BOOK REVIEW Nov 2017. Christian Journal for Global Health 4(3):103-104. Finding Grace in the Face of Dementia by John Dunlop - Crossway, 2017 Daniel W. O’Neilla a MD, MA(Th), Associate Clinical Professor of Family Medicine, University of Connecticut School of Medicine, USA Dementia is an increasingly common major neurocognitive impairment which was estimated to affect 35.6 million people globally in 2010. As a major non-communicable disease with 7.7 million new cases per year, this number is likely to double by 2030 and triple by 2050. Yet many countries lack awareness and understanding of dementia, resulting in stigmatization, inadequate care, and significant economic hardship. For these reasons, the World Health Organization has made dementia a public health priority.1 With the globalization of Christianity, a distinctly Christian approach to dementia is needed in the face of these realities in communities everywhere. John Dunlap, a geriatric specialist and ethicist writes this book to provide a theological lens through which we can view dementia, then gives practical ways for professionals, pastors, caregivers, and families to care for people living with the condition. He comes with an American perspective, but his approach can be applied in any context where Christian principles and practices can be applied to retain human dignity and embrace the value of care giving toward those losing their cognitive abilities toward the end of life. Dunlap, speaking from his personal pain of both parents with the condition and acknowled- gment of his own high risk, first presents a very simple treatment of the sovereignty of God in all things, the dignity of all human life from creation, the pain and corruption of the fall, and the hope of full cognitive redemption. He proceeds to provide a helpful distinction between benign senescent forgetfulness and mild cognitive impairment, as well as the various causes of dementia. Then using vignettes from his own patients, he lays out the steps and challenges of a proper diagnosis. He takes a very pastoral and practical approach to timing and communicating with family, social support engagement, etc. He describes exacerbants and alleviants of the condition, medication treatment options, and integrates spiritual resources such as prayer and anointing for a refreshing whole-person care approach. In Chapter 5, Dunlap presents a very valuable empathetic picture of what it is like from the inside of a person with dementia, which can help enhance understanding and compassion. He then lists challenges from the patient and the burdens on the care giver that a deep trust in God can help overcome. Chapter 7 is a powerful call to serve and love those with dementia based on clear biblical principles, followed by practical guidance on resource utilization to ease the burden, and a description of the rewards of caregiving, both temporal and eternal. The heart of Dunlop’s call begins in chapter 8 with how God can be honored through dementia. This involves applied biblical values, trust, respect, loving care, relationship building, living for the moment, cherishing memories, citing scripture, church involvement, spiritual growth, prayer, and ending life well. A dignifying approach enters their world, follows Jesus’ example, gives the gift of time, is person-focused, clearly communicates, respects 104 O’Neill Nov 2017. Christian Journal for Global Health 4(3):103-104. autonomy, preserves dignity, helps find meaning, and maximizes potential. Meeting needs in the physical, social, emotional, and spiritual domains attends to every dimension affected. He calls the church to deeper commitments to care for others, embrace a theology of suffering, and to spiritually care for those afflicted and their caregivers. He gives hope for a resultant growth for all those involved. Since dementia is a terminal condition, it is highly relevant for palliative and end-of-life care. Dunlop finished the book by giving a cogent biblical perspective on death, decision making in the often- variable course of the diseases, the futility of some types of treatments, avoidance of artificial hydration and nutrition, the value of comfort care, embracing the mystery of the timing of death, the ethical problem with assisted suicide, and eternal destinies to be embraced. Dunlop’s use of scripture and prayer, along with integration of the patient and caregiver’s spiritual life gives an important model for whole- person care. It is unclear how well this would apply in non-Christian contexts, in low-resource settings, or in other cultures whose values toward the elderly and dementia differ from those in the West. However, there are many trans-cultural principles which can be applied, and the light of the gospel, communities of faith, and the deep value of Scriptures emerge. The challenges of palliative end-of-life care, loss of capacity, resource allocation especially in low- and middle-income countries, and pressures by government policy makers to support euthanasia are challenges the global church must face.2 Dunlop’s pastoral and clinical approach is most welcome in the face of this increasing and very costly global burden of disease. Having this degree of clarity regarding intrinsic imago Dei human dignity, radical person- centered compassion, the value of caring for the vulnerable, promoting the best palliative care available in a context of scripture and prayer makes this book a high-value resource — one which the global church and others could seek to apply in many contexts. References 1. WHO. Dementia: a public health priority. Geneva: WHO; 2012. [cited 2017 Oct 30] Available from: http://www.who.int/mental_health/publications/deme ntia_report_2012/en/ 2. Swift C. Dementia. Triple Helix [Internet]. April 2009;44:6-7. [cited 2017 Oct 30] Available from: http://admin.cmf.org.uk/pdf/helix/2009easter/THeast er09-p6-7.pdf Competing Interests: None declared. Correspondence: Daniel O’Neill, Christian Journal for Global Health and Assistant Clinical Professor of Family Medicine, University of Connecticut School of Medicine, USA. dwoneill@cjgh.org Cite this article as: O’Neill DW. Finding Grace in the Face of Dementia by John Dunlop – Crossway, 2017. Christian Journal for Global Health. Nov 2017; 4(3):103-104. https://doi.org/10.15566/cjgh.v4i3.200 © O’Neill DW. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/ www.cjgh.org http://www.who.int/mental_health/publications/dementia_report_2012/en/ http://www.who.int/mental_health/publications/dementia_report_2012/en/ http://admin.cmf.org.uk/pdf/helix/2009easter/THeaster09-p6-7.pdf http://admin.cmf.org.uk/pdf/helix/2009easter/THeaster09-p6-7.pdf mailto:dwoneill@cjgh.org https://doi.org/10.15566/cjgh.v4i3.200 http://creativecommons.org/licenses/by/4.0/