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Designing Worship Services to Support African-American Persons Living with Dementia


The church has played an integral role in the African-American community for a number of years. With the growth in population of African-American older adults living with dementia, it is critical for the church to understand how they can support these individuals in continuing their engagement in meaningful religious activities. The purpose of this qualitative descriptive study was to explore how to design or modify worship services to support African-Americans living with dementia. Interviews were conducted with church leaders, current and former caregivers, and service providers (n = 12). Analysis of their responses revealed worship services should include components in relation to the following categories: “simplicity,” “support,” “imagery and sound,” and “music.” Although participants held different views on the delivery of worship services for persons living with dementia, interview results provided key elements on how worship services can be meaningful and supportive of African-Americans living with dementia.

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  1. Agli, O., Bailly, N., & Ferrand, C. (2015). Spirituality and religion in older adults with dementia: A systematic review. International Psychogeriatrics,27(5), 715–725.

    Article  PubMed  Google Scholar 

  2. Alzheimer’s Association. (2019). Facts and figures. Retrieved from

  3. Assari, S. (2013). Race and ethnicity, religion involvement, church-based social support and subjective health in United States: A case of moderated mediation. International Journal of Preventive Medicine,4(2), 208–217.

    PubMed  PubMed Central  Google Scholar 

  4. Assari, S., & Moghani Lankarani, M. (2018). Secular and religious social support better protect Blacks than Whites against depressive symptoms. Behavioral Sciences (Basel, Switzerland),8(5), 46.

    Article  Google Scholar 

  5. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology,3(2), 77–101.

    Article  Google Scholar 

  6. Centers for Disease Control and Prevention. (2018). Alzheimer’s disease. Retrieved from

  7. Centers for Disease Control and Prevention. (2018) U.S. burden of Alzheimer’s disease, related dementias to double by 2060. Retrieved from

  8. Centers for Disease Control and Prevention. (2018). Alzheimer’s disease. Retrieved from

  9. Chatters, L. M., Taylor, R. J., Bullard, K. M., & Jackson, J. S. (2009). Race and ethnic differences in religious involvement: African Americans, Caribbean Blacks and non-Hispanic Whites. Ethnic and Racial Studies,32(7), 1143–1163.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Clayton, J. (1991). Let there be life: An approach to worship with Alzheimer’s patients and their families. Journal of Pastoral Care,45, 177–179.

    CAS  Article  PubMed  Google Scholar 

  11. Despoina, M., Marianna, T., Moses, G., & Magda, T. (2018). Differences in religiosity among cognitively intact, mildly cognitively impaired, and mildly demented elderly, and its possible relationship with depressive mood. Applied Nursing Research,43, 69–74.

    Article  PubMed  Google Scholar 

  12. Ellor, J. W., Stettner, J., & Spath, H. (1987). Ministry with the confused elderly. Journal of Religion, Spirituality, and Aging,4(2), 21–32.

    Article  Google Scholar 

  13. Epps, F., Brewster, G., Alexander, K., Choe, J., Heidbreder, V., & Hepburn, K. (2019). Dementia-friendly faith village worship services to support African American families: Research protocol. Research in Nursing & Health,42, 189–197.

    Article  Google Scholar 

  14. Epps, F., Skemp, L., & Specht, J. K. (2016). How do we promote health?: From the words of African American older adults with dementia and their family members. Research in Gerontological Nursing,9(6), 278–287.

    Article  PubMed  Google Scholar 

  15. Epps, F., & Williams, I. C. (2018). The importance of religiosity to the well-being of African American older adults living with dementia. Journal of Applied Gerontology.

    Article  PubMed  Google Scholar 

  16. Given, L. M. (2008). The SAGE encyclopedia of qualitative research methods (Vols. 1-0). Thousand Oaks, SAGE Publications, Inc. doi:

  17. Hamilton, J. B., Galbraith, K. V., Best, N. C., Worthy, V. C., & Moore, L. T. (2015). African American cancer survivors’ use of religious beliefs to positively influence the utilization of cancer care. Journal of Religion and Health,54(5), 1856–1869.

    Article  PubMed  Google Scholar 

  18. Hamilton, J. B., Worthy, V. C., Kurtz, M. J., Cudjoe, J., & Johnstone, P. A. (2016). Using Religious Songs as an Integrative and Complementary Therapy for the Management of Psychological Symptoms Among African American Cancer Survivors. Cancer Nursing,39(6), 488–494.

