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Caring for Elders Suffering from Dementia

Shaykh Abdul-Rahim Reasat is asked for advice on how best to treat an elder in one’s care, who suffers from dementia, within the bounds of Islam.

Question:

Assalam alaykum wa rahmat Allah wa barakatuh.

I have a question. Where and how can I draw the line between what my religion has taught me, and what the doctors say in regard to caring for my elder with dementia?

Religion teaches I should not say an “uff” to my elders. The physiotherapist says I have to force her to do her movements – if she cries, so be it. She says I have to be cruel to be kind.

The intention is clear for me – I want her betterment and I want her to be independent for as long as it is possible. Can you please help to explain to me how to deal with this situation from an Islamic perspective?

Jazak Allah khayr.

Answer:

Wa alaykum assalam wa rahmat Allah wa barakatuh.

I pray you are well.

Not Offending Parents

You are indeed in a very difficult situation. May Allah make it easy for you. In short, do pretty much what the physiotherapist says to keep her mobile – but use the nicest language, the softest tone of voice, and as much compassion as you can muster.

Allah has commanded the believers to be excellent to their parents, “And your Lord decreed that you worship none but Him, and [that you treat] your parents with the very best of conduct. If one, or both, of them reach old age with you then do not even express any frustration to them [literally, do not say ‘Uff’], and do not scold them. Use the very best choice of words with them.” (Sura al Isra 17:23)

Scholars mention that it is impermissible to use harsh language with one’s parents. This is understood from the first part of the verse, but Allah then explicitly mentioned it to further emphasize the point (Sayis, Tafsir Ayat al-Ahkam). Rather, the way of Muslims is to always try to be kind, merciful, and gentle with them — which is not always easy when they reach old age.

Practical Steps

Help her as much as you can with her mobility issues, but make sure you lovingly explain the importance and need for the movements, and that the physiotherapist requires a certain degree of movement. Make sure she understands the benefits of it, and the harms of neglecting it.

Support her through the pain with care and compassion, and realize the she has limits. Maybe pushing her to the degree you have been told to is not best for her. Try to strike a balance between what she wants and what she is capable of doing.

Also, you may want to look into alternative methods of restoring movement. Original Strength Restoration is a good resource on this topic.

May Allah make this test easy for you, and make this service a means for you to enter Paradise. Amin.

Abdul-Rahim

Checked and approved by Shaykh Faraz Rabbani.


What Are the Islamic Rulings Related to Someone Suffering From Dementia?

Answered by Ustadh Salman Younas

Question: Assalam aleykum

My grandma has totally lost her mind. She doesn’t know what she is saying, can’t eat, or relieve herself, so the family need to do everything for her.

a. Is she exempt from prayers?

b. Does she still have to cover herself in the presence of non-mehram man?

c. When taking her up the stairs to the bathroom, at times, I have to help lift her. There are occasions when we make body contact. Is it sinful?

Answer: assalamu alaykum

We ask God to grant your family health and ease.

Regarding your questions:

a. Based on the description you have given, it does not seem like the prayer would be obligatory on your grandmother as she is no longer considered morally-responsible (mukallaf) due to a deficiency in intellect (aql).

b. The basis is that a woman must cover her entire body in front of a non-mahram man except the face, hands, and feet.

However, in the case of an elderly woman who is no longer sexually desirable, a number of scholars stated that it is permissible to look at those parts of the body that are “generally” uncovered in front of her mahrams. This would include her face, hands, head/hair, feet, arms, neck, and shin. [Ibn Qudama, al-Mughni (9:491) & Sharh al-kabir (7:342); al-Buhuti, al-Kashshaf (5:31); al-Mardawi, al-Insaf (8:26)]

c. The general rule is that it is permissible to touch those areas of a woman that are not considered part of her nakedness (awra). The exception to this is (a) if one fears desire in doing so and (b) a non-mahram. In your cases, as your grandmother is your mahram, it would be permissible for you to touch the areas mentioned above. This is especially the case if there is no one else able to properly assist her as it would be a genuine case of need.

[Ustadh] Salman Younas

Checked and approved by Shaykh Faraz Rabbani

Ustadh Salman Younas graduated from Stony Brook University with a degree in Political Science and Religious Studies. After studying the Islamic sciences online and with local scholars in New York, Ustadh Salman moved to Amman. There he studies Islamic law, legal methodology, belief, hadith methodology, logic, Arabic, and tafsir.