Who Are You if You Don’t Know Who You Are? I’ve been wondering what happens to a person’s beliefs if they no longer have the cognitive function to remember them. For instance, if you were religious before you developed Alzheimer’s, are you still religious after? Conversely, if you weren’t religious before the onset of dementia, what does it mean if you decide to practice a religion after diagnosis? These questions are going through my mind as I watch my wife lose hers. I’m wondering to what extent I should honor her beliefs as she forgets what they are. Should I just follow what she used to believe, comply with what she says now, or take over for her according to my own views, including what happens at the eventual funeral?
—She’s No Longer Herself
Dear No Longer,
You have my deepest sympathy for what you’re going through, and I commend you for your thoughtfulness about these issues.
First, I recommend you join an Alzheimer’s or dementia caregivers support group, not only to help you explore your questions, but also for practical as well as emotional help caring for your wife—and yourself—during this very difficult transition.
Next, I think the answers depend to some extent on what, if any, promises you made to your wife before she became incapacitated, and what other family members may expect or need. For instance, if she was religious and wanted religious rites, it would good if you honored that, possibly even if she can no longer express her preferences. If, on the other hand, she has suddenly become religious but never was before her illness, you might want to comply with whatever she asks (within reason) while she can still articulate her wishes, but you don’t need to continue when she is clearly incompetent or after she’s gone. If your/her family expects religious rites or the absence of them, and that was what she wanted before she fell ill, it’s best to comply with that.
Finally, you need to consider yourself. If your wife in her illness makes demands that make you extremely uncomfortable or are difficult for you to fulfill, as her guardian you don’t need to do anything that goes beyond your comfort zone emotionally, logistically, or financially. You should check with a lawyer to confirm what decisions you’re free to make on her behalf, and to ensure her will is in order or whether anything needs to be amended in light of her deteriorating health. Then do your best to balance your wife’s wishes with yours and those of other key people in your lives.
Although you often hear that everyone becomes religious when faced with death, it simply isn’t true. Christopher Hitchens was one of many examples of atheists who never wavered despite a long, painful, and predictable demise. And if people embrace religion only when they’re losing their minds, are in extreme pain, or are terrified by impending death, that doesn’t change what is—or isn’t—real.