Spirituality and Aging

"To watch corn grow, or the blossoms set;
To draw hard breath over the plough share or spade;
To read, think, to love, to pray
Are the things that make men happy."
-- John Ruskin

People of all ages often seek to find meaning in their everyday activities. Understanding the relationship as well as the differences between spirituality and religion may explain and support the interest of older adults in reaching beyond themselves, doing and caring for others, and disinterest in the material. Defining spirituality, identifying its threats and strategies may lead readers into incorporating spirituality into or finding meaning in their lives. Expressions of spirituality through religious practice or compassion, service to others or passing on wisdom to succeeding generations (generativity) often bring deep personal satisfaction, comfort, and peace to older adults and thus help them mature more successfully.

OVERVIEW

"We worry too much about something to live on -- and too little about something to live for."
            -- Jimmy Townsend, in
                Virtues of Aging,
                -- by Jimmie Carter

The Difference between Religion and Spirituality

Many people think that spirituality and religion are the same. Religion and spirituality may exist together, but as Twycross (1988), wrote: "Everyone has a spiritual component, but not everyone is religious." Religion is generally recognized to be the practical expression of spirituality; the organization, rituals and practice of one’s beliefs. (Davis, 1995). Religion includes specific beliefs and practices, while spirituality is far broader.
(Ebersole & Hess, 1998)

What We Know About Spirituality

"It speaks to people of many denominations and beliefs." (Tessmer, 1998). Spirituality is thought to include a system of beliefs that encompasses love, compassion and respect for life. Individuals may experience both spirituality and religion very privately within themselves (internally), and/or through social interaction with persons and organizations in an external way. Spirituality is about our existence, relationships with ourselves, others and the universe. It is something we experience and requires abstract thinking and will. Spiritual development provides us with insight and understanding of ourselves and others. "The spiritual component of a personality is the dimension or function that integrates all other aspects of personhood…and is often seen as a search for meaning in life." (Twycross, 1988). Spirituality extends beyond the physical, material and self to a state called transcendence. (Thibault, 1991).
(Ebersole & Hess, 1998)

Observations of older adults have shown increased reflection, less concern for material things and more interest in satisfaction with life. By later in life many older adults may have experiences that may seem mystical. These may be responses to illness or other life changing occurrences. It is thought that transcendence appears in five ways:

Creative work

Religious beliefs

Children

Identification with nature

Mystical experiences

(Reed, 1991)
Within the experience of aging and the notion of spirituality there is an expanded sense of time in relation to quality of life. There is emphasis on internal processes or inner experiences which facilitate expanding concsciousnesses. Hence, time to meditate, fantasize, and participate in other more passive activity can be healthy for older adults as they contemplate and reflect (Newman, 1987). Some studies suggest that life satisfaction increases simultaneously with aging as a shift takes place from the material world to the cosmic (Tornstam, 1994) .
(Ebersole & Hess, 1998)

Studies have related happiness, morale, and health to spirituality. However, there are differences across individuals and cohorts in these experiences and their perceptions. For relevant reading through databases, please search Ageline, Age Search, etc.

RELIGION AND OLDER ADULTS

Public Policy and Historical Background

Public policy activity in the realm of spirituality first occurred in the Committee on Religion, part of the While House Conference on Aging in 1961. More than 2,500 delegates made 947 recommendations for action specific to the spiritual concerns of older adults. The 1971 While House Conference on Aging included a focus on spiritual concerns. One hundred thirty-six delegates, representing diverse national religious organizations, developed 710 recommendations, one of which called for a National Conference on Spiritual Well Being. This concept of Spiritual Well-Being (SWB) has been widely used since.
(Moberg,1995 & Clingan, 1995).

In 1972 the National Interfaith Conference on Aging was held and led to the National Interfaith Coalition of Aging (NICA). This has been a source of leadership to religious and spiritual communities. They developed a definition of SWB, "the affirmation of life in a relationship with God, self, community and environment that nurtures and celebrates wholeness."
(Moberg, 1995)

The 1981 White House Conference on Aging did not include a section on spirituality, reportedly to avoid violating the relationship between church and state. The NICA, which was still active, passed 45 recommendation focused on spirituality at that time.

