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Are you navigating the challenging journey of caring for a loved one with dementia? Today's episode related to ethical decision making in dementia caregiving is one of these journeys It’s a path that not only tests our patience but also our spirits and moral compass, particularly when viewed through the lens of Christian ethics.

Lizette discusses how the medical model of ethics, which includes autonomy, beneficence, non-malfeasance, and justice, differs from biblical ethical standards. She encourages listeners to base their decisions on God's perfect character and to frame their choices through scriptural teachings.

By glorifying God in decision-making processes, caregivers can navigate the challenges of dementia caregiving with faith and purpose.

2:39 Navigating Ethical Decision-Making Challenges
9:58 Understanding God's Moral Character
15:19 Using the Bible to Frame Ethical Standards
24:08 Aiming for God's Glory in Decision-Making
27:51 Considerations for Ethical Decision-Making

Understanding Ethical Dilemmas

Dementia caregiving can place you at the heart of numerous ethical decisions, ranging from medical choices to daily care details. Each decision might test your principles, especially when balancing medical recommendations with the individual’s dignity and quality of life.

Balancing Medical Ethics with Spiritual Beliefs

The intersection of medical ethics and spiritual beliefs often poses a profound challenge. Traditional medical ethics emphasize autonomy, beneficence, and justice. However, for Christian caregivers, these are not just medical principles but deeply spiritual ones. How do we align these with God’s law and the teachings of Christ?

Understanding Ethical Dilemmas

Dementia caregiving can place you at the heart of numerous ethical decisions, ranging from medical choices to daily care details. Each decision might test your principles, especially when balancing medical recommendations with the individual’s dignity and quality of life.

Balancing Medical Ethics with Spiritual Beliefs

The intersection of medical ethics and spiritual beliefs often poses a profound challenge. Traditional medical ethics emphasize autonomy, beneficence, and justice. However, for Christian caregivers, these are not just medical principles but deeply spiritual ones. How do we align these with God’s law and the teachings of Christ?

Scriptural Guidance

Turning to the scriptures offers a foundation for these tough decisions. The Bible provides not just comfort but also guidance on how to embody Christ’s teachings in our care. It challenges us to reflect on how our actions can both glorify God and preserve the dignity of our loved ones.

Practical Applications

In practice, this might mean prioritizing compassionate care and respect for the person’s wishes, even as dementia progresses. Decisions about medical interventions, living arrangements, or end-of-life care should be approached with prayer, consultation with faith leaders, and scriptural study to ensure they align with Christian ethical standards.

Community and Support

You are not alone on this journey. Engaging with a community, such as through church groups or Christian caregiving resources, can provide both support and shared wisdom. Additionally, platforms that focus on the intersection of faith and caregiving can offer guidance tailored to your values.

Navigating dementia care as a Christian is not just about managing symptoms but about enriching the soul of the caregiver and the cared-for. It’s a journey of faith as much as it is a journey of love and responsibility. Remember, every decision made in love and faith reflects the teachings of Christ and brings glory to God, even in the most challenging circumstances.

By embracing both medical knowledge and spiritual wisdom, Christian caregivers can find the strength and guidance needed to make ethical decisions that honor their loved ones and their faith.

Read More:

A New Perspective: Navigating in Reverse During Dementia Care With Anna Edmonds

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Beginning the Dementia Caregiving Journey

[0:00] When we first start down a dementia caregiving journey, we do not necessarily think through some of the harder decisions that we will have to make as a family member who is a Christian, helping either a believing parent or a believing spouse, or even more difficult sometimes, an unbelieving parent or an unbelieving family member. And so today's episode in Dementia Caregiving for Families, we are looking at what you need to know about ethical decision-making in a dementia caregiving journey, but from a Christian perspective. And this is part of a new series that I'm doing called Dementia Caregiver Tips. And I invite you to listen to today's episode where we're going to briefly unpack three different things that I want you to know. And I'm going to give you a couple of scenarios in dementia caregiving that these types of questions come up with related to how to navigate this journey.

