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BY: MARTHA HOLSTEIN, PhD

The theologian Reinhold Niebuhr once observed that confronting "the deeper terrors of the soul" gives meaning to human experience. For many people, old age is one such terror. Older people, especially those who are sick or frail, remind us visually and often viscerally of what we wish to evade for as long as possible. The young, with few exceptions, see the old as "other," while the middle-aged distance themselves from images of their future selves. Yet most of us will grow old, and at least some of the terrors we once held at bay will likely visit us.

To come to know the old in the first person is a step toward transforming our terror into a source of meaning. First-person knowing can alter our perceptions of aging and old age, help us see beyond wrinkles, white hair, shuffling gait, or stroke-induced paralysis to a whole person with a past, a present, and an identity. Believing that the world's religious traditions can assist in that process of "seeing beyond," the Park Ridge Center for the Study of Health, Faith, and Ethics (PRC), Chicago, undertook a three-year project called The Challenges of Aging: Retrieving Spiritual Traditions.

A major source of wisdom for the project's researchers was the stories and concerns of older people, especially when they talked about the religious and spiritual dimensions of their lives. These interviews, combined with an exploration of how the five major religious traditions think about aging and old age, became the foundation for a program that could be used to teach members of religious congregations:

• What their traditions have to say about old age
• How they might apply this wisdom in visits with older people in nursing homes

The Project
PRC researchers visited three nursing homes in the Chicago area and talked with more than 45 residents, staff members, and administrators. All three homes were affiliated with not-for-profit organizations. All three had a high quality of care; high levels of staffing; some connection to surrounding communities; and a variety of programs and activities, including religious ones, available to residents. All residents interviewed were very elderly, nearly all were white, many had dementia, and most came from the same general economic background and were of the same religious backgrounds (Jewish and Christian) as other residents of the homes.

Although residents interviewed talked with relative ease about death and spoke of using the time they had left to take stock of their lives, their nursing homes are very much "about" living. In that regard, religious activities served multiple social and psychological functions. They offered—in addition to worship, ritual, and other specifically religious activities—social interaction, spiritual enrichment, and emotional interaction with staff and others. Even those residents with advanced dementia often participated in prayers, singing, and other religious rituals.

The researchers also explored views of aging as reflected in the literature of Christianity, Islam, Judaism, Buddhism, and Hinduism. They found in these very different traditions a number of common themes that could be used to form a foundation for the PRC training materials on Christianity and Judaism. This comprehensive training program—which includes a trainer's manual, participant's workbook, handbook, and two videos—weaves together the voices from interviews, the words of the Hebrew Bible and the New Testament, and other religious literature. The program thus fashioned focuses on aging as a spiritual journey, as a blessing, as an honor, as a covenant, as faith, and (for Christians) as grace.

As the researchers began to use the training materials with members of religious congregations, it became clear that each of these themes deeply engaged participants and revealed possibilities for wider cultural relevance. These religious views, if taught and made part of the day-to-day worldview of anyone who knows and cares for and about frail older people, can help launch a process of cultural transformation. They also can, more modestly, affect the quality of public and private relationships with elders.

The Context
During the course of the project, researchers saw first-hand how vital the cultural dimension is to the quality of the aging experience. The way American culture understands the role and importance of the elderly has an enormous impact on how we experience old age.

Indeed, for most of its history, America has struggled with old age. In colonial times, the great Protestant divines emphasized the honorable place of the aged in God's great plan for humankind. By the early 19th century, though, the great age of Jacksonian democracy and the need to master a new continent left little tolerance for those unable to keep up, to manifestly live the quickening spirit of the age. For more than a century, old age conjured negative images of decline and loss, while a variety of writers announced the social and intellectual uselessness of people over 45 or 50.¹

In 1969 Robert Butler, a psychiatrist who became the first director of the National Institutes on Aging, coined the term "ageism," reminding his audience that systematic negative stereotyping directly harmed the well-being of older Americans.² With that gauntlet thrown down, the effort to rescue older people from the culturally imposed myths and stereotypes has proceeded apace. New images—slim and trim 70-year-olds on the golf course or riding bicycles through hilly terrain—both tame and glamorize old age. It is not so unlike middle age after all; we can age "successfully" and "productively," reserving the nursing home bed or the bedpan for the hidden few.