    Article  PubMed  Google Scholar 

  19. Heo, G. J., & Koeske, G. (2013). The role of religious coping and race in Alzheimer’s disease caregiving. Journal of Applied Gerontology,32(5), 582–604.

    Article  PubMed  Google Scholar 

  20. Hepburn, K., & Johnson, T. (2014). Alzheimer’s disease and dementias. In E. L. Idler (Ed.), Religion as a social determinant of public health (pp. 396-407). New York: Oxford University Press.

  21. Jing, W., Willis, R., & Feng, Z. (2016). Factors influencing quality of life of elderly people with dementia and care implications: A systematic review. Archives of Gerontology Geriatrics,66, 23–41.

    Article  PubMed  Google Scholar 

  22. Katsuno, T. (2003). Personal spirituality of persons with early-stage dementia: Is it related to perceived quality of life? Dementia,2(3), 315–335.

    Article  Google Scholar 

  23. Koenig, H. G., McCullough, M., & Larson, D. B. (2001). Handbook of Religion and Health. New York: Oxford University Press.

    Book  Google Scholar 

  24. Lincoln, Y., & Guba, E. (1986). But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. Naturalistic Evaluation, 30, 73–84.

    Google Scholar 

  25. Morano, C. L., & King, D. (2005). Religiosity as a mediator of caregiver well-being: Does ethnicity make a difference? Journal of Gerontological Social Work,45(1–2), 69–84.

    Article  PubMed  Google Scholar 

  26. Morris, J., & Robinson, D. (1996). Community and Christianity in the Black Church. Counseling and Values,41(1), 56–69.

    Article  Google Scholar 

  27. National Institute of Mental Health. (2018). Autism spectrum disorder. Retrieved from

  28. Neergaard, M. A., Olesen, F., Andersen, R. S., & Sondergaard, J. (2009). Qualitative description—The poor cousin of health research? BMC Medical Methodology,9, 52.

    Article  Google Scholar 

  29. Pew Research Center. (2014). 2014 religious landscape study. Retrieved from

  30. Plunkett, R., & Chen, P. (2016). Supporting healthy dementia culture: An exploratory study of the church. Journal of Religion and Health,55(6), 1917–1928.

    Article  PubMed  Google Scholar 

  31. Reese, A. M., Thorpe, R. J., Bell, C. N., Bowie, J. V., & LaVeist, T. A. (2012). The effect of religious service attendance on race differences in depression: findings from the EHDIC-SWB study. Journal of Urban Health,89(3), 510–518.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health,23(4), 334–340.;2-G.

    CAS  Article  Google Scholar 

  33. Sandelowski, M. (2010). What’s in a name? Qualitative description revisited. Research in Nursing & Health,33, 77–84.

    Article  Google Scholar 

  34. Sung, H., Chang, A., & Lee, W. (2010). A preferred music listening intervention to reduce anxiety in older adults with dementia in nursing homes. Journal of Clinical Nursing,19, 1056–1064.

    Article  PubMed  Google Scholar 

  35. Tobin, G. A., & Begley, C. M. (2004). Methodological rigour within a qualitative framework. Journal of Advanced Nursing,48, 388–396.

    Article  PubMed  Google Scholar 

  36. Tufford, L., & Newman, P. (2012). Bracketing in Qualitative Research. Qualitative Social Work,11(1), 80–96.

    Article  Google Scholar 

  37. Unantenne, N., Warren, N., Canaway, R., & Mandwerson, L. (2013). The strength to cope: Spirituality and faith in chronic disease. Journal of Religion and Health,52(4), 1147–1161.

    Article  PubMed  Google Scholar 

  38. Alzheimer’s Association. (n.d.). African-Americans and Alzheimer’s: The silent epidemic. Retrieved from

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The authors gratefully acknowledge participants of Phase 1.


This work is supported by the Alzheimer’s Association Research Grant‐Diversity (AARG‐D‐18‐56229) and Emory Alzheimer’s Disease Research Center Pilot Award (P50 AG025688).

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Correspondence to Fayron Epps.

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Authors have no conflicts of interest to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution or practice at which the studies were conducted. Georgia State University Institutional Review Board reviewed and approved this study (IRB# H18283).

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Informed consent was obtained from all individual participants included in the study.

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Epps, F., Choe, J., Alexander, K. et al. Designing Worship Services to Support African-American Persons Living with Dementia. J Relig Health 59, 2163–2176 (2020).

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  • Church
  • Alzheimer’s disease
  • Cognitive impairment
  • Religion
  • Liturgy