Reflections on Pastoral Care to the Elderly
1. Some Comments on the New Testament View on Life and Aging
Compared to the Old Testament, the mention of elderly in the New Testament is scarce. Only three persons are mentioned by name, all in Luke's account, and all in connection with the birth of Jesus. They are Zechariah, his wife Elizabeth, and Anna, who receives special mention as being "very old." She was a widow until she was eighty-four.1 A possible fourth elderly person is Simeon (Lk 2:25-26), but there is no actual reference to him being old. However, the fact that it had been revealed to him that he would not die before he had seen the Lord's Christ is generally taken to mean that Simeon was advanced in years.
One conclusion we can draw from this scant information is that in the New Testament the emphasis is no longer on the quantity of years, but on life with the Lord that continues on. The focus has been re-directed from life as an earthly existence, to life on earth with a view to the life to come (Col 3:1-4). Christians are en route to the new earth and new heaven where God will dwell with redeemed humanity. And so we can say that, for Christians, this life is a prelude to eternal life.
1.2 Life, a Prelude to Eternal Life
What is the core concept of life from a New Testament perspective? As in the Old Testament, so the New traces life as coming from God. But there is a shift in emphasis. While the old dispensation focussed predominantly on the covenant relationship between the Creator God and the creature with regards to life on this earth, the new dispensation deals primarily with re-created life through the Son of God. Simply stated, Christ is our life (1 Jn 1:1‑ 3; 11:25) and access to God is through the Son (Jn 14:6). Life with Christ is living under the umbrella of God's protection. In the Sermon on the Mount, Jesus talked about living without worrying because the Father will take care of our needs (Mt 6:25-34). Christians can unburden themselves with Christ and find rest for their souls (Mt 11:25-30). These are wonderful messages of hope that can be related to the elderly in pastoral care to them as they journey from this life to everlasting life.
Among some Reformed believers, doubts persist about the "worthiness" of being saved. This happens when they look at themselves and their sins, rather than look on Christ the Saviour. If there was one man who had reason to doubt God's saving grace, it would be Paul. He could not forget his "sins of youth" either. As an old man he could not forget that in his youth he persecuted the church of God. Time and again he mentioned it, even calling himself the worst of sinners.2 Still, he did not dwell on his past so as to cast doubt on his salvation; he put his past in the spotlight of God's grace, and rejoiced in the renewal of his life in this way: "But by the grace of God I am what I am" (1 Cor 15:10). Like the Old Testament believers before him (cf. Ps 103; Isa 1:18), Paul knew of God's forgiving grace. In pastoral care to the elderly, this glorious message may and must be proclaimed for their benefit and encouragement. Life with God is sustained by God's grace. By grace we are saved through faith (Rom 1:17; cf. Hab. 2:4; Eph 2:8). Saved from sin, and saved for eternal life.
While this hope and expectation of eternal life with God is great news, the fact is that, before we reach that state of perfection, life needs to be lived on earth. Since life is a journey and a prelude to eternal life, we also need to look at some of life's duties within the church community.
1.3 Duties within the Church Community
1.3.1 General Pastoral Duties
To the young pastor Timothy, Paul wrote: "Have nothing to do with godless myths and old wives' tales; rather, train yourself to be godly" (1 Tim 4:7). These instructions were written to Timothy to tell him not to get embroiled in useless talk. At the same time, he should not let anyone look down on him because of his youth (v.12). This word of advice applies to all those labouring in pastoral care. One of the difficulties that can arise is that an elderly person does not want to accept a much younger elder or deacon. But if elders and deacons stay above the fray, they can provide leadership as shepherds of God's flock and as examples for the congregation to follow (1 Pt 5:1-4).
Paul reminded Timothy that as a pastor he would have to deal with people of all ages. The sound pastoral advice Timothy received was: "Do not rebuke an older man harshly, but exhort him as if he were your father. Treat younger men as brothers, older women as mothers, younger women as sisters, with absolute purity" (5:1-2). The message is: do not let anyone in your charge get away with sinful behaviour, but in correcting them, an attitude of love, humility, sensitivity, and respect must prevail.
What are some of the items that need attention in pastoral care to the elderly? If we take Paul's instructions to Titus and Timothy as our standard — and there is no reason to assume that human nature has changed — then we need to pay attention to such areas as: teaching the elderly to be temperate, worthy of respect, self-controlled, and sound in faith, in love and in endurance. Likewise our elderly need instruction and correction where necessary. They need to be reverent in the way they live. We can say: they need to act their age. Since gossip receives special mention, the elderly need to be reminded not to say things that slander (Tit 2:2-3).
1.3.2 Specific Duties
22.214.171.124 Addressing Real Need
In his instructions to Timothy, Paul draws specific attention to the place of widows in the church (1 Tim 5:3-16). He focusses especially on the task of the older widows and gives this explicit instruction: "If any woman who is a believer has widows in her family, she should help them and not let the church be burdened with them, so that the church can help those widows who are really in need" (5:16). Timothy should give proper recognition to those widows who are really in need, i.e., those who had no other means of support and who therefore depended on the church for help (5:4). Paul wanted to make sure that those who really need the help and attention are the ones who receive it (5:16).