Introducing Dementia Caregiver Tips Series

[1:05] Music.

[1:12] Have you recently found out someone you love has dementia struggling to wrap your head around how to be a Christian caregiver searching for answers by joining countless facebook groups but find them toxic learning how to cope with dementia feels difficult but learning a Christian caregiving worldview can be easy. Hey, brother and sister in Christ, I'm Lizette, occupational therapist, pastor's wife, turned dementia coach, and a daughter of dementia. In this podcast, you will learn the truth that the way to make dementia care easy is your faith. Knowing that a loving God has decreed this hard providence in your life makes all the difference. Here you will gain skills. You will be challenged by what God says in his word about caregiving, and you will learn exactly what dementia is and is not. Find clarity and certainty from God's word so you have perseverance for this journey. Use science-backed solutions and biblical principles to redeem your time. Praying this blesses you as we dive into dementia from a Christian perspective. Let's glorify God despite dementia.

Navigating Ethical Decision Making Challenges

[2:40] Have you ever embarked on a journey where you know that you are not necessarily equipped for the journey? Today's episode related to ethical decision making in dementia caregiving is one of these journeys where I don't quite feel prepared to be embarking down this journey and And discussing this with you as dementia family caregivers coming from a Christian perspective.

[3:14] Not because I don't know what to decide or that I have bad ethical decision making.

[3:22] But because this is a topic that can be extremely in-depth related to biblical ethical decision making. And the reality of the 30 years of working as a healthcare provider is I'm much more familiar with the medical model of ethical decision-making. And today's episode, I'm going to try to combine these two concepts of biblical ethical decision-making as well as medical ethical decision-making and trying to unpack it for you in more of a Christian worldview perspective. But having said that, I know that I am very ill-equipped for this journey, and I have prayed today that the Lord would guide the words of my mouth and the meditations of my heart and that they be acceptable in his light. But I ask your patience and your forgiveness if I misspeak or if I am not as clear in my podcast today in talking about what you need to know about ethical decision-making in dementia care in today's episode 113.

[4:46] So we're going to look at this in a couple of different ways. I'm just going to talk real briefly about what the medical model considers to be ethical decision making.

[5:00] One is autonomy. We talk about people's autonomy to make their own decision a lot in the medical model. The second thing that we talk about a lot in the medical model is beneficence and non-malfeasance, which is to do good and avoid harm. And the third thing is justice, but not God's justice, man's justice, utilization of limited resources justice. That is what the medical model means when they talk about justice to be fair and equitable. And that is not at all what God means to be fair and ethical. So we are going to consider this and keep it in the back of our minds that what the medical model is looking at related to ethical decision making is vastly different than what God tells us to look at related to ethical decision making. So we're going to look at this in three points today. We're going to understand, first of all, God's moral character as the basis of our ethical foundation.

[6:10] The second thing we're going to look at is using the Bible or the word of God to actually frame our ethical standards. And then we're going to aim for God's glory in decision-making. So those are the three points that we are going to explore briefly today related to biblical ethical decision-making in dementia caregiving. And I will work on finding a pastor who has, or an elder in a church who has a better understanding and view, perhaps, of biblical, ethical, medical decision-making to interview in this podcast. Because I think this is a topic that we need to explore a lot more closely from a Christian perspective so that when we make our decisions and when we help the family that we are helping related to a dementia caregiving journey, that we know where we are coming from and how to actually frame those decisions. So the first point is understanding God's moral character as our ethical foundation. So what do I mean by that?

[7:26] God's character is perfect. He is perfect in holiness and justice. And that is the basis for all our decision making, whether it be medical decision making, whether it be, you know, where you're going to end up working, all of these different kinds of decisions that we make, we have to run through the.