Former President Bill Clinton called on religious and spiritual organizations and delegates of the 1995 White House Conference on Aging to address the religious needs of older adults and their spiritual well-being. This led to eleven mini conferences on the spiritual and religious aspects of aging. These were held across the U.S., and affirmed the importance and everyday impact of spirituality in the lives of older adults (Ellor, 1995). The details of the resolutions are presented in a Special White House Conference Edition of the Center for Aging Religion and Spirituality Chronicle.
(Ellor, 1995)

RESEARCH FINDINGS ON OLDER ADULTS AND RELIGION

Religion and associated activities are common among older adults (9 of 10 older adults rate religion important in their lives)

There is a positive relationship between religion and physical health

Most older persons report that religion helps them cope or adapt with losses or difficulties

African American Black women are more religious than African American Black men and all Caucasians

While other sources of well being decline, religion may become more important over time

At the time when religious support is most needed ,older persons are less able to access it (due to failing health, immobility or lack of transportation)

40-60% of congregations are composed of retired persons

The church has the greatest potential for reaching older adults with needed services

People do not necessarily become more religious as they age.

Because many of the present cohort of elderly were religious in their youth, a large percentage of them will retain their religious interest. Others will not; hence it is important to remember that elders -- as with the members of other populations -- are independent in their thoughts and actions.
(Ebersole & Hess, 1998)

Older adults may turn to spirituality and religion when they meet difficult life changing events and experience personal losses. Their reaction to these events and losses may cause distress, temporary or chronic psychological conditions. Mental health interventions may include or add to one’s faith or practice of spirituality in times of difficulty. Coping patterns and skills develop over a lifetime. See Emotional Well-Being.

SPECIAL POPULATIONS AND SPIRITUALITY

"No racial ethnic group can flourish without remembering, reconnecting and using its distinct cultural and religious traditions."
- L. L. Lee, 1992

Religion offers a way to express spirituality with social support, security, a sense of belonging through religious affiliations and is significant in coping with age related changes. Traditions become more important as persons age. If these are lacking for older adults, feelings of meaninglessness occur. Often these traditions are especially important to special ethnic populations. These groups seek to recover wholeness and well-being through their distinct cultural values and structures within their own communities while they connect to their history and heritage.
(Garrett, 1998)

Native Americans

Native Americans follow their ancestors' two purposes of life: to know the self and be of help to others. They vest many of their beliefs and spiritual powers in nature, the land, and animals. While there are literally several hundred tribes with many different rituals and practices, there are many commonalties among their values. For example, Paul White Eagle writes about the Cherokee Vision of Healing for Elders. White Eagle claims that the past gives tribal members their identity and origin, and these determine what the present is. Persons with these beliefs will be able to decide who they will be in the future without limitations of physical movement in their travels in spiritual realms. Confining their aging to their physical structure may lead to depression or defeat. As the individual plans for his/her future beyond death, spiritual realities become most important. He anticipates the call of his ancestral spirits who have found healing themselves. White Eagle asserts that older adults do not simply relive their past, but reconnect with that which has created them and leads to healing the wounds of a lifetime.
(White Eagle, 1999)

Japanese Americans

Each generation of Japanese American families face different issues. The oldest group faced economic and racial prejudice when they settled here and suffered societal injustices with their children when interned in relocation camps during World War II. Parents of the third generation of Japanese Americans devoted and attended to their children and vested in them the hope of success while being accepted into the dominant culture. The youngest cohort learns their spiritual heritage as they try to reconnect with the traditional values, culture, and rituals of their grandparents who are simultaneously coping from the pain of their experience. Programs to promote intergenerational healing among the four distinct generations in families are developing in communities with Japanese populations.
(Lee, 1992)

African Americans

The African American church serves many important functions in the community. Studies have shown that African American Black women attend church more frequently, participate more in church related activities and score higher on measures of religiosity and commitment than African American Black men. Elderly African Americans score higher than other age groups.
(Chatters, Levin & Taylor, 1992)

Women have played major parts in the organization and programs of support within African American churches. The church itself is the agency of social support in African American communities. A "disproportionate number of Black women in service roles while Black men hold more positions of leadership within the church," has been identified. Some strategies African American women use in resolving adverse experiences include accepting reality, turning over things to a higher power, identifying life lessons, and recognizing purpose and destiny and achieving growth.
(Mattis, 1997)

Mexican Americans

Mexican Americans' struggle to survive in America may result in broken families and communities. Women, especially, use their religious and cultural traditions to adjust to their new country, sustain their families and build more secure communities. Their religious practices often give them strength to cope with the stress in their lives.