We can learn a practical lesson from this with regard to pastoral care to the elderly. Everyone loves attention but concern should be channelled first to those who really need it. Age alone does not determine the level of attention a person should receive; the specific need of the person should help determine how much time and attention he should receive in pastoral care. An elderly person in her eighties who is still healthy and mobile, may have less need for pastoral care than a sixty-five year old person who is housebound. The church must give attention where the need is greatest.
But in addressing the needs of the elderly, Paul is quite adamant in stressing the role of children towards parents.
126.96.36.199 Duties toward Family
Children and grandchildren should learn first of all to put their religion into practice by caring for their own family and so repaying their parents and grandparents, for this is pleasing to God (5:4). Paul's words seem harsh when he says that anyone who does not provide for his relatives, and especially for his immediate family, has denied the faith and is worse than an unbeliever.
The guidelines Paul presents are important for the proper functioning of the church community. His instruction to Timothy is an expansion on the Old Testament value system which required respect for elderly, and care for orphans and widows. I agree with J.N.D. Kelly's comments on 1 Timothy 5:3-16:
This surprisingly long section throws a precious light on conditions in, and problems facing, the apostolic Church. In Judaism widows were regarded as the object of special solicitude, the obligations of the good Jew towards them being deduced from the Fifth Commandment, and Christianity naturally inherited this attitude.3
This view is also supported by Acts 6 where the first Christian church in Jerusalem took action to look after the widows. Also James made the plight of the widows a matter of concern for the church Jas 1:27). Therefore, in 1 Timothy 5, Paul is expanding upon the obligation within the Christian church in conformity to the Old Testament requirements. The New Testament church community builds upon the principles of communal life as stipulated in the Old Testament covenant community.
Paul's instructions to Timothy remain of great practical value. Here we can point to the role of pastoral care not only to, but especially on behalf of, the elderly. Aging parents sometimes need help, and the first responsibility in helping out lies with the children. Interestingly enough, Paul writes that the children and grandchildren need to learn this responsibility. It does not come automatically and, therefore, the children need to be reminded of their duties at times. It is so easy to get totally absorbed in one's own nuclear family and one's own world, but a God-given responsibility to assist the parents when necessary, remains. Life is a two-way street. While on the one hand we read in Scripture that parents ought to save up for the children (2 Cor 12:14) — and from the context it is clear that Paul uses the term "to save up" not only for possessions (v.14) but also in the sense of spending one's time and energy (v.15), in other words, to stand ready for the children — in his instruction to Timothy (1 Tim 5:8) he shows the other side of responsibility within the family. When parents are in need of help the roles may become reversed where the children ought to help out their parents with their time, energy, and financial support. In pastoral care for the elderly, this responsibility needs to be impressed upon the immediate family of the needy elderly.
This biblical principle needs to be practised within our Reformed church community. When elderly persons are in need, they may rely on the church deacons and the church community for help, but the children are expected to be involved and do as much as they can for their parents. The point is, the children should take the responsive and leading role towards elderly parents who have specific needs, and assist them wherever and whenever possible. If they do not, they deny the faith, i.e., they fail in their Christian duties as faith demands of them.
Sometimes the relationship between parents and children is strained. In that case the role of pastoral care is to try to bring them together and restore the relationship.4 From a New Testament understanding, anyone who does not to the best of his/her ability look after the needs and affairs of his/her immediate family acts worse than an unbeliever. This comment by Paul is very much religiously charged, and I believe he wrote it to shame Christians into action. If Christians look around them they will find that unbelievers sometimes display great dedication in helping family. They put Christians who ignore their family to shame. Christians who do not acknowledge their responsibility towards family act worse than unbelievers.
Paul is setting a high standard for us to follow. He is intimating that Christians ought to be shining examples. Unbelievers should not be examples of a loving attitude for Christians; it should be the other way around (Gal 6:2) especially when it pertains to (elderly) parents.
Only a few elderly are mentioned by name and a preliminary conclusion seems warranted that in the new Testament the emphasis is no longer on the quantity of years, but on life with the Lord that continues on eternally. This life forms the prelude to life with God forever which is promised through faith in the risen Lord. Christians are en route to the new earth.
While there is the focus on the new life, the New Testament, like the Old, portrays life with God as staying in the ways of the Lord. Life under the umbrella of God's care and protection is now a life of trust in Christ's saving work. In the Sermon on the Mount, Jesus encouraged his followers not to worry about tomorrow (Mt 6:25-34), and urges Christians to place themselves into his care and to unburden themselves with him and so find rest for their souls (Mt 11:28-30). Elderly persons who doubt their salvation need to be assured that life with God is sustained by God's grace. Sins of youth need to be placed in the spotlight of God's grace. In pastoral care to the elderly the glorious promises of God in Christ must be proclaimed for their benefit and encouragement.
Those who labour in pastoral care should be aware that some elderly persons might not accept immediately a much younger pastor.
However, this should not stand in the way of carrying out one's ministry with an attitude of love, humility, sensitivity, and respect. Also, in providing pastoral care to the elderly the church must give attention where the need is greatest.
Life within the church community takes on certain duties in which the needs of the community are met. Special attention is given to the task of children to parents in keeping with the Old Testament requirement of honouring father and mother. The New Testament is not detached from the Old, but has its roots there, and is an expansion on the Old Testament value system. In pastoral care for the elderly this responsibility of children to parents may need to be stressed from time to time. God's requirement to honour one's elderly parents is not set aside.
