« Back to Issue 51

How Do We Care for Seniors

By Paul Beasley-Murray.

Once a term I meet on a Sunday afternoon with the thirty or so people in our church responsible for pastoral care. We always focus on a relevant topic - sometimes I invite an outside speaker, but mostly I tend to lead the session myself.   Last Sunday I took ‘ageing’ as my theme and asked the question, ‘How do we care for our seniors?’

What is a senior?

Immediately the question is raised: what is a senior? When is the beginning of old age? To this there is no uniform reply, although I identify with the suggestion that ‘aged’ is 15 years older than one is! In spite of the government welfare cuts, we still get our seniors rail passes and bus passes at the age of 60. However, I know of no 60 year old who regards him (or her) self as old! Retirement used to be another marker of old age, but that is complicated, because people do not retire at the same age: some take early retirement, while some keep going. Another possible marker is the time when we receive our state pension, but that too is changing.

Sometimes generational changes cause us to realise that we are getting older. It may be the death of a parent, and the realisation that we are now the family elders. For me it was the experience of becoming a grandfather. In the past, when an older man was taking his time to cross the road, I tended to say to myself “Come along, Grandpa!”. Now I am a Grandpa, four times over!

Another marker of growing old is the gradual loss of energy. Last Monday week I worked a 15 hour day - I left home to go to my church office just after 7am and did not return until gone 10pm, dog-tired. What’s more, I felt tired the following day.  By contrast, when I was younger I would think nothing of working those kind of hours. Certainly as a young minister I would never dream of putting up my feet during the day, whereas now I often take a ‘power nap’ before going out for the evening.

So, when do we grow old? The terms ‘young-old adult’ (65-74) and ‘old-old adults’ (75 years of age and older) have been used. But the reality is that as we grow older, our chronological age becomes less important. An age ‘label’ can be misleading - the fact is that ‘one size does not fit all’. So much depends upon health. People in their 60s living with chronic illnesses and disabilities may well feel - and act - in a more elderly fashion than people in their 70s and 80 blessed with good health. The older we get, the more health becomes an issue.

But - and this is an important qualification - when it comes to ageing, people’s attitude is also key. Some people are happy to watch ‘soaps’ on the television day in and day out, while others are determined to  keep their minds sharp. Some are happy to be entertained and to have things done for them, others want to be active and often spend much of their time caring for other seniors!

Yes, attitude is key. The American pastor Chuck Swindoll hit the nail on the head when he wrote:

“The longer I live, the more I realize the impact of attitude on life. It is more important than the past, than education, than money, than circumstances, than failures, than successes, than what other people think or say or do. It is more important than appearance, giftedness or skill. It will make or break a company... a church... a home.  The remarkable thing is we have a choice every day regarding the attitude we will embrace for that day. We cannot change our past... We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude. I am convinced that life is 10% what happens to me and 90% how I react to it. And so it is with you... we are in charge of our Attitudes”[1]

From Ageing to Sage-ing

There is more to ageing than simply growing older. One of the key tasks of people engaged in caring for seniors is to encourage our older people to grow in wisdom. Wisdom is not an automatic gift - it is something which is developed through reflection. In this respect Zalman Schachter, a Jewish commentator, wrote:

“One is only old by the calendar, but one becomes an elder when one knows how to use those years, and that means life review, life repair, relationship repair, and a way of thinking about, how do I want to harvest what I learned in life.  And there are good memories and there are some other memories that are not so happy, but they contain in themselves some good too, if one looks into them”[2]

Sage-ing involves looking back on our past and making sense of our lives. Hopefully, such looking back will create a sense of pride as one perhaps becomes aware of one’s achievements, not just in the world of work or of the wider community, but also in terms of the family. But almost certainly, looking back will also involve coming to terms with disappointment - for the fact is that for most of us there will be unfulfilled dreams. For some, looking back will involve a sad realisation of broken relationships, and the need to forgive, both others and maybe oneself too.

Sage-ing involves a good deal of self-awareness. In my experience, however, few of us are truly self-aware. We need others to help us see ourselves as we truly are - we need others to see our lives as they truly have been.  But where do we find that help, apart from paying for the services of a professional therapist? Ideally this should be one of the tasks of pastoral care. Yes, there is much more to the pastoral care of seniors than just ‘visiting’. Pastoral care is enabling people to continue to grow and develop, whatever their age.

Indeed, I would like to suggest that the task of the church through its activities is to help our seniors shift from ageing to sage-ing. A church that simply puts on lunches for older people or even devotional services for older people is failing in its task of helping older people grow in their understanding of God and self, and as also in their understanding of the relationship between God and self.  

Some while ago I found myself challenged by these words of Arthur Creber:

“It really cannot be satisfactory for us to present a gospel which encourages older people to withdraw from life and to prepare for death (although this may be wholly appropriate for a person suffering from a terminal illness). Neither is it satisfactory to reduce our ministry to the patronizing provision of free handouts or cheap trips to the pantomime at Christmas. If the gospel has to do with new Life, we should be encouraging older people to explore their potential for creative activity, for maintaining and improving their health, and for establishing or re-establishing loving relationships with other people and with God. We should be providing opportunities for the development of understanding, growth and experimentation.”[3]

If I am honest, my church has yet to rise to the challenge. One of the difficulties of enabling this transition from ageing to sage-ing is finding the right context in which to do this work. Whereas lunches and devotional meetings can be large-scale activities, the sharing of past memories and of present feelings involves a major degree of honesty and of vulnerability which in turn demands an atmosphere of trust and non-judgmentalism. Possibly such a deep sharing of self could take place in a small group of friends, but maybe the safest context is within the one-to-one pastoral conversation. I would be interested to hear of the experience of other pastors and other churches.