[7:54] We have to consider that God is perfect in his holiness and his justice. And so when we remember that, it totally frames our own decision making. So I'm going to use the Westminster Shorter Catechism to help us in a definition of what is God. And I have my cheat sheet here to the side because I wish I were really good at memorizing scripture verses and catechism questions and so on, even though I'm very familiar with them and read them every single week. I am not really good at memorizing, so that's my excuse. It's probably not a fact, but the reality is I don't have it memorized. But the question four of the Westminster Shorter Catechism says, what is God? God is a spirit, infinite, eternal, unchangeable in his being, wisdom, power, holiness, justice, goodness, and truth. And so when we consider that that is who God is, and obviously we are not God, we are not spirit, infinite, eternal, and unchangeable. We are definitely not any of those things.

[9:18] God is who he is, and we are created in his image, but we are not any of those things. But we do carry some characteristics, and when we are considering his character, we have to be wise and work on being holy and consider biblical justice or God's justice and being good and telling the truth, right? So we have characteristics that we are to emulate when we are being a.

Understanding God's Moral Character

[9:58] When we are a Christian. Leviticus 19 verse 2 says to us that we are supposed to speak to all the congregation of the sons of Israel and say to them, you shall be holy for I the Lord your God am holy. So we are to strive to be holy, but we are for sure going to fall far from being holy. And so we have to consider God's holiness and justice as a basis for our ethical decision making as a foundation. And then the next question in the Westminster Shorter Catechism that we're going to look at real quickly is, how did God create man? That's question number 10. And God created man, male and female, after his own image in knowledge, righteousness, and holiness with dominion over all creation or all creatures.

[11:01] And so we are image bearers of God, and we want to make sure that as an image bearer of God that we are going to reflect these characteristics of God back to him. Now, how does this relate to a dementia caregiving journey? When we know a few things, right? We know that the person that we are helping who has dementia is losing ability over time. And even though, especially because they are created in the image of God, we want to continue to honor them in whatever relationship we are in. Whether we are spouses or whether we are adult children of somebody, and give them as much ability to continue to maintain and use and make their own decisions for themselves or being an autonomous or independent person. But we have to recognize throughout this journey That their capacity to make decisions are going to change over time. And when we get to the point, when they get to the point in their journey, when they are unable to make these decisions for themselves safely anymore.

[12:27] It is up to us to recognize that it is time for us to help and take over. And it's not that we are not, at that point, honoring the person anymore, it is just recognizing that in this stage of their journey, they are not able to make those decisions independently for themselves anymore.

[12:52] And so we have to understand that as a foundation. That God is holy and perfect and justice, that we are supposed to be able to make those decisions for and with the family that we are supporting. And that because we are created in the image of God, that we carry a burden to be able to make these decisions through a biblical lens.

[13:24] And so that's the first very short, consideration related to God's character and reflecting his character back to him in all of the decisions that we start to make and are required to make for a person who is losing their own capacity. So we have to do it through the lens of God's moral character. I am very excited to announce this next part of our journey together. Once a month on a Thursday evening, I'm going to do a segment called Ask the Dementia Coach, where you can actually come into a coaching session with me and other people if they register for the same time, so you can feel what it feels like to actually have dementia coaching. The reason I'm doing this is because I know so many of you guys are struggling on your own and may feel like you're at the end of your rope. And in order to help serve you better, I wanted to open up this opportunity once a month for you to register for a free Ask the Dementia Coach segment.

[14:52] Like I said, it will be Thursday evening once a month, 6 o'clock Eastern Time in the evening, and the segment is called Ask the Dementia Coach. So if you're interested in signing up for that, the link will be in the show notes below, and I look forward to seeing you on one of these special sessions.

Using the Bible to Frame Ethical Standards

[15:19] Then the second point that we're going to look at is we have to use the bible.

[15:26] Or scriptures, God's word, to help frame our ethical standards. So, Westminster question and answer number three talks about what does the scripture teach us, right? What does scripture principally teach us? And the scriptures principally teach us what we men is to believe concerning God and what duty God requires of us. So, 2 Timothy 3 verses 16 through 17 says, all scripture, all scripture is inspired by God and beneficial for us for teaching, for rebuke, for correction, for training in righteousness.