2. Some comments on the needs Assessment Analysis by the Elderly
2.1 Greatest Adjustment
As one would expect, the loss of a spouse ranked at the top as the greatest adjustment in the lives of the elderly. 88% of the widows and widowers indicated this to be the case.
The next biggest adjustment was retirement. This is not so startling considering that the routine of a lifetime of work and daily involvement has come to an end. It is important to recognize that during the working years about two-thirds of one's waking hours is invested in work. That is more time spent on one specific activity than on all other activities combined. When retirement approaches some major adjustments need to be faced. Something needs to fill the void that is created when work demands are no longer part of the daily routine. This implies that retirement needs careful preparation.
Loss of income was also mentioned as a major adjustment. This signals that in pastoral care attention should be given to possible financial support from family and the church community if government assistance does not fully meet their needs. Here the task of the deacons comes into play and, as is clear from responses given by widows and widowers, the deacons did indeed offer this assistance to them. For a few, relocating to another town and church community required some adjustment.
2.2 Greatest Fears
Changes feared most were mental and physical decline. Here, an interesting phenomenon surfaced. Women tended to fear physical decline more so than mental decline, while the men indicated the opposite. Perhaps the reason for this difference lies in the fact that these elderly have grown up with the more traditional role of the woman as the homemaker and caregiver, and the man as the leader and breadwinner. Physical decline among the women would result in loss of homemaking and care-giving capability, and therefore loss of their greatest identity; mental decline among the men would result in loss of their leadership role and, hence, loss of their identity.
Another change some anticipated or dreaded is the fear of being or becoming lonely. Out of the thirty-two respondents who voiced a fear of becoming lonely, fifteen were couples. The reason for this fear may be that they are scared that if the partner dies, loneliness will be part of life. It appears that their fears can be calmed somewhat, for in response to the question as to whether the elderly are lonely, 78/117 or 67% indicated they are seldom lonely; 32% answered they are lonely at times, while only one widow in her eighties said she is always lonely.
These figures confirm the findings reported in a 1994 research paper stating that most older people are seldom lonely. I quote:
Research shows that persons under fifty-five hold the view that most older people are lonely, while in actuality, most older people report that they are seldom lonely ... the majority of older people have regular contact with their families, and many live within ten to fifteen minutes from some family member. Living alone does not limit outside activity or the development of meaningful social networks.5
My questionnaire results support this observation. Ninety percent indicated that they had family nearby, and there is a social network that the elderly use. A fair number are involved in church related activities. Others volunteer in the wider community, travel, or keep busy with hobbies. Making visits to family and friends also ranks high on the list.
No doubt, receiving visits also cuts down on lonely moments. About sixty percent mentioned that they receive visits from members in the congregation.
So then, the issue of loneliness seems to be a minor one. But the same research paper also states:
Although the research indicates that older persons do not suffer from such loneliness as the general public might imagine, nevertheless the ... trauma of widowhood produces a profound sense of loneliness in most older persons.6
If the authors mean that the trauma of becoming a widow or widower produces a profound sense of loneliness, my findings agree. The first year is hard and produces loneliness. Overall, however, my findings are somewhat different. Twelve widows and widowers age 70-79 and five widows in the 80+ years, 34% of all the widows and widowers, indicated that they are seldom lonely. The other 66% of the total number said they are lonely at times. That is not an indication of "a profound sense of loneliness." Maybe we need to inquire how the elderly define loneliness. Do they differentiate between being lonely and feeling lonely? Perhaps those who experience a profound sense of loneliness are the ones who are no longer able to be involved, or who are no longer physically active. Or maybe they do not receive many visitors from church members or the pastoral care team. This last comment is important in connection with another observation by the same researchers that:
The failure of the church to retain contact intensifies feelings of loneliness.
Sometimes, clergy and laity fail to recognize that even those elders able to attend religious services can still feel lonely because so many of their cohort have died.7
Which raises the question: How many pastoral visits do the elderly need?
2.3 Pastoral Visits
Realistic number of elder visits, 54% think two visits are the minimum requirement. These expectations are currently not met (only 21% received two visits). A significant gap of 33% needs to be bridged.
Concerning the realistic number of visits by the deacons, 65% expect one visit and 68% received one visit, is pretty well right on target.
Concerning pastoral visits by the minister, 45% expect at least two visits per year. Only 33% received two visits, a 12% spread.
These expectation of 54% of the elderly members for a minimum of two visits per year from district elder appears to be a realistic expectation. In most instances an elder has a section of, on average, thirteen to fifteen families or addresses. Taken over the whole year, visiting fifteen families twice a year works out to making two visits every three weeks. A schedule of one visit per week would enable an elder to visit the fifteen families three times in the year. This does not seem to be unreasonable, and the expectations by the elderly of two pastoral visits from their district elder seems realistic.
