Not Knowing After Knowing: Illuminating an Islamic Perspective Towards Compassionate Care for Elders with Dementia
Shirsho Shreyan, Rajshahi Medical College, Rajshahi, Bangladesh; Yasir Akhtar, MD, Tennessee Heart Clinic, Knoxville, TN and Darul Qasim College, Glendale Heights, IL; Ahsan Arozullah, MD, MPH, Darul Qasim College, Glendale Heights, IL; and Shaykh M. Amin Kholwadia, Darul Qasim College, Glendale Heights, IL
Developing a cure for neurodegenerative diseases, such as Alzheimer's disease, has proven to be an enduring challenge for medical researchers. Despite early promise, monoclonal antibodies have demonstrated limited success in reversing or impeding the progression of this debilitating ailment. No current treatments have demonstrated the ability to cure Alzheimer’s disease. The minimal progress in creating effective treatments, despite an estimated $42.5 billion invested in R&D since 1995 for Alzheimer's disease alone, raises the possibility that our current scientific approach lacks coherency and needs to be expanded and re-examined.
The purpose of this paper is to describe an Islamic perspective on dementia in older adults. Based on Islamic revelational sources, we summarize a foundational understanding of aging and dementia and outline Islamic civilizational values that inform the care of elders. The Quran states in Surah al-Nahl (16), verse 70 – Allah (God) has created you, and then causes you to die. And some of you are left to reach the feeblest stage of life so that they may know nothing after having known much. Indeed, Allah is all-Knowing and Most Capable. The reality (haqiqah) described in this verse is that there will be some people who reach old age and will know nothing after having knowledge at earlier stages in their life.
Concurrently with the Quran, Muslims seek guidance from authenticated transmissions (hadith) from the Prophet Muhammad ﷺ. The following hadith is related in Sunan al-Tirmidhi (2038) in the chapter about remedies and encouragement for their use: Usamah bin Sharik said "Some Bedouins asked: 'O Messenger of Allah ﷺ shall we treat (our ill)?' He said: 'Yes, O worshipers of Allah! Use remedies. For indeed Allah did not make a disease but He made a cure for it' - or - 'a remedy. Except for one disease.' They said: 'O Messenger of Allah ﷺ! What is it?' He said: 'Old age.'" This hadith provides tremendous inspiration for the researcher who seeks cures with the notable exception of old age itself. For the Muslim researcher, this hadith may raise the question of whether there can be a ‘cure’ for those who reach old age and develop dementia.
In the absence of a cure, how should one ideally care for someone with dementia? The Islamic civilizational approach to caring for elderly parents provides a framework as described in the Quran (Surah Bani Israel (17), verses 23-24): Your Lord has decreed that you worship none save Him, and that you show kindness to parents. If one of them or both reach old age with you, say not ‘Fie’ to them nor scold them, but speak to them a gracious word. And lower the wing of humility to them in mercy and say, ‘My Lord, have mercy on them, since they cared for me when I was small.’
Recognizing the reality that caring for elders with limited cognitive and physical abilities can be challenging, Allah ﷻ reminds the caregiver that their parents cared for them in childhood when their cognitive and physical abilities were similarly limited. These verses highlight the ideal formula for caring for older adults: do not scold them, speak gently, treat them with mercy and pray for Allah ﷻ to have mercy on them. These Islamic civilizational values elevate the caregiver's own spiritual well-being by actively engaging with the undeniable realities of the human life cycle and temporal aspects of existence in this world. It assures caregivers of great rewards for their compassionate and unwavering support while deeming any manifestation of annoyance towards them as a transgression.
This paper illuminates the potential for increasing coherency in our current scientific approach to researching and treating patients with Alzheimer's disease. By utilizing Islamic revelational sources of knowledge, a greater coherency may bridge the gap between medical and religious approaches to treating and caring for elderly patients with dementia.
The purpose of this paper is to describe an Islamic perspective on dementia in older adults. Based on Islamic revelational sources, we summarize a foundational understanding of aging and dementia and outline Islamic civilizational values that inform the care of elders. The Quran states in Surah al-Nahl (16), verse 70 – Allah (God) has created you, and then causes you to die. And some of you are left to reach the feeblest stage of life so that they may know nothing after having known much. Indeed, Allah is all-Knowing and Most Capable. The reality (haqiqah) described in this verse is that there will be some people who reach old age and will know nothing after having knowledge at earlier stages in their life.
Concurrently with the Quran, Muslims seek guidance from authenticated transmissions (hadith) from the Prophet Muhammad ﷺ. The following hadith is related in Sunan al-Tirmidhi (2038) in the chapter about remedies and encouragement for their use: Usamah bin Sharik said "Some Bedouins asked: 'O Messenger of Allah ﷺ shall we treat (our ill)?' He said: 'Yes, O worshipers of Allah! Use remedies. For indeed Allah did not make a disease but He made a cure for it' - or - 'a remedy. Except for one disease.' They said: 'O Messenger of Allah ﷺ! What is it?' He said: 'Old age.'" This hadith provides tremendous inspiration for the researcher who seeks cures with the notable exception of old age itself. For the Muslim researcher, this hadith may raise the question of whether there can be a ‘cure’ for those who reach old age and develop dementia.
In the absence of a cure, how should one ideally care for someone with dementia? The Islamic civilizational approach to caring for elderly parents provides a framework as described in the Quran (Surah Bani Israel (17), verses 23-24): Your Lord has decreed that you worship none save Him, and that you show kindness to parents. If one of them or both reach old age with you, say not ‘Fie’ to them nor scold them, but speak to them a gracious word. And lower the wing of humility to them in mercy and say, ‘My Lord, have mercy on them, since they cared for me when I was small.’
Recognizing the reality that caring for elders with limited cognitive and physical abilities can be challenging, Allah ﷻ reminds the caregiver that their parents cared for them in childhood when their cognitive and physical abilities were similarly limited. These verses highlight the ideal formula for caring for older adults: do not scold them, speak gently, treat them with mercy and pray for Allah ﷻ to have mercy on them. These Islamic civilizational values elevate the caregiver's own spiritual well-being by actively engaging with the undeniable realities of the human life cycle and temporal aspects of existence in this world. It assures caregivers of great rewards for their compassionate and unwavering support while deeming any manifestation of annoyance towards them as a transgression.
This paper illuminates the potential for increasing coherency in our current scientific approach to researching and treating patients with Alzheimer's disease. By utilizing Islamic revelational sources of knowledge, a greater coherency may bridge the gap between medical and religious approaches to treating and caring for elderly patients with dementia.