Ethnic groups appear to find comfort in their cultural and religious traditions. As the groups look for solutions to their unique problems, their healing often comes from within their cultural and religious traditions.
(Lee, 1997)

Threats to Spirituality

Events or circumstances may threaten the strength and stability of spirituality in Older Adults:

Losses (age changed mobility or skills, job loss or retirement)

Challenged value systems (forced retirement from long tenured job)

Separation from religion and/or culture (move from native country or church)

Death ( of a loved one)

Personal and Family disaster (bankruptcy or estrangement of family member)

Changes in environment, health or self concept ( move to nursing home or catastrophic illness)

(Ebersole & Hess, 1998)

There may be symptoms or signs of unmet needs or unstable spirituality:

Threats to self

Insecurity, lacking self-esteem

Seeking out spiritual assistance

Questioning one’s existence or meaning of life

Depression

Doubts, despair

Guilt

Boredom

Anger

(Ebersole & Hess, 1998)

STRATEGIES TO BRING SPIRITUALITY INTO OLDER ADULT LIVES

Hope

" [Hope] is the human passion for the possible that makes difficult circumstances endurable."
(Post, 1995, p.124)

In the medical literature we associate hope with the delivery of bad news. Early Greek poets and thinkers viewed hope as a helpful illusion. Others did not attribute much importance to hope. Still others valued stoicism which seems the opposite to the notion of hope. Hope may have its positive roots in Judeo-Christian teachings of hope directing man to his faith and as a force of life. Studies of Nazi prisoners correlated lost hope with shorter survival.

Hope may be used as a means of coping. Critical aspects of hope include:

Expectation for future

Motivation for action

Means of fulfilling goals

(O'Connor, 1998)

There are elements of hope:

Recognition of a threat or predicament

Realistic assessment of the severity and its implications

Determination of ways to resolve -- or get out -- the situation

Recognition of negative outcome and how to deal with it

Retention of optimism about outcomes

Assessment of condition and resources that influence outcomes

Location of supportive relationships and realistic supports

Evaluation of progress to goals -- and revision as needed

Determination to endure

(Morse, 1995)

Other Strategies

Professional and personal ways to assist individuals may be tried :

Assess available and appropriate supports

Identify a comforting environment

Assess past coping abilities

Identify changes needed to improve situation and abilities

Refer to clergy, chaplain or appropriate professional

Prayer

Imagery

Artistic expression

Healing

Memory, reminiscence

Medication

Relaxation

Professional psychiatric therapy

(Ebersole & Hess, 1998)

Personal Experiences

Some persons have unique and very personal experiences that may be outside the realm of usual or traditional practices of most older adults. Hence, individuals may be reluctant to describe these. However, this sharing may be very helpful in resolving some distress older persons may feel in their spiritual lives. Allowing persons to express these personal experiences serves as an outlet for emotions. Some of these experiences may include:

Dreams

Hypnosis

Fantasies and Daydreams

Near Death Experiences

Visions/Hallucinations

Meditation

(Ebersole & Hess, 1998)

Legacies

Legacies given by an individual or collectively by a group are another very constructive approach to bringing meaning and spirituality into peoples’ lives. This strategy is a means for the process of a life review that has long been recognized to help older persons resolve past issues. These may be expressed in many ways :

Writing memoirs

Previewing and assembling photograph albums

Taping memoirs

Expressing through art

Creating a memory gardens

Giving away mementos, distributing possessions to others

Developing family histories or genealogies

Making important trips to family homes or pilgrimages to locations of spiritual significance

Autobiographies or Life Histories

(Generations, vol. 20 (3), 1996)
also: (Generations, XV, (2) 1991)

Practical Approaches

There are many simple approaches that individuals may use to help persons who are looking for meaning or spirituality in their lives:

