Aging in the United States—The Church's Response
I. The Situation
Older adult membership in The United Methodist Church is growing rapidly. In the past, the role of older people in congregations was limited, either by choice or circumstance. Congregations often viewed older adults as a liability rather than emphasizing the potential for a renewed or visionary ministry. Many of the myths and stereotypes of aging and older persons are changing.
During the past 100 years, life expectancy in the United States has increased by almost 28 years. The number of persons 65 years of age and older has grown from 3.1 million in 1900 (4.1 percent of the total population) to 33.5 million in 1995 (12.8 percent of the total population). This number is expected to increase from 34.7 million in the year 2000 (13 percent) to 70 million in the year 2030 (20.0 percent). In 1995, persons reaching age 65 had an average life expectancy of an additional 17.4 years (18.9 years for females and 15.6 years for males). By 2030, minority populations will represent 25 percent of the elderly population, up from 13 percent in 1990. The older population includes a disproportionate number of women (145 women to 100 men) and persons with a wide range of capacities, from active, healthy, and employed to fragile, frail, and chronically disabled.
As a result of better health care, nutrition, and job safety, many more Americans are living into older adulthood. By the year 2030, there will be proportionately more older adults than young people in the population. Every day in the United States 5,600 people celebrate their sixty-fifth birthday, and 4,550 persons, 65 years or older, die. The result is an increase of 1,050 older adults per day.
Most older persons have at least one chronic condition and many have more. Hospital expenses accounted for the largest share of health expenditures for older persons. Benefits from government programs, including Medicare, Medicaid, and others, covered about two-thirds of the health expenditures for older persons.
Lack of adequate health insurance is the most pressing health issue faced by older adults today. Private health insurance is so expensive that it is affordable or impossible to buy because of the exclusions for "existing conditions." This problem is made worse because persons that were not employed outside the home often have no claim on employer-based group policies in which the employed spouse participated if divorce or death occurs, and they have fewer job options with good insurance plans if they choose to work outside the home.
Medicare is a health insurance program primarily for persons over the age of 65. Medicaid provides a supplement to Medicare primarily for low-income persons. Medicare only covers about 40 percent of most older adults individual medical expenses. Older adults who have need for specialized residences, or their families, often have no choice but to opt for a nursing home that is covered by Medicaid. This is more costly and usually not the choice of the parties involved.
Although most older persons live in urban places, they also comprise a large proportion of rural populations where facilities and resources for them are extremely limited. Health care availability, transportation, and job opportunities are often lacking in rural areas. This condition is complicated further by a disproportionately low allocation of federal funds to meet the needs of the rural elderly.
Race and ethnicity are important determinants of the residential patterns of elderly people. While about one third of all older persons live in central cities, one half of all African Americans and Hispanics over 65 is heavily concentrated in urban areas. The popular shifts in housing patterns brought about by urban renewal and gentrification (higher-income persons buying property in formerly poor neighborhoods) and the resultant increase in homeowner taxes have a major impact on the elderly, especially minorities. Houses that have been paid for are lost because of the tax increases, or low rents rise astronomically.
We need to dispel the common misunderstanding that aging is synonymous with senility and dementia, and that older persons are unable or unmotivated to learn, grow, and achieve. Opportunities for continuing education and growth have long been unmet by a system geared to the needs of the young. Hearing and vision loss and other physical or biological changes may impede or change the way an older adult learns; however, old age can be a time of continual learning.
Like society, faith communities are "graying," but at an even faster rate. It isn t unusual to find many local churches having an older adult membership that represents over 60 percent of their total membership, with some even higher! This is due in part to younger and middle-aged adults choosing not to participate in congregations.
Some problems that beset older persons are the result of the social and physical process of aging. These include changes in work, family, and community roles; the reduction of energy; and the increase in chronic illness and impairments. These conditions can lead to increased dependence on others for life s necessities. Other problems faced by the elderly are the result of subtle and overt discrimination by social and political institutions. Being old today is not easy, in either the church or society. If the situation of older persons is to be improved, the church must act.
II. A Theological Response
Aging is a process involving the whole life span from birth to death. The response of the church begins with a theological understanding of aging concerned with the whole life process rather than with only its final stages. The meaning of life, rather than death, is the central point from which to theologize about aging. In The United Methodist Church, there are many legitimate theological understandings of the meaning of life in its progression from birth to death. The position presented here is one attempt to express this meaning.
A. All of creation is God s work (Genesis 1). Human beings are only a small part of the totality of life forms. The aging process is universal in all life forms. Birth, aging, and death are all part of divine providence and are to be regarded and taught as positive values. This does not in any way mean that such things as birth defects, disease, or deaths at an early stage in life are the will of God.
B. As Christians, the mystery of God s involvement in the person of Jesus Christ provides us with a unique source of divine help (grace) in our passage through life s successive stages. This is especially significant in the later stages, when spiritual maturation and well-being can be experienced even in times of physical decline. The power of the cross is a special revelation of how suffering can be reconciling and redemptive. Faith in the Resurrection provides us with an assurance of the abiding presence of the Risen Lord (Matthew 28:20) and the Holy Spirit (John 14:16-19; 2 Corinthians 3:17-18; Romans 8:9-11), and the permanence of our relationship with God beyond the mystery of death. In this spiritual presence we also find the source of the potential of all persons for self-transcendence. God s act in Christ was for life abundant (John 10:10) in all stages of life. Christ also gives us our traditional Wesleyan vision of the goal of ultimate perfection (Matthew 5:48). The grace of God in Christ is therefore important throughout life, including its last stages.