How realistic is the expectation of 45% of the elderly to receive two visits from their pastor each year? That depends entirely on the size of the congregation and the number of addresses he has. In a congregation of sixty addresses, two visits per year to each family translates into making four visits per week. That is manageable. When the number of families approaches the one hundred mark, it will be a real juggling act to visit every family twice. Anything above one hundred addresses makes two visits per year unrealistic. This means that if the pastor visits the elderly twice per year he would do so at the "expense" of other families. Since among us churches of more than one hundred families are not uncommon (Burl. Ebenezer has 165, and I urge all churches to list addresses in Yearbook to give more accurate reflection of workload), a solution needs to be found in order to address the pastoral expectations of the elderly. These expectations highlight the need for closer cooperation and coordination of visits between elders and minister so that each takes a responsible share in making visits to the elderly.
Most elderly would rather have short visits more often than few long visits. Visits of half an hour to forty-five minutes seem to be optimum for all. 74% distinguish between pastoral and social visits, and 68% consider visits from their elder or deacon to be pastoral visits. Two-thirds expect a pastoral visit to be concluded with Scripture reading and prayer; the other third did not have this expectation.
2.4 Greatest Pastoral Need
Responses to the question as to what the elderly consider to be their greatest pastoral need can be summed up under two main headings: assessment and communication.
Under this heading we find a variety of issues that need assessment on how to best help the elderly person. Most of these are relational issues and gravitate to purely personal needs. Two examples:
First, a man who himself served as elder for many years, mentioned that he longed to pass on his experience to the younger generation, especially the younger elders and ministers. He expressed the desire to instill a love for the confessional standards of the church and the importance of the Church Order to these office-bearers. However, he had difficulty communicating with his minister and elders. He demurred: "They listen, but do not answer or act upon it, and often go a different direction."
Two things come to mind here, the first being that this former elder considers it his duty to share his experience and to instruct the younger elders and ministers. In the second place, the fact that, in his opinion, the younger elders and ministers often go in a different direction may be an indication of a growing generation gap where elderly cling to old, and maybe ineffective methods, while younger leaders travel newer paths. In any case, in these comments by the elderly we have an indication that change is not desirable.
Second, a similar concern came from a widow who expressed the need to assess what is happening in church today and the direction the Reformed churches are going. It is obvious that this senior member looks beyond her own personal world. The broader church community plays a significant part in her life. In this she is not alone for another elderly person commented: "We need to discuss the change of views." These comments are solid indicators that church life and one's place within the church community rank high among the elderly. At the same time, these comments reveal a sense of unease in what the elderly perceive not merely as a change of direction, but what is for them a worrisome change from true and trusted paths. In these sentiments shine through a sense of collective responsibility to keep each other in the ways of the Lord (Dt. 29:18; 4:9), and they enforce the point that the elderly wish to stay involved, tuned in, and heard. Their belonging to the church is an essential part of their lives, and one they wish to guard and preserve where necessary.
Another area of pastoral need is meaningful communication. Many of the elderly responded that they have a need for frank and open talks where truth and openness are communicated. One person stated: "I need to talk about my place in the church." The elderly want to talk about their personal faith and share their struggles with others. It is interesting that the need to have these talks were voiced especially by the widows who miss regular communication because they are now alone. The need to talk about the faith in search for spiritual guidance and encouragement ranks very high. They are asking for a listening ear and meaningful dialogue.
When it comes to matters of faith the elderly wish to address issues of substance. They wish to talk about the Bible and about church matters; they want to talk about the Saviour and their final rest. They seek assurance of God's plan in their lives in order to be strengthened in the faith. From these responses, which came from quite a few elderly, it is clear that religion lives among them and has a prominent place in their lives.
2.5 Responses by Widows and Widowers
One question asked which period of bereavement was the most difficult for them. Both sexes replied that the first year was the hardest. This hardly comes as a surprise. Besides facing daily aloneness, a whole year of "firsts" had to be worked through in which birthdays, anniversaries, social outings and family gatherings had to be attended without a spouse.
More startling is the disparity between those who have been widowed for more than five years and still find it difficult. While twenty of the twenty-eight widows responded that after all those years they still find being alone difficult, none of the four widowers expressed that sentiment. It is difficult to assess this surprising discovery. If almost three quarters of the widows still find being alone difficult after five or more years, one would expect a similar ratio of three out of the four, or at least two out of four, to apply to the widowers. If anything, one would expect more widowers to be lonely because many men are lost without their wives since they were used to being looked after and now have to look after themselves.
One reason why widows may find the loss of the spouse still difficult after five years may be linked to the fact that nurturing and care-giving has been a major part of their lives. This stops when the husband dies and this vacuum perhaps translates into a form of loneliness. Also, women are generally more communicative than men who are more solitary by nature. Perhaps the widows miss the communication more than the men. Another possibility is that the women have always been dependent on the men so that the loss of a spouse creates a greater and more lasting vacuum in their lives. Whatever the reason for the difference may be, the questionnaire results seem to suggest that males have a different coping mechanism that lets them block things out and get on with their lives.
2.6 Fear of Dying
Three questions dealt with fear of dying. Sixteen people expressed such a fear, five widows and two widowers, and nine who were married. The overriding concern among the married couples seemed to be what would happen to the surviving spouse. In other words, it was not so much a fear for oneself — no one stated so — or being afraid to face God, but uncertainty how the surviving spouse would cope.
Nonetheless, death is still an "unknown" to be faced. That may be the reason why 61% of all the respondents expressed the need to talk about dying. Seventy-four percent of all the widows mentioned the need to talk about dying compared to 29% of the widowers. As to the question whether this issue is discussed with them, 56% said that their minister or elder never discussed dying with them.