[16:14] So that the man or woman of God may be fully capable, equipped for every good work. So we have to consider that you as a Christian family caregiver living with a person or caring for a person living with dementia, we have to know the scriptures. We need to know what scripture teaches about all of the different things that we as a caregiver are going to be facing. It impacts our roles and responsibilities. For example, I am a daughter of a family member with dementia, but because I'm married to my husband, my first primary relationship is between me and my husband. And so that supersedes my relationship with my parents and everything my husband and I do and decide we need to do in conjunction together.

[17:10] And we are honoring my parents, but we have to understand the relationship between me and my parents is different than it was when I was living in their household. And so you have to understand what scripture teaches related to everything in our journey as a human being related to our different roles, our different responsibilities, our different stations in life. And i want to encourage you from a practical perspective if you are a christian, who is helping a family member living with dementia stay in the word read the scriptures every single day and continue to learn and understand and ask god to show you from his word, what he would have you do in a particular situation um and if you if you.

[18:13] Come to this process related to dementia caregiving, framing it through the lens of scripture, it will significantly increase your ease and comfort in this journey. Scripture speaks to so many different passages where we can lament to God our struggles. And, you know, I'm not suggesting that we only look at scripture that is, you know, edifying and raising us up, but we also can turn to God in scripture and say, oh, but why God, like David did in the Psalms?

[18:55] And so when you frame everything in a dementia caregiving journey through the lens of scripture, you will make the right ethical decisions because you are reflecting back to God what he has shown you and taught you that scripture teaches. It teaches you what you need to believe about God and it also teaches you what your duty is to what God requires of you and that duty is to you amongst your fellow people that you are helping take care of. And so, just, you know, very shortly and briefly, always stay in the Word, always continue to read.

[19:44] I've mentioned this in other podcast episodes. If you are struggling to read the Bible because of a time constraint, then I invite you to go look at sermon audio and download some wonderful sermons that you can listen to. You can search them by topic, so you can look for the providence of God or sovereignty or all these different topics, and then try to continue to stay in the word that way. The third point today is we are going to also aim for God's glory in decision making, which is a very challenging thing sometimes, is to think through how does the dementia caregiving journey continue to glorify God? And the Westminster Shorter Catechism talks about question and answer number one, which is one of my favorite, favorite question and answers is, the question is, what is the chief end of man? And man's chief end is to glorify God and enjoy him forever. And I know it seems counterintuitive when we are helping somebody living with dementia to think about how can I glorify God in my dementia caregiving journey? But when we.

[21:05] We glorify God in our dementia caregiving journey when we are focused on Christ and when we are focused on the fact that this too is for our good and for God's glory. And I know that that is very difficult to get to. That's a journey a lot of us have to go through. But I encourage you to think through every single day, and this is a question I ask myself every single day, is what am I grateful for today? What can I be grateful for in a dementia caregiving journey?

[21:47] And something that has really been very near and dear to my heart is, and this This is truly counterintuitive to so many people, but I am grateful for my mom's dementia journey because my mom had a relatively challenging marriage with my dad and my dad is not a believer and I actually believe that my mom is a smoldering wick. And it has been only over the last several years that I've been able to peel back the layers or break down some of the barriers that my mom has put up through decades of living with a non-believing husband to see the soft, sweet, gentle spirit that is behind and underneath the facade and the veneer that my mom put up in living in a very difficult marriage for 54, 55 years now. And so I have become extremely grateful to God for my mom's dementia because I'm able to see a different part of my mom.

[22:59] It's been fascinating. My husband and I will sit and we will have conversations with my mom. And it is evident that my mom has read her Bible, maybe not recently, but she extensively read her Bible because she will come out with very obscure Bible facts and places in the Bible and names of mountains that unless you have actually read the entire Bible, you would never know because you have not read your Bible. So I'm grateful.

