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BY: PATRICK LAMPE

Early in my association with the Alexian Brothers, I accompanied Brother John Grider, CFA, an Alexian Brother serving as a community nurse, on home visits to people in a St. Louis neighborhood. One of our first stops was to see Walter, who lived in an unfinished, dimly lit basement. He was elderly and confined to a wheelchair, as he had no legs. It took two men to carry him up a flight of stairs and outdoors in order to get him to doctors' appointments.

Brother John did most of Walter's shopping, helped bathe him, checked his vitals and mostly just chatted with him. For this man who was seemingly abandoned by everyone, Brother John was his connection to the world.

This was the first of many such visits that brought to life for me the Alexian Brothers' charism, their ministry to the outsider and the frail elderly and a tangible expression of their core values of compassion, care of the poor, dignity of the person, holism and partnership. These experiences have made an indelible impression, and they fuel my desire to work in partnership with the Brothers in answering the call to serve.

The Alexian Brothers are a Catholic vowed order of men who promote health and care for the poor, the sick, the aged, the mentally compromised, the dying and the marginalized throughout the world.¹ That call particularly addresses the elderly with cognitive impairment, such as Alzheimer's disease or other dementias. The serious impairment of those afflicted robs them of the ability to function in a society that values one's capacity and intelligence. Eventually the loss of memory will cause the person to depend entirely on another for care and support.

When loved ones are unable to provide the level of care required, Catholic health care offers programs and institutions that extend compassionate, dignified, holistic care. In the United States, the Alexian Brothers are noted for their senior ministries in Tennessee, Wisconsin and Missouri.

HISTORY
The Brothers have a long and rich history, stretching back before the Middle Ages. Their call to serve the elderly began with groups of laymen and laywomen in the Rhineland and the Low Countries of Northern Europe who drew inspiration from the acts of the apostles as recorded in Scripture.

They banded together to start a grassroots movement of lay religious. The women were called Beguines and the men, Beghards. They lived in semi-monastic communities, took no formal vows but, in sacred tradition, imitated Christ's life through religious devotion, voluntary poverty and care of the poor and sick. The Beghards accepted many elderly men into their communities and provided for their needs.² This is the first evidence of the group's call to serve the elderly.

The Beghards of 800 years ago were the early Alexian Brothers. While there is no record of the founders of these first communities, and no exact dates of when they began their ministry, the early Alexians were known as voluntary "poor ones" who visited the sick, stayed with the ill to guard and nourish them, and they gave ecclesiastical burials to the bodies of the deceased faithful. This keen sense of vita apostolica, more through action than word, gained the Brothers favorable support among prominent and influential citizens in the cities in which they ministered.

A distinguishing hallmark in their history was the Brothers' ministry to victims of the bubonic plague, which decimated more than one-third of Europe in the mid-1350s. It was a task that few had the courage to perform, and many Brothers died of the plague they contracted from those in their care.

During the medieval period, the Brothers continued to work with the sick and dying, and were designated as burial Brothers in almost every town in which they lived. The Brothers sheltered the sick in their hospice, served as in-home nurses, ministered spiritually to the criminals and women accused of witchcraft on death row and cared for the mentally ill. Records show a woman was confined to one of their houses in 1585 who was "bereft of her senses."³

By the late 1700s, the Brothers routinely cared for the elderly who were mentally ill. A report from their Cologne community dated April 11, 1786, showed the number of pensioners in their care totaled 15, two of whom were secular priests and the remainder mentally ill and what was described as "feebleminded."⁴

The French Revolution (1789-1799) ushered in wars of French military expansion which moved across Europe and took its toll on the Alexian communities. By the early 1800s, few Brothers remained. Their property had been seized, and their main source of income as funeral directors had been privatized and contracted out to other sources. This left care of the mentally ill as their primary ministry and source of income.

The Alexian Brothers' "Institutions for the Insane" contributed to great advancements in medical psychiatric research in Germany. The following rules in the Brothers' constitution of 1870 for the "care of the insane" illustrate the ideals of the religious civility at a time when the understanding of mental illness was in its infancy and its subjects often treated inhumanely:

• Every Brother should look upon the insane who are entrusted to his care as beings whose unusually helpless condition claims a greater share of Christian charity, and for whose security and welfare he must labor to the best of his power, for the love of God, whose image they still retain in their souls.
• Every Brother should make it a constant rule to treat the insane with kindness and love, for the more gentle he shows himself, the greater will be his merit before God. It is never allowed to lay violent hands on an insane person. It is sufficiently plain that the Brothers are allowed to defend themselves, provided they observe due moderation in their defense, from the attacks of furious madmen; but in this case they must intend nothing more than to deprive such persons, and that with all gentleness, of the power of doing injury.
• When the insane persons give vent to foolish or delirious language, or when they are disturbed by strange phantoms of the imagination, the Brother should endeavor to quiet them with kind words; he should beware of enraging them still more by contradictions, and if he sees that he cannot pacify them with words of kindness, he should be silent.
• He should attend with particular care to such as refuse all nourishment for a considerable time, especially when they manifest an intention to starve themselves. In such cases, he should refer the matter to the rector, who should obtain the personal aid of the physician.
• The taking of medicines should never be left entirely to the patient, but the Brother should watch that the remedies be taken, or administer them with his own hands.
• When a Brother notices that any of the patients under his charge has disappeared, he should inform the rector, whose duty it is to see that necessary measures be taken.⁵