But myths and stereotypes are not so easily overcome. They serve useful functions in a culture that wants to distance itself from both death and old age. By emphasizing the positive features of old age, one can obscure a great deal—that, for example, the ability to age "well" depends in large measure on living in safe and nontoxic communities, having regular access to good healthcare (access that many cannot afford), and possessing the other benefits that an adequate income and supportive community provide.

Americans also need to learn, as our Puritan ancestors knew so well, that the positive and negative poles of aging are always simultaneously present. A culture that devalues mental or physical slowness cannot see—as does Jungian analyst Florida Scott Maxwell—that though drab on the outside, many elders burn inside with a fierce energy that can no longer be expended.³ It is easy to watch John Glenn, in blooming health, go once again into space; it is hard to watch the woman searching the halls of a nursing home for her long-dead child. Both are part of the aging experience.

The PRC interviews with nursing home residents revealed that religious reflections about old age could challenge the dominant culture's inadequate understanding of the aging process. The religious traditions offer a way to reconcile the good and the bad, the positive and the negative, by encouraging a view of aging that blends the realities of loss with a potential for growth and change. They also integrate, rather than implicitly marginalize, older people with physical or mental disabilities. In the tradition of covenantal relationships, religion also reminds us that at no time are we excluded from responsibilities, although those responsibilities change as our abilities change.

Aging in the World's Religions
Questions about meaning and purpose in human life have traditionally been under the purview of religion, yet contemporary culture reflects an understandable skepticism about the relevance of religion to the experiences of aging. How can the religious traditions—developed hundreds or even thousands of years ago—respond to the significant challenges faced by today's elders and those who care for them?

Although differing in many ways from one another, the world's five major religions say much about the experience of aging. Each challenges conceptions of the elderly that tend to dominate contemporary secular culture. They ask, for example: How can the elderly maintain their sense of self in the face of potentially momentous physical, emotional, and social changes? How can they communicate their experience and wisdom to others? And, ultimately, how do elders make sense of increased dependency, loss, and death?

The religious traditions insist that the elderly can play a valuable role in developing the cultural, political, and economic priorities of their communities. When older people are able to encounter and learn from the spiritual challenges of aging, they can bring to the public arena particular qualities only they possess: a long-term perspective encompassing wisdom, faith, and compassion that can be present despite loss. As the religious traditions assert, when elders are not integrated in society, the dignity and integrity of all are compromised. Society's first challenge, then, is to create an environment conducive to elders' spiritual aging and social involvement. The second challenge is to transform younger people's attitudes toward the elderly so that the culture does not cast them into the role of "other." This transformation requires coming to know elders deeply and fully.

Broadly speaking, religious perspectives on aging originate in a seeming paradox: Humans experience growth in the midst of physical decline. The religious traditions reconcile this challenge by viewing loss—be it physical, psychological, or social—as fertile ground upon which spiritual growth can flower. The losses associated with age catalyze the beginning of a spiritually rich phase of life. As individuals grow and change, the most difficult circumstances often shape their spiritual lives.

The conditions of later life, including the awareness that death is inevitable, often bring renewed urgency to the spiritual quest. In this way, the events of later life—the possible or actual loss of family, friends, work, health, mobility—might be viewed as an invitation to meet with particular vitality the spiritual challenges of aging. These challenges encourage older people to reflect inward, evaluate their relationships and choices, and come to terms with what was and what is in their lives. Thus, from the perspective of many religious traditions, the later years are not the denouement of the life story; rather, they represent the meaningful culmination toward which life has been tending (see Box).