Listen
Be aware of signs of mental health problems and urge professional help
Share concern and observations
Provide privacy
Reassure the value of the person
Allow decisions to be made
Accept without judgment
Help express religious, spiritual or social needs
Recognize cultural differences
Keep separate values and spiritual beliefs that are different
Refer to professionals when needs are beyond listener's ability to help
Use humor as appropriate

(Ebersole & Hess, 1998)

Organizations to Help

There are many ways that organizations can help persons to find meaning and spirituality:

Gerontological education of clergy in seminaries and training of existing religious staff
Outreach programs to homebound elderly
Prayer Circles
Telephone reassurance programs
Televised religious services
Tapes of Services
Visitations
Sacred readings
Parish Nurse Programs (nurses within congregations are identified and develop a practice with home visits to needy older adults within the church family).

(Ebersole & Hess, 1998)

SUMMARY

Spirituality is far more encompassing than religion, though we often see the two used interchangeably. Studies have found this state of transcendence, beyond the material and self (Thiabault, 1991) or spirituality positively correlated with morale, health and happiness. National initiatives such as the National Interfaith Coalition of Aging and facets of the White House Conferences on Aging have ignited interest and programs within the formal religious communities and other nonprofit entities.

While we understand that older adults may turn to religion more over time to help them cope or adapt, the church often becomes less accessible in their time of need. Different individuals within cultures have differing philosophies and practices of spirituality, but derive similar positive outcomes.

Losses and life changes increase in later life and challenge older adults. Instilling hope, offering supports and therapeutic interventions such as prayer, meditation, artistic expression or professional referrals may lead to spiritual renewal and healing. Enhanced understanding of spirituality through the information, resources and links on this site may lead readers closer to a successful aging process.

RESOURCES

American Society on Aging. (1991).

Creativity in later life, Generations. XV(2):1-72.

Reasons to Grow Old: Meaning in Later Life. Generations, xxlll, No. 4.

REFERENCES

Blazer, D. (1991). Spirituality and aging well. Generations, xv(1) pp. 61-66.

Chatters, Linda M., Jeffrey S. Levin and Robert J. Taylor. 1992 "Antecedents and dimensions of Religious involvement among older black adults." Journal of Gerontology: Social Sciences 47: S269-S278.

Clingan, Donald F. 1995. "Aging: Gathering a spiritual perspective." Center for Aging Religion & Spirituality CHRONICLE.
[http://www.luthersem.edu/cars/newsletters/FRSTNEWS.HTM]

Ebersole, P., and P. Hess (1995). Toward Healthy Aging: Human Needs and Nursing Response. (5th edition) St. Louis, MO: Nosby-Year Book, Inc.

Ellor, Jamaes W. 1995. "Special White House Conference Edition. Mini Conference Resolutions." Center for Aging Religion & Spirituality CHRONICLE.
[HTTP://WWW.LUTHERSEM.EDU/CARS/NEWSLETTERS/frstnews.htm]

Koch, K. (1977). I Never Told Anybody. New York, NY: Random House.

Koenig, Harold G. and David B. Larson. "Use of hospital services, religious attendance, and religious affiliation." Southern Medical Journal. Vol. 91, No. 10 (1998). pp. 925-932.

Lee, Ramonia L. 1992. "Healing connections: Ethnic perspectives on spirituality and mental health." Aging & Spirituality. [http://www.asaging.org/networks/forsa/a&s92.html]

Waxman, B.F. (1999). Nature, spirituality and later life in literature: An essay on the Romanticism of older writers. Gerontologist, 39 (5) pp. 516-524.

LINKS

The Forum on Religion, Spirituality and Aging - part of American Society on Aging

Everyday Mysticism: Spiritual Development in Later Adulthood - Article by Robert Atchley. On web site for Naropa University, a private, non-profit, fully accredited liberal arts college with a unique Buddhist educational heritage.

The National Interfaith Coalition on Aging (NICA) - offers information on aging and spirituality with links to other mainline Christian agencies dealing with aging.

The Institute of Spirituality and Aging - a nonsectarian, interfaith nonprofit organization, created to help elders and caregivers of diverse faiths identify and promote spiritual values in their lives and develop a more meaningful connection between spirituality, health and aging.

For other information and research findings, please refer to data bases, such as Ageline or Age Search

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