To quickly recap the highlights: The greatest adjustment in the lives of the elderly is the loss of a spouse, followed by adjustment retirement brings. The greatest fear among the women is physical decline, among the men it is mental deterioration. Loneliness is not their greatest burden. As to pastoral visits, the visits of the deacons are what is expected; those of the elders are 33% below expectation, and those of ministers somewhere in between. On a scale of 1-10 the deacons would score 10, the elders 4, and the ministers 7. Most respondents consider visits by their elder or deacon to be pastoral visits.
Several elderly expressed fear of dying, but among the married couples this was more as a concern how the remaining spouse would fare when she/he is alone. Almost two-thirds expressed the need to speak about death and dying but that the issue is seldom discussed.
3. Some comments on the needs Assessment Analysis by Elders and Deacons
3.1 Where is the greater need in Pastoral Work?
The majority of elders and deacons envisaged the greater pastoral need to be among families (37%), next among youth (27%), followed by the elderly (22%) and singles (12%). The surprising element in these figures is that among those who mentioned pastoral care among the elderly as the greater need, the highest response rate came from deacons and elders in the 30-44 year range, and from the elders in the 55-64 age bracket.
What do we make of the fact that the youngest age bracket lists the elderly as needing the most pastoral care? As we learned from Payne and McFadden's study, persons under fifty-five hold the view that most older people are lonely. This may also be the perception of these elders and deacons and therefore they concentrate on the elderly. Indeed, in answer to the question what the elders and deacons perceived to be the greatest need or burden of the elderly, sixty-one percent of all respondents put loneliness at the top, and again, the highest numbers came from the 30-44 age bracket.
3.2 Why not Visit more than once per year?
Some replies here were interesting. One person said he does not visit more than once per year because he feels that the minister should visit the elderly, while another mentioned that the minister should be at least partially involved in visiting. One can fully agree that the minister should also visit the elderly in the congregation, but the comment that the minister should be the one to visit is out of tune with the expectations of the elderly. Elders do well when they take note of the expectation of the majority of elderly to have at least two visits per year unless they state they do not wish special visits. Does this mean that the majority of elders fail in their mission? No. Only one-third of them visit their section once per year. The other two-thirds visit twice or more a year.
Several office-bearers responded that visiting the elderly is enjoyable but that the greater need for pastoral care is among young families and among widows and widowers. Basically, if the elderly are still able to attend church every Sunday, the elder or deacon visits when the need arises, such as when there is sickness, death in the family, or other crisis. This approach seems to be in keeping with Paul's instruction to Timothy to look after those who are really widows, i.e., those who need it most (1 Tim 5:4). However, if elders and deacons only visit when there is a need, then their work will always tend to be reactive rather than proactive. The purpose of visiting is to build a relationship of trust so that people can and will confide in the pastoral caregiver (pro-active), rather than to show one's face when there is a need (reactive). Pro-active visiting takes more than one or two visits in a year.
One person listed inexperience for his not visiting more than once per year while another stated his young family needed time and attention as well. One's own family, of course, is an important responsibility. Careful time management in pastoral work should eliminate most of the problem. If, as I pointed out, a district of fifteen addresses can be visited three times in one year by making just one visit per week, it would appear that with proper planning the problem of not spending ample time with one's family can be minimized, if not solved. Regular visits would also overcome the matter of inexperience rather quickly.
3.3 Role of the Elderly
As to the question as to what the office-bearers consider the role of the elderly to be within the church community, a wide range of worthwhile comments and suggestions were made. Highest on the list is the expectation that the elderly give leadership and direction by teaching and motivating youth in keeping with Deuteronomy 29:18 and Deuteronomy 4:9. Others expected elderly persons to be role models by being examples of a trusting faith which radiates a happiness and contentment with life as a whole. The general consensus is that the elderly are looked upon as sources of wisdom and knowledge who share their experience with younger generations, inspire youth, and offer to be listening ears.
All these views recognize the fact that the elderly serve as a bridge between the past and the present. In essence, the expectation is for the elderly to play a similar role the elderly fulfilled in Old Testament times as sages and leaders in their communities. From these expectations by the office-bearers we get a true sense that says: the elderly belong. They have a task to fulfil for the good of the church community. This general opinion conforms to the biblical model that the older and the younger generations belong together. Even though they stand at opposite ends of the spectrum of life, they form one church community.
3.4 Role toward the Elderly
Concerning the task of the pastoral caregivers towards the elderly, two words were used repeatedly: comfort and encouragement. These words sum up the main area where the elders and deacons see the bulk of their work, and this ties in with the expectations they have from the elderly. The office-bearers not only expect the elderly to remain involved within the congregation, but they also see it as part of their task to motivate and encourage the elderly to remain involved and use their gifts in the congregation for the benefit of all, and not become isolated.
Especially the deacons confirmed my earlier remarks on duties toward the family that they see it as part of their task to provide pastoral care not only to the elderly but also on their behalf. Deacons are prepared to be motivators by reminding the children of their need to be involved with their aging parents in keeping with the directives given in 1 Timothy 5. The deacons see it as part of their task to remind the children that when parents are in need of help, they ought to help out their parents with their time, energy, and financial support, if needed.
