As a process theologian I believe in the primacy of moments. Yes, we live our lives year to year, week to week, day to day. But most deeply, I believe, we live from moment to moment.
I learned this lesson in my twenties in a very pleasant way from a Zen master for whom I was an English teacher. His name was Keido Fukushima. (I tell the story in a short essay called "Can a Christian be a Buddhist, too?") He would always say that Zen is about living in the moment and responding to the circumstance at hand in a spirit of creativity and compassion, as best we can. I saw this in the way he lived his life. He could remember the past and anticipate the future, but he was always "present" in the here and now. Often he would encourage me to forget the past and all that I'd learned, in order to see what was present before me: another person, for example, or a tree, or a sunset, or a challenge to be faced with courage.
I learned about the primacy of moments later, in a more difficult way, from friends with Alzheimer's and dementia who had lost their memories and for whom living in the moment was the only option they had. From them I saw that living in the moment is not always happy. It can be happy, not least when they can enjoy pleasant emotions, as elicited by music or by seeing Christmas lights while riding in a shuttle bus. But it can be confusing and anxious, angry and terrifying. My friends did not choose to forget the past; their brains forced them to forget the past, even as they are more than their brains.
I also learned about the primacy of the moment from their family members, who can also be confused and anxious, because the person they once knew is no longer present, and a new person has taken his or her place. It was easy and exciting for me to be with Keido Fukushima as he lived in the moment; for caretakers it can be absolutely draining and almost life-destroying, unless they get help. I do not want to romanticize living in the moment. Sometimes living in the moment can be agonizing; we can only survive by hoping for a better future or remembering a better past.
For my part, as I came to have friends with Alzheimer's, I came to respect nurses in memory care units whose very job it was to live in the moment, without expecting their patients to be the kind of self who remembers the past. I say "kind of self" because I do believe that having a sense of past identity and future hopes is one way of being a self. But I believe that being without memory and anticipation is also a way of being a self, and not necessarily or at least not always a sad one. The nurses were treating their patients respectfully, as selves who matter, even if they lack memory and certain kinds of processing functions.
We never really know what kinds of experiences the person with moderate or severe Alzheimer’s might have, and even enjoy, hidden within deep recesses of the self of the moment. My own hope is that they experience certain planes of existence we do not and enjoy them. As a friend puts it: "In the later stages my mom had one foot on earth and another in heaven." In any case, kind nurses do indeed treat all people with respect, no matter what state or stage of selfhood they are in. These nurses are my heroes and heroines. They are my Zen Masters. They teach us to love.
We can love them for the selves they are and the selves God lovingly redeems, moment by moment.
Perhaps we can love our friends with Alzheimer's, not for the selves they were in the past, but for the selves they are in the present. We can bring them moments of joy, adding richness to their self-of-the-moment, even if that joy is forgotten by the self-of-the-next-moment. And perhaps we might also trust that their moment-by-moment selves, and ours as well, are being transformed into something less painful and more beautiful in God's ongoing life, not unlike the way that individual notes in a musical melody have their meaning only as gathered into a larger whole.
We might speak of fine-grain love (loving them for who they are in the moment) and faith-nourished trust (loving them for who they are as part of God). Faith-nourished trust is not trust that God intended our friends to have Alzheimer's or that our caring for them is part of a divinely ordained plan. It is trust that God is with them and us no matter what happens, as a fellow sufferer and an indwelling lure, and that God is embracing them and us, in redeeming ways, at every moment, past and present and future.
The redemption of selves does not happen later, in heaven alone; it happens now, as all that happens on earth becomes part of God in heaven. We can live in the moment like the kind nurses and see all people, plus more, through the eyes of faith in God's redeeming love. We can love them for the selves they are and the selves God lovingly redeems, moment by moment.