[23:34] For this gift that God has given me related to a dementia caregiving journey because I see my mom's spirit and my mom's heart in this and it is glorifying God in her own small way. So my aim through a dementia caregiving journey is to still continue to glorify God and to be grateful for this journey that I'm on, as difficult and as challenging as it is.

Aiming for God's Glory in Decision-Making

[24:09] And it's been fascinating to me when I work with family caregivers who are Christians to see the difference in a Christian dementia caregiving journey versus a unbelieving dementia caregiving journey. They are very different journeys. No, not all people who are Christians will have the.

[24:35] As the veneer, as the executive functions, as the brain changes occur, sometimes we see what man truly is without God evident in a dementia caregiving journey. And that does not mean that that person isn't really a believer. I just believe that sometimes as we change in this dementia caregiving process.

[25:02] That we see who we are without Christ, which is totally wretched and horrible human beings, because sin is the lack of conformity to the, you know, word of God, to God's revealed will in our life. And so when, sometimes when people say to me that my family member doesn't look like they're a believer, even though they were always godly people, I don't think we should automatically say, well, they are not a believer, because I think sometimes it changes, and we see what we are without the grace of God, without that inhibition switch that the Lord gives us.

[25:46] But then I've also seen the opposite. I've seen some people who are our Christians be given an extra measure of grace. And it's like the Holy Spirit is continuing to work very deeply and giving them a sweetness and a kindness and a different type of a journey. So neither of those do I feel preclude the fact that, you know, sometimes we will see certain behaviors in a dementia caregiving journey. But what we do control is how we respond, right? And we can continue to glorify God in our decision-making process when we are considering this from an ethical perspective for our family members who we are supporting. So 1 Corinthians 10 verse 31 talks about, therefore, whatever you eat or drink or whatever you do.

[26:47] All things for the glory of God, all things, including a dementia caregiving journey, including how we make decisions for our family members and with our family members.

[27:00] And so I just want to encourage you today. Like I said, today's episode was really a little different for me and very difficult because I don't feel like I really did a good job of unpacking this for you. But I do think that if you truly understand the character of God as your ethical foundation, it will make it easier for you when you are making difficult decisions in a dementia caregiving journey. If you understand the scriptures and frame everything through a scriptural lens when you are looking at ethics in making decisions for other people, And if you are glorifying God in your decision-making, then you will not make

Considerations for Ethical Decision-Making

[27:48] bad decisions for the people that you are helping. So what are some of the ethical things that we have to consider when we are in a dementia caregiving journey related to helping other people? Number one is, and this is, these are some hard questions. These are some hard considerations for you to start thinking through.

[28:14] One of the things that I think we delay early on in our journey is actually having these hard decisions with family related to what their end of life wishes are. Some people have more emphasis on length of life versus quality of life. And if you are supporting somebody who is more into.

[28:41] Extending the length of their life versus the quality of their life it can make things a little bit more challenging for you but sitting down early on and having these conversations about things like if you were to live longer with your dementia would you like us and you get to a point where you are not eating or drinking anymore do you want us to extend your life or do you want us to keep you comfortable. Did you know that caring for a person with dementia doesn't have to be this hard? If you are struggling and you would like to join our next free workshop, the topic of the workshop is three tips how to avoid challenging dementia behaviors without stress, anxiety, or burnout. I invite you to walk away with science-backed, dementia caregiving skills that many professionals don't even know after attending this free workshop on Saturday. If you'd like to register, message me the word workshop on Instagram or check out the link in the show notes below.

[30:10] A very difficult conversation, very hard for people to talk through, especially when it occurs, is the decision related to a feeding tube in a person living with dementia. My consideration related to that is if it's a person living with dementia who is not far along in their journey and they have a massive stroke and they have the ability to recover from the stroke, having a temporary feeding tube because they're having difficulty swallowing may not be a bad decision or a wise decision at that period of time. But if it's a person who is at the end stage of their dementia caregiving journey and they are not eating or drinking because their body is changing and it's slowing down, then.