Of special interest is the comment made by several elders and deacons that visiting has a twofold effect. In visiting the elderly they not only give, but also receive by learning from them. This is an important assessment because it allows for greater communication opportunities. It may make one even look forward to the visits which serve the purpose of mutual upbuilding. When such dialogue is present the elderly persons unintentionally become sages to the younger generation.
3.5 Difficulties in Visiting the Elderly
Difficulties in visiting the elderly can be grouped under three headings: communication, age barrier, and miscellaneous.
Language was mentioned as the main barrier among elders and deacons in the 30-44 age bracket.
Another obstacle is that many elderly experience a loss of hearing which makes communication difficult. Obviously, this also makes it more difficult to keep the conversation going and the topic focussed. Also the loss of mental capabilities by some of the elderly makes meaningful contact difficult. However, here we must qualify the word meaningful. What may not be so momentous or profound for the pastoral caregiver may be very meaningful for the elderly person. Therefore, a very meaningful visit can simply be to read some familiar Bible verses and pray with the person.
3.5.2 Age Barrier
Visiting the elderly can be somewhat daunting if there is quite an age gap. This is the perception of a number of deacons and elders who are the same age or younger than the children of the elderly they visit. On a casual basis this age difference is no problem, but in a pastoral function it makes the visitors feel insecure. Two main areas were highlighted. The first age barrier deals with gaining the trust or openness of the elderly; the second has to do with the young elder or deacon feeling intimidated by the elderly. This is clearly evident from responses such as: "it is difficult to give advice to people who have gone through more than I have," (a matter of life experience) and, "when something is wrong and you cannot say it" (a matter of generation gap).
Of course, these are areas in which younger office-bearers need to gain confidence. Scripture is definitely on their side since it states that if an older person needs to be rebuked, this should be done. The trick lies in how it is done. Paul's instruction to Timothy is helpful and significant on this point. It is of timeless quality when he writes: "Do not rebuke an older man harshly, but exhort him as if he were your father" (1 Tim 5:1), but also, "Don't let anyone look down on you because you are young" (1 Tim 4:12).
How real is this perceived age barrier? Only a small percentage (12%) of elderly feel there is an age gap that stands in the way of meaningful communication. In practice, then, age difference should not be an insurmountable problem, but one that young office-bearers should deal with on the basis of biblical directives found in Timothy. Regular visits to the elderly should go a long way in gaining their trust and openness. If elderly persons do not right away accept a much younger pastor this should not stand in the way of carrying out one's ministry with an attitude of love, humility, sensitivity, and respect.
It came as quite a surprise that some of the harshest comments about the elderly were voiced by elders over the age of sixty-five. But a general sense of frustration emerges when words as stubbornness, headstrong, self-centred, bored, complaining, and cantankerous are being used. There is a perception that among the elderly there is an uncompromising spirit, an unwillingness to change or to listen. Some have petty complaints and others are always critical of younger people. A number of deacons and elders observed among elderly persons a deep-rooted bitterness from dwelling on past incidents. They just are not able to let matters rest but keep on stewing on them and this makes the pastoral care needlessly difficult.
On a more gentle tone, many office-bearers also sensed that there are changes happening that move too rapidly for the elderly. Therefore we do well at this point to compare notes and interact with some of my findings that reflect the views of the elderly and which may help shed some light on, or even undo, some of the harsh criticism by a few elders and deacons.
When elderly people are viewed as complainers it is important to screen genuine concerns from complaints. For example, if there are elderly who are constantly down on youth, or harp on the olden days as better times, it can very well be that they do not see things in the proper perspective and are indeed complaining. In that case they should be reminded of the insights of the Preacher: "Do not say, 'Why were the old days better than these?' For it is not wise to ask such questions" (Eccl 7:10). Also, the elderly should be made aware that Scripture nowhere considers youth to be "bad" and elderly "good". Such complaining cannot be condoned. However, it may be that the elderly are trying to point out areas where they see things "going off the rails", so to speak. Their "complaints" may be voices of genuine concern that should be heeded because the elderly do worry about deviations from the tried and trusted paths and consider it their duty to sound the warning bells. This is in keeping with what is expected of them. One of the expectations the office-bearers have of the elderly is that they are wise and discerning people. As biblical wisdom is practical in nature, so the concerns of the elderly are usually practical in nature. Based on their long life experience they know that new things are not necessarily improvements. That is why they voice their concerns. Of course, if a deacon or elder does not share these concerns, it can be construed as complaining, especially if the matter is raised more than once.
From the side of the elderly came the comment that we need to analyse the way one gets older. This can be construed as simply being a word of advice that the elderly should evaluate their own aging process, but it is much more likely meant as a plea to the younger generation for understanding of the elderly and their needs. One can interpret this comment as a complaint that younger people do not understand the elderly, but that does not take away the fact that it contains a valid truth. Just as we need to understand and objectively evaluate the needs and aspirations of our youth, so we need to understand and evaluate the needs and convictions of our elderly. Especially when one's own age range falls somewhere in between, being no longer a youth and not yet an elderly person, any objective evaluation will be a challenge.