Despite their historical and theological differences, the spiritual traditions of Judaism, Christianity, Islam, Hinduism, and Buddhism have all reflected considerably on the aging process and on the significance of the elderly for society. Each tradition's sacred texts point to late life as an honorable phase of the life cycle that presents distinct opportunities for spiritual growth and community involvement. In From Age-ing to Sage-ing, Zalman Schachter-Shalomi and Ronald Miller note that "all the world's spiritual traditions hold up models of realized elders. There are the roshi in Zen Buddhism, the lama in Tibetan Buddhism, the sheikh in Islam, and the rebbe in Hasidic Judaism. Each tradition offers a set of practices, handed down through an unbroken lineage, that leads to self-knowledge."⁴ This self-knowledge proceeds, in part, from the development of a perspective on life that only longevity affords. As Bernice L. Neugarten puts it, "One special satisfaction that old people talk about is that you now understand life in ways that no young person can understand it. That you have a certain new kind of wisdom."⁵

The elderly can take stock and reexamine and shape new meanings from a whole life for the benefit of themselves and others. Many religious traditions consider later life a contemplative period. As individuals age, the roles and responsibilities of work and family diminish, freeing them to focus their attention on questions of meaning, purpose, and the work of integration. In this sense, older people have the privilege of time, the opportunity to modify activities no longer possible for them and develop ways to live with new and different capacities. Sometimes this change involves a letting-go to permit, in the words of Schachter-Shalomi and Miller, "shifting identity from the smaller self, which is concerned with personal survival and well-being, to the larger self," which acts out of a deeper awareness of and concern for the whole of creation and one's place in it.⁶ Aging may involve a shrinking of the external world but, from religious viewpoints, there can also be a "broadening of the mind and expansion of the spirit."⁷

The Elderly in Community
The religious traditions tend to view the elderly as bearers of collective memories and valued knowledge, which makes them particularly deserving of respect, regardless of their mental or physical capacities. From the Hebrew commandment to "honor thy father and thy mother" to the practice of honoring ancestors in Buddhist prayer rituals, respect is a powerful religious obligation. Respect for elders presupposes a community of interests—rarely available in today's world—shared by the young, the middle-aged, and the elderly, to which the elderly make a particular contribution. This contribution, in religious terms, honors the elderly not for what they do but for being fully who they are.

This focus directly confronts mainstream American cultural norms, which value individual autonomy, activity, and productivity. These American preoccupations can easily lead one to devalue the relative inactivity and interiority of later life and to overlook the contributions elders can and do make, even when impaired. Rejecting the values and viewpoints cultivated in this time of life causes many to forget that, in religious terms, "growing older gives us an opportunity to practice dispositions essential for growth in the spirit, such as gentleness, joy, gratitude, and surrender."⁸ Such qualities contribute to the greater harmony of self and society, and are an important counterpoint to the intensity and busy-ness of our earlier years.

This idea points to one of the most critical contributions that religions make to the discussion of aging. Each tradition calls on older people to take up important roles and responsibilities vis-à-vis their communities, roles we do not expect to see filled by younger people. From the religious viewpoint, these roles, broadly conceived as "wisdom givers," can be filled only by elders whose life experience gives testimony to the larger truths of existence.

Elders are called first and foremost to play a role in mediating the relationship between the temporal and the eternal. As the PRC interviews affirmed, death is a constant aspect of life for nursing home residents. But, like most older people, nursing home residents are more comfortable talking about it than are staff and families. We can learn from their level of comfort. Being in the company of the elderly—and encouraging them to talk freely—can remind younger people that the present moment is precious, whether that moment is difficult or delightful. Seeing an older person struggle to walk or even to talk, observing an older person relish the company of others, younger people can remember and be grateful for all that they have and do in this moment of their lives. Thus, from the religious perspective, elders can teach that life is always a gift.

