As a chaplain I think about what leads to salvation with people. I know it is not up to me, but I do as much as I can to help people build a relationship with the Lord and heaven. A lot of people have various levels of dementia, and this complicates it.
For example, I have a pt who was/is a very smart man; he used to be a physicist, and an actual rocket scientist at Lockheed. He is now bed ridden and able to hear and communicate, though in a tired way. He can remember who I am from visit to visit, but not much at all about what we talk about. My goal is to form a bond, primarily a bond with God, and as a step to that a friendship with me. I seek to gain his trust and make the visit interesting to his mind and soul.
He will ask me amazing questions like why was God born on the earth, and I ho very deep with sharing with great depth and feeling. We talk about the sort of things I post on this site. I assure him the depth of what he feels in the moment matters.
There are two levels I seek to reach him in terms of preparing the soil; one is depth of feeling in the moment; and two, progressing and persevering over time to deepen and advance the understand and love of God. The second option is not so available because he doesn’t necessarily remember. He can understand in the moment but he cannot remember much from one visit to the next. But the depth an impression is made in the soul deosn’t go away but remains if there is love and affection joined to the ideas expressed. My presence with love for them, God and the Word can uplift the atmpshere, but they still must process themself. The Lord said, ‘Where two or three are gathered in His name there His is’. So the presence of those who love the Lord can magnify faith for each other.
But for a person to change and transform in their soul it is necessary that they be able to use their mind and will; they must have some cognitive ability to take in, feel and process the thoughts and ideas and scripture or issues discussed with them. This doesn’t mean they have to talk, it means that their affections can be stirred inside at whateve level is possible that can form a bond. Even with those with severe dementia one can see little signs in minute gestures, touch of hand, expression and many other things. I bring the best quality of understanding and affection I can, and often do it through music – and pray for the rest from God. Jesus is the true inner teacher.
So even if a person can’t remember moment to moment, the depth that they can go to in the moment can make an imprint in the soul that can contribute to their state of faith or transformation. But it gets much harder, more tenuous and uncertain with dementia, and the older people get. In old age people tend to get more fixated also.
A lot of people think/hope that death bed conversions are common, but it doesn’t really work that way. It is definitely possible, but a lot of preparation and ground work had to have taken place to lead up to it, and most of this goes unseen. The reason is that the soul of a person is being formed all throughout life, and for most the pattern of it is pretty established by the time they get old. It can’t be changed except by the process of growth, and that is not easy. The change takes place when a person soul is humbled in the face of love and understanding of what the Lord has done for us, and in the face of love for the good of another. In this a bond is forged that can’t be taken away – if is done from love. But the other part of it is that one must persevere in this love to the end. And, because they can’t remember much for moment to moment, day to day, this part is a challenge and uncertain. Their ability to retain being diminished it is hard to tell what happens, but one perseveres in helping nevertheless. God knows and I trust in him. Also, it is fundamental that the Lord doesn’t providentially let a person into the internal bond unless He sees they will essentially keep it to the end. This part is entirely up to God’s infinite wisdom, and I can only do our best to foster it. I never know for sure what happens but pray to the Lord it is well. I trust in God.