Regarding to charge of petty complaints, I am reminded of the person who mentioned that the music in church was too loud. To some of us that may seem like a non-issue. We may be ready to dismiss this as a petty complaint, but from personal contact with members who have suffered a stroke, or those who rely on hearing aids I have learned that for some of them the volume factor is a real frustration and obstacle. Pastoral caregivers need to be sensitive to these things, show discernment, and not be too hasty in judgment.
The idea that the elderly are self-centred emerges easily enough because they often talk about their own situation. Indeed, there are elderly persons who live in a very small world and who have little interest in the larger community. These are the men and women who become prime candidates for feeling bored, lonely and isolated. Perhaps this is what some deacons and elders faced who indicated they were bothered by the shallow interests some elderly show towards church life. These elderly have little perception of their role in the church community and are hardly involved.
But what constitutes involvement? Do the elderly and pastoral caregivers give similar content to the word? According to the survey done by the elderly, seventy percent believed they are involved and said they have something to offer to their church community. Nearly 40% indicated they would become more involved if asked. So, first, then, four in ten elderly need a nudge to become more active. And it is positive to note that elders and deacons see it as their task and follow through on giving such encouragement. However, most elderly persons indicated that their involvement is limited in scope. Not everyone is fit to serve on committees, teach Bible classes, or maintain church property. For the vast majority, involvement centres mainly around praying for others and visiting fellow elderly. Therefore, more creative ways need to be found to get them more deeply involved as advisers and to tap into their creativity. For example, some churches have set up a program in which elderly persons are asked to be mentors for college and university students living on campus. Their task is not only to keep a particular student in his/her prayers, but also to encourage the student through regular contact. In that way they can be teachers of youth. The important thing is that ways be developed in which elderly persons can use their gifts in the best way so that they will like what they are doing and are best at doing.
By far the most troublesome difficulty encountered by elders and deacons is when the elderly do not open up about their faith. Not a few elders voiced disappointment that the elderly sometimes lack evidence of faith or have a reluctance to talk about their faith. Unfortunately, the short, cryptic replies by the office-bearers did not always paint a complete picture. Nor do their comments appear to be representative of the views by the elderly. Two-thirds of the elderly, and among them especially the widows, stated that they have a need for frank and open discussions about faith. In these discussions they want to talk about their place in the church and wish to address matters of substance for them. They seek assurance of God's plan in their lives and they seek encouragement in growing older.
At the same time, many of the elderly responded that they prefer to discuss matters of faith with their minister. Maybe they wait for the minister to come and hold back on discussing pertinent matters of faith with their district elder or deacon. One reason for this may have to do with the fact that, in general, the older generation is fairly guarded about what they say and to whom. They do not so easily talk about family problems, or discuss the difficulties they experience with their children. Nor do they readily admit that they are perhaps struggling with past sins. Sins of youth can weigh heavily on the conscience and these are not freely divulged to others. But in order for healing to take place the Bible tells us to confess our sins to one another (Jas 5:16) and the elderly may feel most comfortable doing so with their minister.
It is entirely possible that the deacons and elders who lament that elderly persons do not want to speak about their faith are faced with this sentiment that the elderly prefer to speak with their minister. If so, this needs to be addressed because the office-bearers, too, are pastoral caregivers who minister to the elderly. Here we have further evidence of the need for more than one visit per year in order to win the confidence of the elderly before they share their faith and struggles with the officebearers.
While some elderly are reluctant to open up about sensitive issues, others have a hard time believing they are saved. This observation by a few office-bearers confirms that some elderly struggle with doubts about their worthiness of being saved. This happens when they look at themselves and their sins rather than look on Christ the Saviour. At times they have difficulty putting their trust in God's promises. Pastoral caregivers need to remind elderly persons of God's promise recorded in Isaiah 46:4,
Even to your old age and gray hairs I am he, I am he who will sustain you. I have made you and I will carry you; I will sustain you and will carry you.
Elderly persons who doubt their salvation need to be assured that life under God's umbrella of protection is sustained by God's grace. And for those who cannot seem to let matters rest but dwell on past incidents, the office-bearers can remind them of Paul's urging in Philippians 3:13-16 about forgetting what is behind and focussing on the goal to win the prize for which God calls his people heavenward in Christ Jesus (cf. Isa 43:18-19).
Regarding the charge that some elderly are stubborn and headstrong, one elder mentioned the difficulty of making the elderly see that they are not always right. No doubt such elderly persons exist and they make things difficult for themselves and others. But a similar sentiment of obduracy was also levelled towards pastoral caregivers by the elderly person who tried to pass on his experiences but felt that his insights and suggestions were ignored. When suggestions or concerns are not taken seriously it sends signals that the elderly do not belong. And it is precisely the longing for belonging that is strong among the elderly. They want to belong to a church community where they feel fully a part of the congregation. In an interesting article on old people in the church, Martina Blasberg-Kunke writes that we should recognize that the elderly with their unique needs have a special expectation of the churches. That expectation is to be wanted and accepted.8 They are attached to their religious roots. Koenig also highlights this sense of belonging and affiliation when he writes:
One of the reasons why older adults are more likely to be church members is that this generation is known for its pro-institutional stance, whereas more recent generations born since World War II have tended to be anti-institutional.9
This desire to belong and the pro-institutional stance of the elderly may play a role in the perception that the elderly are unwilling or unable to accept change. Elderly people crave stability and consistency rather than change. They have outgrown the desire of renewed challenges and rather stay in the tried and trusted paths they know well. This is an aspect of pastoral care that needs to be kept in mind. Pastoral care to elderly persons is care to individuals who belong to the community.
