There's been a lot of study of Alzheimer's disease (from which some four to five million Americans and 15 million people worldwide suffer), but until recently little of it has looked at the impact of Alzheimer's on the patient's spirituality. Calvin College professor Glenn Weaver is among the researchers helping to change that.

He has a chapter on spiritual suffering in people with Alzheimer's in a new book from Eerdman's due out in 2004 and tentatively titled From Cells to Souls). Weaver says Christians think of Alzheimer's as a health problem, which it is, but do not ponder its spiritual significance.

"Such a medical compartmentalization of Alzheimer's," he says, "neither fits the understanding of persons presented in the Bible, nor the experience that most patients know firsthand."

For Weaver the issue is professional and personal. His mother was diagnosed with the disease in the mid 1980s. He says after the diagnosis the family had a label for what afflicted their mother and a grim prognosis, but they had little insight into the psychological meanings Alzheimer's might hold for her life, including her spiritual life.

Soon those meanings became clearer.

As the disease progressed, Weaver noticed change in his mother's spiritual life, including her sense of relationship to God and to other Christians.

So in 2000 he pulled together a team of Calvin psychology majors and they set about interviewing family members of Alzheimer's patients, looking, says Weaver, for changes in experiences of God and faith. And while the research continues, it has already brought to light some important truths about the relationships between dementia and spirituality.

Some are obvious. People with dementia lose the ability to follow most text-based presentations, including listening to sermons or following the order of a worship service. Says Weaver: "People who relied on these activities as key mediators of God's grace often found it more difficult than before to find God's presence when they most needed spiritual assurance and security."

But Weaver's research also showed that patients almost never have the opportunity to take communion once they stop attending worship services. It's a vital oversight he says.

"It's amazing the awakening of memory that taking communion can have. It offers a sense of community. But it also takes on a new meaning -- this is the presence of Christ for you. It makes it real and concrete in a manner that those suffering with Alzheimer's are capable of experiencing."

The psychological regression in age that oftens accompanies Alzheimer's also has a spiritual dimension. For patients who had a happy childhood the stage of Alzheimer's in which they see themselves as children is often positive, including their return to a simple, child-like faith in God. But other patients might "return" to a time prior to a conversion experience, making their last days even more confusing and more fear-filled.

Weaver says caregivers can help make some of these spiritual experiences less traumatic for Alzheimer's patients.

This can be as simple, he says, as talking about a sermon heard in church earlier that day, but filling in lots of details while doing so: everything from the name of the pastor to the church's surroundings to the lines in the songs that were sung. It also can be as divine, he says, as giving patients a sense of being "located in moral space," the daughter, he says, who "gently took her father's arm and hand, and, moving it along with her own, reached out to caress the forehead of the granddaughter who had come to visit."

Weaver recommends too that families of Alzheimer's patients tap into what psychologists call procedural or implicit memory, the kind that governs such things as riding a bike or playing a musical instrument. Such memory processes, says Weaver, are controlled by brain structures below the cerebral cortex such as the cerebellum, structures relatively resistant to Alzheimer's in its early and middle stages. Such resistance is important for spirituality, says Weaver, for it means many Alzheimer's patients can sing or hum familiar tunes, including the songs of faith, thus allowing patients a continued participation in the community of faith.

Scientists believe that up to five million Americans suffer from Alzheimer's, which usually begins after the age of 60. Alzheimer's is a slow disease, starting with mild memory problems and ending with severe brain damage. According to the National Institute on Aging the course the disease takes, and how fast changes occur, vary from person to person. On average, patients live from eight to ten years after they are diagnosed, though the disease can last for as many as 20 years.