According to some traditions, older people are also witness to the eternal. Again, the value many religions place on being helps society perceive elders' presence as a reflection of eternity. For Christians, this may be an understanding of heaven; for Hindus, it might be the unity of Brahman. Elders, occupying a place of relative stillness and contemplation, are perhaps closer to the divine or, as in Buddhism, to some greater truth about the nature of existence.

From the religious viewpoint, then, one honors God by honoring the elderly who suggest the presence of the spirit in the fullness of their age. By virtue of their long lives, older people also share a broader and deeper perspective on what is important in life. They can teach—either by positive or negative example—lessons about love, faith, forgiveness, and acceptance, if only someone will listen.

Religious Realism and Aging
Although the religious traditions view aging as a vital and integrated phase of the life cycle, they do not ignore its more negative aspects. Indeed, each tradition frankly acknowledges its disadvantages. One Buddhist text openly acknowledges the sufferings of old age:

Painful is it to see one's body
Becoming frail and quite worn out
Who can help but feel dismayed
At the threat of growing older?⁹

As our interviews showed, many older people today acutely feel the sense of loss, uneasiness, and isolation expressed in these ancient verses, a sense confirming the relevance of religion to the contemporary experience of aging.

Enormous variety marks the human experience of aging, and the religious perspective calls on all believers to value this diversity just as they are to value the diversity of all creation. Whether it is the 80-year-old who just earned her college degree or the 80-year-old who has been bedridden for several years, each older person has something different to teach those around him or her. Older individuals who can neither speak nor move can nevertheless demonstrate how one can find peace in stillness. They can also show how life can be less than ideal but still rich with meaning and possibilities. Other older people, still active and vigorous, inspire others to live life fully, even within the limitations of age.

As Henri Nouwen observed, "Aging is the turning of the wheel, the gradual fulfillment of the life cycle in which receiving matures in giving and living makes dying worthwhile. Aging does not need to be hidden or denied, but can be understood, affirmed, and experienced as a process of growth by which the mystery of life is slowly revealed to us."¹⁰ This religious insight goes to the heart of the contemporary experience of aging: Longer lives afford more time to learn to live with compassion and wisdom.

Dr. Holstein is senior research associate, Park Ridge Center, Chicago.

The Park Ridge Center project was made possible by funding from the Nathan Cummings Foundation; the Open Society Institute (Project on Death in America); the Mather Foundation; Robert A. Pritzker; and the Emily Davie and Joseph S. Kornfeld Foundation. The educational program The Challenges of Aging: Retrieving Spiritual Traditions, as well as the handbook of the same name, from which parts of this article were adapted, is available from the Park Ridge Center, 211 E. Ontario, Chicago, IL 60611; phone 312-266-2222.

NOTES

1. See Thomas Cole, The Journey of Life, Cambridge University Press, New York City, 1991.
2. Robert N. Butler, "Age-ism: Another Form of Bigotry," The Gerontologist, vol. 9, no. 4, 1969, pp. 243-246.
3. Florida Scott Maxwell, The Measure of My Days, Penguin, New York City, 1978.
4. Zalman Schachter-Shalomi and Ronald S.Miller, From Age-ing to Sage-ing: A Profound New Vision of Growing Older, Warner Books, New York City, 1995, p. 67.
5. Bernice L. Neugarten, "Growing Old as Long as We Live: An Interview," Second Opinion, November 1990, p. 48.
6. Schachter-Shalomi and Miller, p. 69.
7. Neugarten.
8. Adrian Van Kaam, Aging Gracefully, Pauline Books & Media, Boston, 1992, p. 7.
9. The Hundred Thousand Songs of Milarepa, translated and annoted by G.C.C. Chang, University Books, Secaucus, NJ, 1962, pp. 554-555.
10. Henri J. M. Nouwen and Walter J. Gaffney, Aging, Doubleday, New York City, 1990, p. 14.

Copyright © 2000 by the Catholic Health Association of the United States
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