Let me sum up this section by stating that it is quite evident from the comments supplied by the elders and deacons that they have identified real day to day issues they are facing in ministering to the elderly. My interaction with some of these comments was not meant to minimize the concerns that were raised. If anything, my aim was to heighten our awareness of the issues raised by both the pastoral caregiver and the elderly, and by comparing both sides to get a better perspective on the issues at hand before proposing possible solutions.
3.6 Difficulty keeping Conversation going
Sixty percent of the elders indicated that they have some difficulty communicating or keeping the conversation going. A main reason for the difficulty cited by younger elders was the language barrier. One mentioned his personality as being in conflict with the elderly. Several others found the constant repetition an irritant and one even had trouble controlling his temper. Elders in the other age brackets mentioned communication on spiritual issues as difficult because some elderly do not respond much or they live in the past.
As to the comment by those who have difficulty when the elderly start reflecting on the past and becoming repetitious, it is necessary to point out that all pastoral caregivers, especially the younger ones, need to realize that by reminiscing the elderly are validating their life's journey. They are not just people who are old, but people who have grown old through times of rapid change and often through personal struggles. Many who are now in their seventies have experienced the terror of war in which they lost close family and friends. Many have experienced economic hardship, and for most there is also the experience of rapid technological change that has transformed their world from village life into the world as a global village. Therefore, when the elderly are reminiscing it is more than a living in the past; it is validating the past in and for the present. In talking with elderly persons of Reformed persuasion one often discovers that the underlying reason for reflecting on the past is not so much recalling how good or bad the past used to be, but how good the Lord has been. Hindsight is 20/20 vision; validating life is like hindsight. Reflecting on life with the Lord is reflecting on covenant faithfulness.
Evaluation of Needs Assessments by the Elderly and the office-bearers shows that there is much common ground. The greatest area of discrepancy is the perception of the needs. To make pastoral care to the elderly more effective, each elder or deacon will have to weigh whether he sufficiently understands, appreciates, and interacts with the needs and concerns of the elderly. How the different perception of needs will be harmonized is mostly a matter of individual maturing by the elders and deacons and growing in understanding of the needs of the elderly. This growing and maturing needs to take place on the biblical basis that old people belong. Their place within the church community is very important to them. It is one of the last vestiges in which they feel at home and where they feel secure and they seek to preserve it the best they can.
It seems to me that we must have clarity of purpose as to where and how the elderly fit in. Living in the covenant community is more than experiencing a personal relationship with God; it also involves the caring for and sharing of each other. The clearest vision of where and how the elderly fit in is found in the biblical example of the church as a community where everyone has a place and a role. We do well to take Georgina Bray's comment to heart:
Elderly people are not 'yesterday's church', just as young people are not 'tomorrow's church'. They are integral to the community of faith," and, "As we age we are not incorporated by the charity of younger members, but by our own standing in Christ are inextricably part of the whole.10
In pastoral care to the elderly there needs to be a perspective on a community in which the elderly have a place and where they fully belong.
To round off the evaluation of the questionnaire results, some strengths and weaknesses need to be mentioned. Under strengths we can list the fact that the pastoral caregivers are essentially "in tune" with the needs of the elderly. Their expectations of the elderly are biblically based. The majority sees the main task of the elderly as giving leadership and direction by teaching and motivating youth. They view the elderly as a bridge between the past and the present, and as people who have a task to fulfill for the good of the church community. In their role toward the elderly the elders and deacons consider it part of their task to stimulate the elderly to remain involved.
From the side of the elderly we can note that most of them feel part of the congregation where they are members, and church life is very important to them. Most elderly stay involved at their own level, and take seriously the expectation to be guardians of tradition as the living link between the past and the present. In spite of some criticism, the majority of elderly are satisfied with the pastoral care they receive.
Under weaknesses I would list the following areas that need serious consideration for improvement. First of all, the expectations of the elderly for at least two visits per year from their elder needs attention as this expectation appears to be a realistic and manageable one. Second, pro-active visiting is a must if elders ever hope to win the confidence of the people in their pastoral care. If visits are made based on need only, there will never grow a bond where the elderly person will confide in the pastoral caregiver. Third, since 61% of the elderly expressed a need to talk about death and dying, ministers, elders, and deacons should also be pro-active in addressing that need. Fourth, in their ministry to the elderly, the pastoral workers should be sensitive to the fact that things which may not bother younger members can be a real obstacle to the elderly.
Therefore the need to screen complaints from genuine concerns is imperative.
As for recommendations, my main recommendation is that all pastoral workers take the needs of the elderly seriously. During the visits they should allow the elderly to validate their lives. After all, the visit is first and foremost for the benefit of the elderly person. By lending a listening ear, we go a long way in showing them that they belong. Since many elderly seek meaningful communication in the visits they receive from their minister, elder, or deacon, this needs to be maximized for the mutual benefit of the elderly person and the visitor. Then the visits will not only become more meaningful for both, but also interesting and pleasant.