Audio Transcript

Thanks for listening to the Ask Pastor John podcast, with longtime pastor and author John Piper. Today’s question comes from an anonymous man. “Pastor John, I heard the episode about caring for aging parents.” (That was episode 1078, published back on August 9th, and titled “Retirement Homes and Caring for Aging Parents.”) “In that episode you got me thinking about my job. I work in a nursing home and see our elders in a way many of us fear becoming. Could you speak to the dignity of people in nursing homes with diseases such as dementia? This seems to be, perhaps, even more foundational under the answers about caring for aging parents. Is that right?”

Right, that’s absolutely right. The God-given dignity of every human being — as created in God’s image and destined for final accountability before the living God, unlike all the other creatures — that dignity is foundational to our thinking about how families or caregivers care for aging parents, or for that matter, any person whose mental capacities are diminished for whatever reason.

Let me just share a few foundational and application thoughts about the dignity of those with diminished powers of thought and self-awareness.

God’s Image

First, we can hardly be reminded too often or go to deep into the staggering truth of Genesis 1:27: “God created man in his own image, in the image of God he created him; male and female he created them.”

“You need to go to nursing homes and remember these people are on the brink of glory and power.”

Then you add the additional truth that even after the fall into sin this great reality of image bearing is still true about all of the people we deal with and should affect our behavior. James 3:9 says, “With it [the tongue] we bless our Lord and Father, and with it we curse people who are made in the likeness of God.”

You see how James thinks that that fact should alter the way we use our tongues and talk about people. Every human being, everywhere in the world — of every race, every ethnicity, class, male and female, rich and poor, sick and well — is utterly distinct from all the other kinds of creatures on earth. Then, 1 Peter 2:17 says (amazingly), “honor all” — meaning, honor all human beings. And the honor clearly does not flow from moral worthiness. They’re not. A lot of them are wicked like Nero. It goes on to say, “Honor the Emperor.” They’re wicked.

The honor is not flowing from their unique moral condition but from their unique standing in the image of God, different from all other creatures. That applies to an 80-pound, arthritic, diapered, drooling, glazed-eyed human being that we love, lying in bed and praying for death in the nursing home, or in the jungle hut.

Future Glory

Now, a second observation needs to be remembered — namely, that in God’s way of dealing with the world, he has elevated weakness to a place of extraordinary importance. “The weakness of God is stronger than the power of man,” Paul says in 1 Corinthians 1:25. Meaning, when Christ died in weakness and dishonor, he accomplished the greatest thing in the world.

Then Paul refers to his own weakness in 2 Corinthians 12 as the best pathway for honoring the all-sufficiency of Christ in his life. Then he brings this weakness in connection with the dying process, and relates it to the resurrection in 1 Corinthians 15:43. He says, “It [the human body] is sown in dishonor; it is raised in glory. It is sown in weakness; it is raised in power.

“I will never assume that anyone that is still breathing cannot in some way be reached at his innermost being.”

In other words, Paul is telling us that the weak, inglorious, demented shadow of a once-strong Christian in front of us is on the brink of glory and power. You need to go to nursing homes and think that way. These people are on the brink of glory and power.

We must keep this continuity in mind between diminished powers of human beings here, and the spectacular powers they will have in the resurrection. This is so important. If we lose a sense of that continuity, we will assume that we are becoming less human rather than being on the brink of being gloriously superhuman.

If the question is raised (because I did mention the word Christian), what about the unbeliever in the nursing home? The answer is, we never give up praying that they too might participate in that glorious destiny.

This is what they could be. We’re not God; we do not determine anyone’s destiny. We treat people — we speak to people — on earth in the prayer, in the witness, in the hope of redemption and glory.

The Mystery

Which leads to one more thing — the mystery of personhood in the presence of dementia. Science cannot answer the question that relates to the soul that God himself created in connection to the body. The relationship is profound beyond all human comprehension. No one knows the precise connection between the demented mind and the real human person within.

My grandfather, just before he died, was curled up like a fetus, wearing a diaper and looking like a corpse. He was uncommunicative for weeks and had slow belabored breathing. But when my father bent over his head and prayed (almost at the top of his voice), my grandfather — almost with his whole body — gave a deep, guttural, unmistakable amen when my father finished.

That was the last we heard of him. We hadn’t heard anything for weeks. I will never assume that any human being that is still breathing cannot in some way be reached at his innermost being. I don’t know. I just won’t assume it.

No Accidents

The last thing I would say is that the encroachment of dementia in the lives of those we love is a gift to us. It tests our love as never before.

“Even after the fall this great reality of image bearing is still true about all of the people we deal with.”

One of the manifestations of dementia is that every moment is real to the failing person but the connection of the moment is lost. As I was driving my father in his last days to his brother’s funeral (a brother he loved dearly), he asked me every two minutes in that twenty-minute drive where we were going. In every single one of those questions, he really wanted to know. If he was really there, he was really curious in that moment about where we were going.

The real test and the real question for me was, Would I patiently, graciously — as if for the first time on the tenth time — answer him with grace and interest, engaging the person who was there in that moment? Such challenges of love are no accident. They are no accident.

God didn’t dream that into my life for nothing. That was a painful gift to me and a test. We all will have them, so let us be full of grace as we give ourselves to care for those who have become too weak physically or mentally to care for themselves. God’s priorities for efficiency in this world are not ours.


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