Where is God when we forget Him? Understanding spirituality in dementia care

“Every single moment, every single day, we are in the process of collecting memories,” says Dr Kenny Tan, CEO of St Luke’s ElderCare.

But what happens when our minds no longer allow us to make new memories? What if our mind fails us when we struggle to retrieve the memories we have painstakingly stored?

This is what dementia does.

Dr Kenny Tan gave pointers to his audience on how to view dementia through spiritual lenses. Photo courtesy of St Luke’s ElderCare.

He added: “Really, the greatest fear a lot of us have in dealing with dementia is losing parts and pieces of memories that are dear to us.”

Dr Tan, who is also Senior Pastor of Zion Gospel Mission and Associate Professor with the Singapore Institute of Technology (SIT), was speaking at the SLEC ElderCare CommCare Symposium 2025. The topic was “Faith, Love and Hope – A Spirituality in Dementia Care”.

The ageing mind

Japan currently has the oldest population in the world, with 30% of its people aged 65 and above. Hong Kong and Singapore are fast catching up. In 2024, Hong Kong became a super aged society, with 20% of its population 65 and older. Next year, 21% of Singapore’s population will be 65 and older.

Fast forward just 25 years to 2050 and one in four populations in developed countries in the world will be super aged. Almost half of Hong Kong’s population (46%)  will be 65 and older. Taiwan and South Korea will not be far behind, with about 40% of their population aged 65 and over. By then, nearly a third of Singapore (30%) will be elderly.

The numbers worsen with time. It is estimated that by 2100, Singapore will have the oldest population in the world.

While dementia is not part of normal ageing, the risk of developing dementia does increase with age.

Today, there are 57 million people living with dementia worldwide. Every year, another 10 million join them because the world in ageing. On average, one in 10 who are 65 and older might suffer from dementia. Given Asia’s rapidly ageing population, dementia will be an ever-increasing reality in the future.

To underscore this, Dr Tan polled the room. About 10% present were caring for someone living with dementia. When it came to knowing someone living with dementia, almost every participant raised their hand.

Dementia is part of our present.

Spirituality approach to dementia

this chasm deep is growing still
as mounting fears its valleys fill
a fading of reality
this distance between you and me
so hear my call when call I can
these words we both now understand
do blend our precious hearts as one
until such time when time is done

This was a poem Dr Tan penned in 2021 to express the deepening divide between those with dementia and the people around them as dementia sets in and their connection “breaks down for a variety of reasons”.

When that happens, what can caregivers and loved ones do to tend to the spirit and soul of those with dementia?

1. Scripture – faith as foundation

Dr Tan urged participants to draw understanding and comfort from Scripture.

He noted that in Jeremiah 1:5, God said: “Before I formed you in the womb, before you were born. I set you apart.”

It was spoken to the prophet, but Dr Tan says: “I think we can apply it to ourselves, too.

“When you were just a little dot, God already knew you. Before the neurons were properly formed, before the brain was properly formed, before that foetus or the baby could respond in any way whatsoever, that little dot was already known.

“I think that’s really the foundation of what we do and our understanding of spirituality in dementia, isn’t it?”

Drawing from Psalm 139:1-4, Dr Tan showed how Scripture can be read “from a dementia lens” so the Words gain deeper meaning for those dealing with the ailment.

Says Dr Tan: “if there’s a dementia Bible, I would like to rewrite this.

“’You know my thoughts, Lord, when I no longer do. You know where I am, Lord, whenever I feel lost. And You know what I want to say, Lord, when words escape my lips. You know who I am, Lord. You always do.’

“So, it’s Kenny’s own version – KOV. Scripture as a foundation is so important to us when we look at dementia and spirituality, isn’t it?

“God loved us when we didn’t and God loves us when we do. God remembers us when we do and God still remembers us when we no longer do.

“That’s the underlying assurance that we must all hold to as perhaps we personally grapple with dementia, or we are caring for somebody with dementia, or we know of someone caring for somebody with dementia.”

2. Suffering – love through fellowship

Quoting theologian, academic and minister John Swinton, Dr Tan says: “One of the problems for people with dementia is that they gradually begin to lose the ability to tell their own stories over time.

“It is the stories of others that shape their experiences and place the parameters on their identity, their personhood and experiences.

“Who will tell our stories well when we have forgotten who we are?”

The suffering is real, but instead of letting their condition become a label that defines them, Dr Tan encouraged his audience to be the ones to tell the stories of those living with dementia when they can no longer do so by themselves.

“That’s fellowship through suffering. The question is, ‘What is that story that you would like to tell for the loved one with dementia?’

“If we could tell and retell his awesome story, let’s tell that story well.”

3. Sacrament – hope in future

Flashing a picture of the Holy Communion elements of bread and wine, Dr Tan says: “Life is a paradox and a promise for people of faith.

“The symbols of bread and wine talks about brokenness as well as wholeness. When you see the wine being poured, you see the bread being broken – there is a picture of brokenness.

“But for a Christian, that brokenness translates into a wholeness; that picture translates into a hope for the future because Jesus said: ‘I will come again. Do this in remembrance of Me.’ There will be a restoration and a reconciliation.”

The bread and the wine are symbols of brokenness and wholeness, says Dr Tan. Photo from Depositphotos.com.

Another familiar set of symbols for Christianity are the cross and the tomb.

“This is a picture of death and yet a picture of life because, in resurrection, Christians have a hope for the future, isn’t it?”

The cross and the tomb, symbols of life and death. Photo from Depositphotos.com.

In the same way, as a person ages and his body and mind deteriorates, the memory of the former self is tempered by the hope that there will be a final restoration, not to that former self but “to a state beyond imagination”.

Said Dr Tan: “That is the hope for a future where a lot of us, who are caregivers for persons with dementia, yearn for restoration. We have a hope for a restoration to an even greater future.”

St Luke’s ElderCare (SLEC) is organising the SLEC Miles of Smiles 60km Challenge to honour and support its elders, the ones who have shaped our nation, communities and families.

Participants can run, walk or hike 60km anywhere from November 1, 2025 to January 31, 2026. SLEC aims to raise S$500,000 for its elders through this virtual challenge. Your support will help build a future with dignity, care and a smile.

Click here to find out more.

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“Nothing in Scripture says that if you have dementia, you cease to be a disciple”: Here’s how the Church can remember those who forget

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