The final frontier

The challenge of aging gracefully

by Caroline Vickery | Presbyterians Today

At the end of the Gospel of John, Jesus tells Peter, “I tell you, when you were younger, you used to fasten your own belt and to go wherever you wished. But when you grow old, you will stretch out your hands, and someone else will fasten a belt around you and take you where you do not wish to go.” According to the Gospel writer, Jesus said this to indicate by what kind of death Peter would glorify God.

Having spent a goodly portion of my pastoral ministry in retirement centers, care centers, nursing homes, rehab facilities and assisted living facilities I think today’s version of this passage might read a little differently. Perhaps something like this:

When you grow old, someone will fasten a belt around you, hoist you from bed to wheelchair, and say, “Now, honey, let’s get ready to go down to breakfast,” even if you just wanted a cup of coffee and to watch The Farm Report in your own room.

As technology and medicine keep us alive longer and longer, we face challenging questions: How do we glorify God in our last few years of life? How can we respond faithfully with failing bodies?

Old age is a time to remember that in baptism we are called to be connected and to let ourselves be loved. Ethel A. Vickery and her granddaughter share a loving moment. (Photo courtesy of Caroline Vickery)

My mother earned two master’s degrees and loved traveling, the opera, knitting and punk rock. She would recite Jabberwocky from memory, and her favorite book was The Golden Mean: Mathematics and the Fine Arts by Charles F. Linn. She was charming, smart and compassionate.

Yet she spent the last year of her life feeling imprisoned in a body that would not hold a book or a knitting needle. She could not hear voices over the telephone, her voice was too weak to use Skype or Facetime technology, and she could neither walk nor fully sit upright after she had emergency surgery.

Embarrassed by her limitations, she sometimes discouraged visitors because she felt ugly and useless. To those who did come, she was friendly and interested but would get angry at herself when she would get sick during a visit, frustrated with those who could not easily handle her wheelchair, and annoyed that she needed special silverware in order to feed herself with shaking hands. Despite her limitations, she was able to keep her dry sense of humor.

“Find any treasures?” she’d ask on the days we spent clearing out her apartment, her last link to her independent life.

I had always been proud of my mother. I grieved with her over her loss of dignity and privacy and over the boredom of her days. But I did not want her to die.

‘A spiritual journey’

Richard L. Morgan, co-author of Pilgrimage into the Last Third of Life, says that life can be divided into stages: the First 30, from birth to about age 30, when we are building our lives; the Second 30, from about 31 to 60, when we are working and creating; and the Third 30, from about 61 on, when we are generating our legacy.

According to Morgan, aging is a gamble because in the first two-thirds of life most of us experience an increase in physical and mental abilities. However, in the last third, changes in physical and mental health will predict and define our quality of life until death.

While aging comes with uncertainties, it can also be a time of great spiritual growth.

“Aging is a spiritual journey, and as we become older adults each of us becomes more unique,” said Quentin Holmes, chairman of the older adult ministries team for Presbytery of the Cascades. The Confession of 1967 tells us that life, even old age, is a gift to be received with gratitude and a task to be pursued with courage.

In the Hebrew understanding of being a human, there is a connection between the mind, body and spirit. What happens with one part of us affects our whole being. Dealing with new physical and mental limitations can end up being a spiritual challenge.

We are created in the image of God, not in the sense of having limbs and faces, but because we were created for relationship, with energy, intelligence, imagination and love. Just as God receives our worship as an act of love, so receiving love from others in our lives can be an act of Christian ministry on our part. Receiving help and welcoming love are spiritual challenges for many of us who are more comfortable in the role of caregivers. But receiving help graciously can be as powerful a way of glorifying God as being the one to reach out with kindness.

A sense of purpose

Morgan says old age can be a time when folks “whine, recline and decline,” or it can be “a time to shine with the Holy Spirit.” Our outlook can be determined in part by how we respond to the challenges of aging.

Morgan believes that people of every age, even the frail elderly, need a sense of purpose. Rather than helping older adults find ways to put their talents and energies to work, however, the church often treats them as “the Model T in the parlor.”

