Hudson United Methodist pastor Dawn Jeffers Ramstad said establishing a dementia-friendly community is common sense.

Since December 2016, she's been helping her church do just that. The efforts are geared toward ensuring members of the church affected by dementia can continue to participate in worship.

Though the process is not overly complicated, it does make a major difference in the lives of those afflicted by dementia. A key to creating a dementia-friendly environment is to simplify hymns and prayers for the aging members of the church that are increasingly surviving major illnesses like cancer, but still suffering from diseases like dementia.

"We focus on attempting to engage everyone in the church," Jeffers Ramstad said. "We try to make sure our services are personal and participatory. Those are the parts of service that make it dementia friendly."

The church in Hudson has done things like returning the Apostle's Creed into the liturgy and shortening sermons.

"Me babbling in a sermon isn't going to help them remember how to pray," Jeffers Ramstad said. "Them singing a prayer together is what will help them pray.

"Amazingly enough, it's the same things that engage kids, too. If you do things right to engage kids, you're going to be dementia friendly too."

Walker 'valet service'

The adjustments are subtle enough for a person with dementia not to recognize the differences. According to Jeffers Ramstad, people with dementia won't be able to recognize the need for these measures.

For instance, the church is considering a "valet service" for members who have walkers. Instead of people leaving their walkers in the aisle as they sit on the end of a pew, there will be members of the church designated to offer to take the walkers to a secure parking area. During the closing hymn, the walkers will be pulled up for their elderly drivers.

Since the passage of the Affordable Care Act, Medicaid covers the cost of walkers which are designed to easily fold up for storage. That way they are not an inconvenience or a danger should people need to make an emergency exit.

Walkers are not unique to people with dementia, but the difference for people with dementia is that they are less likely to have the awareness to fold up their walkers for safe storage.

"We had a lady that would leave her walker out in the aisle (of the sanctuary)," Jeffers Ramstad said. "Her walker flattened, but she doesn't use it."

Which is where the walker valet comes into play.

According to St. Croix County Dementia Specialist Nancy Abrahamson, who is overseeing the process of becoming dementia friendly, people with dementia often have a fading sense of their surroundings.

"When you have dementia you lose that rational and logical ability and you function focused on yourself and from your heart and how you feel," Abrahamson said.

Understanding the necessity to be patient with people suffering from dementia is crucial, according to Abrahamson.

The church is a valuable setting for people to become aware of how they may be able to help people with dementia. Members of the church will be able to take their understanding with them back to their families, friends and places of work.

"Once people start learning about the disease, I think people are enthusiastic to learn more," said Vicki Bolton, the lay pastoral caregiver at UMC. "People are interested in seeing what they can do to help. The only resistance is that some of the people don't really understand how they can help. We've had to frame it that it does affect everyone. It could be anyone's grandpa or grandma. When we frame it in that regard, more people begin to understand why it matters."

Jeffers Ramstad said part of the process has been reiterating to people that there are various types of dementia; not all dementia is Alzheimer's.

The church has been walked through a checklist with the guidance of Abrahamson. The checklist includes creating a clutter-free area that will not overwhelm members of the church. In the area for fellowship, for instance, there are spaces next to the chairs for people to park their walkers.

Another step on the list is to engage people to prevent boredom and agitation while they are in the church. If the service does not maintain a certain level of engagement, people with dementia easily become discouraged in a church that is meant to be uplifting.

In the sanctuary, it's a little more difficult to accommodate people with dementia. As soon as a person feels their routine being taken from them, if they have dementia, they begin to resist the changes.

Sometimes change cannot be avoided.

The checklist also includes simplifying prayers so that they can be read on a single prayer card, or on a projection screen at the front of the sanctuary, which also eliminates the clutter of paper.

When changes have to be made, Jeffers Ramstad said they try to gradually make changes and, more importantly, they do not adjust the order of the service.

"Part of our tradition is to accommodate each of our generations," Jeffers Ramstad said. "At the different services, we usually have different generations for a variety of reasons. So one thing that we do, is we have different music at different services on Sundays and throughout the week."