A person’s identity is not linked to what he or she can articulate. Identity and humanness emerge from the imago Dei bestowed upon each person (Gen. 1:27). John Swinton reminds us that modern thinking often equates humanness with cognitive ability. But knowing about God is not the same as knowing God—and knowing God is not limited to memory or intellect. God knows us at all times (Ps. 139).

The world is ageing rapidly. About 10% of the global population is now over 65, a share expected to rise sharply by 2050. India, though younger, is following the same path, with 7% of its population above 65 and a growing 60+ demographic.

Alongside this shift, dementia is increasing. Over 55 million people worldwide live with dementia, and India alone has an estimated 4–9 million. Loneliness adds a profound social burden, affecting 20–40% of older adults globally and nearly half of India’s elderly. Caring for people with cognitive decline and dementia is very challenging for caregivers.

Recently, a few of us, in our early and mid-sixties, met and took a cognitive assessment test. This stemmed from a need to determine whether we were experiencing age-related memory loss, mild cognitive impairment, or the early onset of other dementia syndromes.

Age-related memory loss (normal ageing) involves a slight, gradual decline in processing speed and memory, such as occasionally forgetting names or appointments but remembering them later.

In contrast, mild cognitive impairment (MCI) represents a stage between normal ageing and dementia. It features noticeable memory and thinking problems that are more severe than normal, but not yet severe enough to disrupt daily independence.

On the other hand, early-onset dementia presents symptoms such as severe memory loss, confusion, or behavioural changes that appear before the age of 65.

The Unspoken Fears

There were three underlying issues that we did not openly express as we started the process, though they surfaced later.

One was the concern that all of us were experiencing some memory loss, but we were not sure whether it was something more sinister than normal ageing.

There was also unexpressed anxiety (at least for me) regarding what the future would look like if something more serious emerged.

And there was a fear, arising from a desire, that we should not become dependent on others at any stage of life. For me, this was real because close members of my family had gone through serious dementia syndromes.

These are legitimate concerns, anxieties, and fears. I have encountered this with many others of my generation. Some may not express it, but it is legitimate and acceptable to have such concerns and fears.

Three Struggles in Dementia Care

Having had the opportunity to care for close family members with advanced dementia and having accompanied others, there are three struggles that stand out.

1. The Question of Identity

One is the issue of changed “identity.” The person who “has lost their mind” or whose “thinking is impaired” does not look and feel like the one you knew. Has his or her identity changed? In the book Dementia: Living in the Memories of God, John Swinton says we see people from what they communicate to us.

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