), is very helpful indeed.

Here is just one quote from it. In his Appendix, he shares a letter he wrote to his family on how he will want to be treated if he gets dementia – looking at its early and later stages. He writes:

As my dementia progresses, I hope you will be willing to spend time with me, and even if you think I might not remember the time we have together, realize that I will have enjoyed the moment. Help me to stay connected with my past through stories and pictures. I hope you will make arrangements for me to hear the Bible being read as well as to hear old hymns I love. Talk to me about the Lord, his cross and resurrection. Speak often of heaven and what it will be like to enter God’s presence. Give me some hugs to allow me to feel your love.

 

If I live into advanced dementia, continue to spend some time with me when you are able. Do not feel guilty if you decide I am best cared for outside the home. Dorothy, I want you to know how thankful I am for the ways God has gifted you to serve Him. I want you to continue to do those things and do not want time spent with me to detract from your other callings. The same applies to all four of my children in each of my grandchildren….

 

I know that being involved in the care of a dementia patient can be very difficult. If at the time I make it harder, please forgive me. I trust God will give you the grace to blame the dementia and not me. Know that I love you, and if I could, I would thank you over and over for your loving service to me.

 

I thank God that no matter what happens to my mind and body on earth, he will take me to be with him, and once there, I will look forward to being reunited with you, my dear wife, and with the rest of our family in the presence of Jesus, with bodies and souls fully redeemed and restored in the image of God.

 

Love,

John

All we can say at times like this is, ‘Come quickly Lord Jesus.’

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