Relating the Gospel to older seniors

Caring for seniors in a church context must always be Gospel-centred. Important as it is to help seniors make sense of their lives, it is even more important to help our older seniors realise the value that their lives have in the sight of God. In a world where all the emphasis appears to be on the young, the old often feel they have little value - and all the more so, as they can do less and less. Old age can be a demeaning process, particularly if it involves having to have somebody wash us and perhaps even toilet us. Dementia itself can be a happy release, but not the gradual loss of one’s ability to think and to remember. Increasingly a burden on society, if not the family, older people often feel that their lives no longer have any value. In this context pastoral carers need to remind those whom they visit as indeed themselves that, however much the years may have taken their toll, even the most senile still have value to God, for not only have we been made in the image of God, we continue to bear that image to the end of our days. The good news is that we all have inestimable worth to God, however diminished we may feel.

Linked with a loss of self-worth is often a sense of uselessness. Whereas in early retirement people can be incredibly active, not least in the service of God and his church, there comes a point when energy is gone and physical limitations appear. Old age for those who are becoming frail can sometimes appears to be nothing more than a waiting-room for death. The reality, however, is that we can still be useful for God. Older people have time to pray - perhaps one of the tasks of a pastoral carer is to share names of people who need particular prayer. Older people too can continue to witness to those who look after them, as well as to family members. As Vernon Grounds puts it:

“Without becoming a loquacious bore, an older person can testify of God’s faithfulness through the years of life. That is the message of Psalm 71. The older generation can pass on to the next generation....  Perhaps a grandparent’s congregation is one small grandchild, but how important it is that the upcoming generations hear about the spiritual experience of the older generations. The good news is that older people, if they look, can find opportunities for ongoing usefulness”.[4]

Older people can become increasingly lonely. True, retirement years are often an opportunity to make new friends, both in the church and outside. Moving into a retirement home or into sheltered accommodation can increase those opportunities. However, there comes a stage as we grow older that our circle of friends diminishes, and all the more so if ill-health causes us to become housebound. The good news, however, is that God never leaves or forsakes his people. As we read the Scriptures and pray for the elderly in our care, we can assure them afresh that there is nothing in this life or the next which can ever separate us from God and his love.   

As we grow older, we become more conscious of our mortality. Friends are dying and we realise that our own death may soon be imminent. Instead of denying the reality of death, our task as pastoral carers is to enable people to face up to their mortality. There comes a point when we need to speak words of hope. The good news is that, for those who die in Christ, death is not the end, but simply the beginning of a new and fuller life.

  

A ‘rant’ from my pastoral deacon

In the final stages of drafting this article, I showed it to my pastoral deacon, Ursula Franklin. “Paul”, she said, “your trouble is that you have yet to experience old age”. Almost immediately she sat down at her computer and produced the following ‘rant’ (her word, not mine). I found it insightful - and reproduce it in the belief that others will find it helpful too.

“At 80+, I observe more and feel differently, my wrinkled skin is sensitive; a kind of adolescent uncertainty and vulnerability together, with an impatient need to understand this world better, struggles to learn the new language that also seems to be the same words dressed up in party clothes.

My values are refined and fewer things are bothering, yet more things are challenging and shaming.

My energy is restricted, but there is the same impatience to understand the new discoveries and sometimes even they are the ‘old discarded ones’ - they are only rubbish after all.

The world of sound and sights becomes more precious and takes on new stimulating colours and force to birth new ideas and hopes. Yet my ability to discern and put into practice is still arthritic, fixed and immoveable.

The poor and destitute are ever wearing away my complacency, so why is my mind so restricted that solutions do not flow?

Fewer things are ‘important’; the abstract values have become gems half hidden by the grimy society. My incompetence remains the same - never enough initiative, energy or vision that can be made useful.

Teeming brains are striving to discover new cures for our disease ridden world. It is a technical search with no security of healing, no balm of love. What is crying out, pleading for recognition, is still not heard.

Communication is still poor; expressing what is exciting and intrinsically good is still snuffed out at birth.

Language has changed; it does not mean what it did previously for the shape and tenor of our world is foreign, yet so familiar. Our sickness is the same: NO love, only efficient formulae.

Our faith is often degenerate, taking familiar paths but not zinging with energy.  Christ’s challenge to love our neighbour as ourselves has little meaning for we do not love ourselves - we are objects to be used, tossed and left tangled in dissolution. How can Christ’s words become the words of life again and not the ritual cant of dead souls? Not ‘old souls’, but young ones with no focus or understanding of real sacrificial love and purpose. Where has the brooding Spirit gone? Are there no children of faith, so why can’t I speak to the deaf and the blind, the crushed and pustulent[5] souls around me? Why do I have no language and they no ears to hear?”

Ursula ended her rant with the comment: “Paul, this is a smidgeon of the frustration and incompetencies that stew in older minds. We talk of physical boundaries and they are real, but the boundaries of the Spirit are more disturbing.  How can they be met?”

[1] Chuck Swindoll, Strengthening Your Grip (Word 1982) 204.

[2]  Zalman Schachter Shalomi - quoted by Rachel Kohn, ‘The Ageing Spirit’ in Ageing & Spirituality across Faiths and Cultures (Jessica Kingsley 2010), edited by Elizabeth MacKinlay,  64.

[3]   Arthur Creber, New approaches to ministry with Older People (Grove, Cambridge 1990) 23.

[4]  Vernon Grounds, ‘A Personal Perspective’, 23-13 in Ageing, Death and the Quest for Immortality (Eerdmans, Grand Rapids 2004) edited by  C. Ben Mitchell, Robert D. Orr & Susan A. Salladay.

[5] A word not found in my dictionary - but a pustule is a ‘pimple containing pus’!