[31:01] Considering to put in a feeding tube is not the wisest decision. And so these are the things that you need to start to think through when you are making decisions or helping make decisions for and with other people. Something else that I think is something that we do not consider earlier on and that is a very difficult conversation and most people do not want to take up this decision is the decision about whether or not somebody is safe to drive a car and the reason I think that this is a significant ethical decision for us is because driving is a privilege driving is not a right and when we allow our family members to continue to drive because we are reluctant to take on, quote unquote, the battle of the car, then we are inadvertently not making good, wise decisions in an ethical framework using biblical principles because there are other people who are at risk in our decision not to take on a difficult challenge because the person that you are helping is unwilling or not ready to rescind their license.

[32:27] And this is where I think we have to really consider the ethics of what we are doing when we do not want to actually take on that battle. Because if we inadvertently allow somebody to continue to drive and they are in a car accident and they kill someone else, then we do carry some responsibility. If we knew that we didn't feel like they were safe to drive anymore, but we were too afraid to take on those that battle because we did not want to offend somebody or we did not want to be able to continue, you know, we wanted, And quite frankly, when you take on the battle of the car, you change your life as a family caregiver because now you're responsible for driving the person places. For example, today I get to, I have the privilege because I made the decision that my dad was not safe to drive and I took the steps as hard as they were to get him to rescind his car and his driver's license. And so today I have the privilege of serving my dad and picking him up and taking him on a couple of errands.

Wrapping Up Ethical Decision-Making Discussion

[33:49] So real brief, like I said, today's episode was a little different.

[33:56] I'm grateful that you stuck it through with me in talking about some ethical decision-making in dementia caregiving. These are hard conversations. These are hard situations to talk through. But three things that I just wanted you to know today is that you have to understand God's character as your foundation when making decisions. You have to totally frame everything through a scriptural lens when you're making ethical decisions, and that the purpose of your decision-making should still be to glorify God and enjoy him forever throughout this dementia caregiving journey. And as fallible as today's episode was, thank you for being here. I pray for you guys every single day as a family caregiver who is a Christian. I invite you to share these episodes with other people and listen and send me a review on Apple Podcasts. I do read them and I really would love to get feedback related to these episodes because sometimes it's hard when you're trying to do something different. But like I end all my broadcasts now, may the Lord bless you and I will see you in the next episode.

[35:24] Thanks for joining me today, Success Seeker. I pour my heart and soul into this program to serve you. You can serve me by leaving a review on Apple Podcasts and join our free Facebook group, Dementia Caregiving for Families. It's a positive and proactive space to navigate dementia caregiving together. Get practical tools and find support, but without the verbal vomit. Be a part of our community where we seek to find peace of mind and ease, despite the dementia diagnosis. So join today and see you next time as our flight takes off.

ethical decision making in dementia caregiving

Subscribe To Dementia Caregiving For Families Podcast

If you feel like dementia caregiving is hard and unpredictable and you are struggling to help a spouse or a parent living with dementia, join our next free workshop.

Join our Facebook Group at: 

Become a  Member of Our Exclusive Program!

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About the author

“Think Different” Dementia’s owner, Lizette Cloete, OTR/L graduated as an Occupational Therapist from the University of Pretoria in South Africa in 1992. Lizette has almost 30 years of experience as an Occupational Therapist in a variety of settings, the latest being in the home health environment. She enjoys teaching on the topic of dementia, most recently presenting at a national conference on the topic “Dementia Made Simple”.

Disclaimer: These blogs, videos and any work done by Lizette Cloete OT, as a Member of Think Different Dementia, LLC, is given only as educational content and consulting work. This does not create an Occupational Therapist-Patient Relationship. The educational content and consulting work performed should not be considered medical treatment as an Occupational Therapist. The consulting work does not take the place of medical work normally performed by a licensed Occupational Therapist. Please consult a licensed Occupational Therapist for medical advice.

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