After the end of the Napoleonic Wars in Europe, the Brothers saw a steady growth in their numbers, and they were encouraged to expand their ministry in the wake of German emigration to England and the United States. In England, the Brothers opened a cemetery, and when denied a license to open an insane asylum — reaching back to their tradition — they opened a home to attend to the needs of elderly men, particularly the senile.

Br. Bonaventure Thelen arrived in the United States in 1866 and established the Brothers' first hospital in Chicago on June 12th of that year. According to the story, Br. Bonaventure found the first patient, an elderly man, on the street and carried him to the new six-bed infirmary. The Brothers subsequently opened facilities in St. Louis and in Oshkosh, Wis.

In 1936, the Alexian Brothers purchased an inn in Signal Mountain, Tenn., just outside of Chattanooga, and converted it to a convalescent home. Today the inn is part of a continuous care retirement community known as Alexian Village of Tennessee.

In 1998 the Brothers opened Alexian Brothers Valley Residence in Chattanooga, not far from Alexian Village. The new, 42-bedroom facility was designed and staffed exclusively to care for those with Alzheimer's disease, dementia and related memory loss. Organized into three identical neighborhoods and staffed with RNs and CNAs 24 hours a day, the furnishings, staffing and management have been conceived to serve the specific needs of residents and their families. As a resident's disease progresses and his or her level of care requirements increase, the resident moves to a new neighborhood that looks the same but offers the higher level of care.

The residents enjoy family-style meals, secure outdoor courtyards, walkways and porches, and recreational programs and activities, many that pay particular attention to spiritual wellness. Knowledge learned from Alexian Valley Residence is in use throughout the Alexian Brothers senior ministries.

For example, the Alzheimer special care unit at Alexian Brothers Lans–downe Village in St. Louis differentiates between early to mid-stage and late-stage dementia residents. The Memory Care Unit at Alexian Brothers Sherbrooke Village in St. Louis has adopted a staffing model that limits the number of different people residents encounter, encouraging trust and a greater sense of community.

I frequently assist with Communion services at Sherbrooke Village, and I enjoy escorting residents from the Memory Care Unit to the chapel. They live in a home-like atmosphere, complete with pets.

Alexian Village of Milwaukee has a memory support unit in their rehab and skilled nursing center, a center that, for the past two years, has gained exceptional recognition based on its health inspections, nursing staff and quality of medical care ratings.

As the Alexian Brothers continue to be guided by sacred scripture, sacred tradition and divine revelation, they continue to discern their call to continue to serve the elderly. Their "Charism Statement" captures the essence of this three-fold guideline and serves to keep the Brothers faithful to their call.

THE CHARISM STATEMENT
The Alexian Charism is the prophetic and daring response of a faith community to the gospel of Jesus. It is rooted in prayer and simple life style. In discipleship with Jesus our response is reaching out to the poor, sick and dying, especially the marginalized and powerless.

Our Charism calls us to conversion and total self-giving in continuing the healing and reconciling mission of Jesus in collaboration with others.⁶

It is not just a call heard by the Brothers living in the United States, or throughout the world. It is a call heard by the tens of thousands of men and women associated with the Brothers as employees, volunteers, loyal physicians, generous donors, religious associates and friends. They, like me, have experienced the Brothers' ministry firsthand and have been moved by its compassionate touch and its power to heal.

PATRICK LAMPE is director of mission integration for Ascension Health Senior Care, St. Louis.

NOTES

1. Congregation of Alexian Brothers, "Mission Statement of the Congregation," in Way of Life, Book III (Signal Mountain, Tenn.: Alexian Brothers Generalate, 1978), paragraph 88.
2. Ernest Gilliat-Smith. "Beguines & Beghards," in The Catholic Encyclopedia, Vol. 2 (New York: Robert Appleton Company, 1907). www.newadvent.org/cathen/02389c.htm (accessed July 25, 2014).
3. Christopher J. Kauffman, Tamers of Death: Volume One, The History of the Alexian Brothers from 1300 to 1789 (New York: Seabury Press, 1976), 199-207.
4. Kauffman, Tamers of Death, 210.
5. Christopher J. Kauffman. The Ministry of Healing: Volume Two, The History of the Alexian Brothers from 1789 to the Present (New York: Seabury Press, 1978), 61-62.
6. Congregation of Alexian Brothers, "Charism Statement," in Way of Life, Book I
   (Signal Mountain, Tenn.: Alexian Brothers Generalate, 1978), 7.