“There was a farmer who had a Model T. He shined it, polished it, kept it in good working order, but kept it in the parlor. It was never on the road, never went anywhere,” Morgan said.

“Churches often patronize the elderly, isolate them, provide large-print bulletins but don’t provide meaningful ways to serve.” Before he retired in 1989, Morgan created a model of ministry in a nursing home where his church in North Carolina had an outreach: he recruited residents of the nursing home to serve as volunteers who would visit other residents there.

Created for connection

Our society has created an idol out of being productive, independent and purpose-driven — so much so that many of us no longer see ourselves in the image of God in our old age. Yet that is not what the confessions teach. According to the Westminster Catechism, our chief end “is to glorify God, and fully to enjoy him forever.” Even in our old age.

The Catechism doesn’t teach us to do as much as we can to earn God’s favor; rather, it reminds us that we are created for relationship and for connection with God, connection that can be had even as ALS or Alzheimer’s strips us of our productivity and ability to care for ourselves.

When we lose the ability to care for ourselves, we are left with a stark reality: No one is truly independent. We may live with the illusion of being self-sufficient. We may worship the idol of being productive. We may take pride in our ability to pull up our own bootstraps or to put on our own shirt. But God does not love us because of what we can or cannot do, but because of who we are. God shines the light of love upon us simply because we exist.

This gift of unmerited, existential love is seen most clearly in the sacrament of baptism. We baptize infants and adults, not because they have done something to deserve it, but because God’s love is unconditional. In infant baptism in particular, our dependence upon God is clearly demonstrated

The church welcomes infants as God’s gift to us. As families and congregations, we affirm that our job is to care for them and to share God’s love with them. We do this even though they contribute very little to our community. Infants cannot read, tithe or head a committee. They cannot feed themselves or walk on their own.

As older adults become more frail, they become like infants again. They are no less valuable than the children we baptize. In fact, old age is a time to remember and claim what we learned in our baptism: We are called by God, not to be productive, but to be connected. We are to let ourselves be loved.

Church as the body of Christ

Connecting with those who are not able to leave their homes or are spending their days in care facilities is a crucial ministry of the faith community. Relational ministry helps overcome crippling, debilitating isolation and reminds those visited to whom they belong.

Learning how to gracefully receive care from the hands of others can be a challenge after years of being taught to value self-sufficiency. Even ordinary tasks like getting dressed and washing hair can require the help and care of another. (Photo courtesy of Caroline Vickery)

The church needs to show the elderly and “illderly” (a term that Morgan uses to include the frail elderly) that they are still valued, through consistent visits by pastors and members.

“A young minister once told me he was going to visit all the older people first and ‘get that out of the way!’ — an ageist comment,” Morgan said. “The frail elderly are often warehoused in nursing homes or confined to loneliness at home.”

A church can grow its ministry to older adults by offering seminars that address concerns about aging, including Alzheimer’s and other forms of dementia, Social Security and Medicare issues, and advance directives.

“How the faith community relates to its older members — recognizing their presence, encouraging their contributions, responding to their needs and providing appropriate opportunities for spiritual growth — is a sign of the community’s spiritual health and maturity,” said Michele Hendrix, president of Presbyterian Older Adult Ministries Network.

The end is the beginning

As a baby, my mother had colic and cried out for the love and care that she needed. In her infancy, she was baptized into Christ’s death, so that she might have a resurrection like his.

Her last year of life resembled her first. Helpless, dependent and needy, she was back to the state she was in when Jesus first welcomed her as a beloved child in her baptism. She was back to the beginning. Through it all she was, and is, loved. Bedridden, she was unable to do the things she enjoyed in other stages of her life.

In the end, all she really could do was to respond to the love from her children and her Creator, and to share her self with the staff, caregivers and visitors at her care home. She continued living out her baptism, which is now complete with her death.

Mom was not an unwanted burden in her bedridden last year. She received this new frail stage with grace and courage. Reflecting on her life and death I treasure this memory: As I walked into her room at the nursing home in New Jersey, her eyes widened with surprise and she beamed with delight. She shone her love upon me. I hold that moment of her ministry to me in my heart, forever.

