Can One Answer Amen to an Alzheimer Patient’s Bracha?
It is fairly common for elderly people to say Kadish in Shul, including individuals with dementia or Alzheimer’s disease. One can also find themselves in a situation where such a patient makes a Bracha when they are eating. Can one respond amen to individuals with Alzheimer's who recite a Birchas Hanehenin or Kadish?
The Gemara in Brachos (53b) asks if one can say amen to children reciting a bracha in school. The answer is that we recite amen to everyone except children in school. We don't answer the children because they are learning to recite a bracha correctly. Based on this Gemara, the Shulchan Aruch rules (O.C. 215) that one should answer Amen upon hearing a Jewish person recite a Bracha. However, if the Bracha was recited by a heretic, a Kusi (a non-Jew), or a Tinok, one should not answer Amen. The Shulchan Aruch (ibid. 3) clarifies that a Tinok is specifically when they are learning how to say the bracha. But when they say the bracha for its own purpose, one answers Amen.
The Pri Megadim infers from this that one does not say Amen to a child before the age of Chinuch when they make a Bracha. More precisely, the idea of a child reaching the age of ‘chinuch’ qualifies to respond Amen to a child's bracha. This idea is more subjective as there is no set age of chinuch because it varies from mitzvah to mitzvah and according to the child’s understanding and ability to fulfill each mitzvah properly.
Rav Yosef Chaim Sonnenfeld zt”l" (Salmas Chaim, O.C., 50) interprets chinuch to mean that a child must understand to whom he directs the bracha and why he says it. Therefore, if the child understands to whom he is making the bracha, he would answer Amen. But even if the child has reached the usual age of Chinuch but has no understanding of the purpose of a bracha, one would not respond amen to such a Bracha. The Mishna Berura (124:47) classifies this as similar to a shotah.
Therefore, the underlying principle in responding amen to a bracha is that the one who is reciting must understand why and to whom he is reciting it. Accordingly, this can be applied to a case of a person with Alzheimer’s disease; even if he is halachically considered to be a Shoteh, it is often the case that he meets the criteria for reciting a valid Bracha: He is accustomed to reciting Brachos, he recognizes his Creator, and he directs his Brachos towards Him. His Brachos are, therefore Brachos, and one should answer Amen. But if this is not the case, an amen would not be recited.
Another reason it would be invalid to answer Amen to an Alzheimer patient is that if the patient forgets to eat, the Bracha would be considered a Bracha Levatala. This would even be true if the patient remembers to eat afterward because when it comes to reciting amen, we say Safek Amen LeKulah. This means that when there is a doubt to respond amen, one does not respond amen.
However, regarding an Alzheimer patient reciting Kadish, the Chashukei Chemed (Brachos 3a) distinguishes between “Yehei Sh’mei Raba” and Amen. This is because they are said for different reasons. Amen is a certification and validation of what one previously said. Yehei Sh’mei Raba is an independent statement of praise to Hashem. Another common custom is having someone else recite Kadish with an individual who may not know to whom he is reciting it.
Shemos 1:17, Sotah 11B
Regarding a case where one is told, “either you kill someone or you will be killed” the Gemara tells us מַאי חָזֵית דִּדְמָא דִידָךְ סוּמָּק טְפֵי? דִּילְמָא דְּמָא דְּהָהוּא גַּבְרָא סוּמָּק טְפֵי (who says your blood is redder, maybe his blood is redder than yours). Meaning, you cannot justify saving one life by killing someone else.
C.M. 436, Chasam Sofer Kesubos 61A, See Radvaz 1052 for a dissenting opinion
Tzitz Eliezer Vol 9 17;5,7
Shu”t Shevet Halevei Vol 8 Y.D. 251;7
112A
Adapted from medicalhalacha.org