Caroline Vickery is pastor of Delmont Presbyterian Church in Delmont, Pennsylvania.

Learn More

Books for group study

• Pilgrimage into the Last Third of Life by Jane Marie Thibault and
  Richard L. Morgan
• Winter Grace: Spirituality and Aging by Kathleen Fischer
• Aging Matters: Finding Your Calling for the Rest of Your Life by R. Paul Stevens

Bible stories for the final third of life

• Grace as a gift of God, Ephesians 1:15–2:9
• Becoming like children, Matthew 18:1–5
• Living like Christ, Matthew 5:1–12
• Ministering from places other than church, Acts 28:23–30
• Being a servant leader, Philippians 2:1–11

The Big Ones

Decisions for the last third of life

By Chris Pomfret

Living fully into the Third 30 years of life can take some preparation. There’s no benefit to ignoring the inevitable lasts and losses that come in this phase, nor does it have to be depressing to discuss or accept these changes.

Instead, embracing the realities of our Third 30 allows us to have the best possible final years of life and to save our loved ones from worry and anguish. Here’s a quick list of things to consider for those entering the Third 30 of life:

Where will I live?

The two-floor, Second 30 family home might not be conducive to our senior years if we can’t tend the yard, clear leaves from the gutters, or walk up the steps. The wise will assess the potential dangers of continuing to live in the Second 30 home. In many cases, modifying the home — for instance, by adding “grab bars” and removing throw rugs — can enhance the home’s safety. Many experts advise having a plan for moving somewhere more compatible with declining physical and mental abilities before an accident or injury forces a quick decision.

How will I live?

Making decisions ahead of time ensures that the last third of life meets the vision we have for ourselves in old age. Many health-care organizations encourage middle-aged and older adults to fill out living wills or other directives that articulate their wishes when it comes to determining how aggressive medical treatments should be. Choosing care options ahead of time means that decisions about life support, resuscitation and power of attorney are yours. Having a living will also can help avoid confusion and disagreements among family members.

What about my stuff?

Do your children really want your beer bottle collection or the four dinner services that you inherited from your grandparents? If not, you can dispose of them on your terms rather than take the chance that someday they’ll be unceremoniously dumped by those who have no allegiance or sentiment to the items.

How long can I drive?

Handing in a license represents a loss of independence, power and mobility. But there are ways to minimize this loss. Rather than assuming independence until death, assume that one day you won’t drive, and reflect on how that will impact your life. Do you live far from others and will you have to depend on people coming to you? How will you get necessities? Before the last day of driving, develop a network of people or organizations that can be called for a ride.

By addressing issues early on in the Third 30 of life, we can head off trouble and heartache for ourselves and our loved ones and maximize our quality of life. Finding the courage, along with trust and faith in God, is fundamental to accomplishing this. Growing older and enjoying a full life is a gift from God, and we should neither be down nor in denial about it. In his book Nearing Home, Billy Graham shares this view on aging: “Don’t resent growing old. Many are denied the privilege.”

Chris Pomfret recently started a Third 30 network in the Presbytery of the Miami Valley. He is vice president of the Presbyterian Older Adult Ministry Network.

The Stages of Life

Most of us know intuitively that we live life in stages. Those who study aging and work with older adults often refer to the life stages in 30-year increments.

First 30 (ages 0–30). The First 30 is a time of acquisition. We learn to do many things for the first time as infants and children. Then, as young adults, we acquire an education, a job, a home and a new family. There is a great variety of ability in this learning phase.

Second 30 (ages 30–60). In this phase, we do what we have learned and hopefully we do it well. It is a relatively stable time, compared with the other stages, as we work and participate in family life. In fact, we get so used to our physical and mental abilities during our Second 30 that we sometimes think they will last forever.

Third 30 (ages 60–90). We begin to shed the things that we have acquired and maintained in the later years. Children leave home, we retire from work and may choose to downsize. Our physical and mental abilities change. Just as there are infants and productive young adults in the First 30, people in this phase of life vary in their ability to care for themselves and others.