C. In response to this saving grace, we believe in the inevitable need to walk in the ways of obedience that God has enabled (Ephesians 2:8-10). These ways are defined by love for God and neighbor (Mark 12:28-31; Romans 13:8-9). It is therefore the privilege of Christians to serve all persons in love, including older persons with their special needs. Furthermore, since God s grace is not conditioned by any human standards of worthiness or usefulness (2 Corinthians 5:19), all persons are valuable to God (Matthew 6:25-30). In the larger pattern of human needs and rights, those of elderly persons must be consciously and intentionally included.
D. Older persons are not simply to be served but are also to serve; they are of special importance in the total mission of the church. Since the Christian vocation has no retirement age, the special contributions of elderly persons need conscious recognition and employment. The experience of all older persons, and the wisdom of many, are special resources for the whole church.
E. The church as the body of Christ in the world today (1 Corinthians 12:27) is God s method for realizing the reconciliation accomplished by Christ (Colossians 1:16-20). As such, it intentionally sponsors institutional forms that help reconcile persons of all ages to one another and to God. This especially includes those institutions designed to meet the needs of elderly persons and to keep them fully incorporated into the body of Christ. The church also is charged with an abiding concern for justice for all. It should work tirelessly for the freedom of all persons to meet their own fullest potential and to liberate those who are captive to discrimination, neglect, exploitation, abuse, or poverty.
III. Calls To Action
A. By society at all levels
United Methodists are called to advocate for the elimination of age discrimination in personal attitudes and institutional structures. We should pursue this advocacy vigorously and in cooperation with appropriate private and public groups, including all levels of government. Our efforts should be based on the following:
(1) Religious institutions make a unique and significant contribution to human life. Living involves ethical issues and value decisions. Therefore, a religious presence is important to the quality of total community life.
(2) Governments should play a critical role in ensuring that all benefits are available to all elderly persons to improve their quality of life. Christians should support governmental policies that promote sharing with those who are less fortunate. This does not absolve either the institutional church or individual Christians from responsibility for persons in need.
(3) A standard of basic survival support systems should be accepted and established in our society and made available to all persons. These systems should include: health care, transportation, housing, and income maintenance at a minimum. Christians need to identify and promote those facilities and services that ensure opportunities for prolonged well-being. These services need to be provided within the financial means of the elderly, with appropriate public subsidy when necessary. They include the following:
(a) universal comprehensive health insurance program;
(b) health-resources systems special to the needs of the elderly that are comprehensive, accessible, and feasible within available resources (these include long-term care, hospice care, home health care, and health maintenance organizations);
(c) health-education systems that emphasize proper nutrition, proper drug use, preventive health care, and immunization as well as information about the availability of health resources within the community;
(d) training for medical and social service personnel concerning the special cultural, physical, psychosocial, and spiritual aspects and needs of the elderly;
(e) adequate housing that is both affordable and secure, with protections that massive tax and rental increases will not create displacement, and transportation systems that meet the special needs of the elderly;
(f) national legislation correcting the disparity in Medicare s failure to cover either assisted living residences or dementia-specific housing, or home nursing care;
(g) a basic governmental income-maintenance system adequate to sustain an adequate standard of living affording personal dignity;
(h) basic pension systems benefit levels adequate to meet economic needs at least equal to the defined poverty level, supplementation by benefits from public funds;
(i) continuing educational and counseling opportunities for the elderly in pre-retirement planning, in work-related training, in interpersonal retirement relationships, and in personal enrichment;
(j) formal and informal community associations such as public and private centers that foster social, recreational, artistic, intellectual, and spiritual activities to help persons overcome loneliness and social isolation;
(k) continuing employment opportunities for those who desire them in flexible, appropriate work settings related to varying lifestyles; and
(l) opportunities for volunteer work and paid employment that best utilize the skills and experiences of the elderly.
(4) Finally, our society is called upon to respond to a basic human right of the elderly: the right to faithful care in dying and to have personal wishes respected concerning the number and type of life-sustaining measures that should be used to prolong life. Living wills, requests that no heroic measures be used, and other such efforts to die with faithful care should be supported.
B. By the church at all levels
(1) All levels of the church are called to:
(a) practice non-discrimination in the church on the basis of age in hiring, deployment, and promotion of older workers, including the appointment of clergy;
(b) include ministries by, with and for older adults as an essential and intentional component of the church and its mission;
(c) promote flexible retirement and eliminate mandatory retirement based solely on age;
(d) develop theological statements on death and dying that recognize the basic human right to faithful care of the dying;
(e) address the questions raised by the declining quality of life; stimulate research to connect the improvement of the quality of life with longevity of life, raised by increased longevity;
(f) develop ethical guidelines for dealing with difficult medical decisions that involve the use of limited resources for health and life insurance;
(g) authorize appropriate research, including a demographic study of members of The United Methodist Church, to provide greatly needed information on the psycho-social and spiritual aspects of aging; and
(h) establish a properly funded pension system with an adequate minimum standard for all clergy and church-employed lay persons and their spouses, including the divorced spouse.
(2) Each local church is called to:
(a) become aware of the needs and interests of older people in the congregation and in the community, including the places in which they reside, and to express Christian love through person-to-person understanding and caring;
(b) intentionally sponsor ministries in institutions designed to meet the needs of older adults, such as nursing homes, assisted living residences, and dementia-specific housing as well as the homes of older adults living alone, as we keep these older persons fully incorporated in the body of Christ;
(c) affirm the cultural and historical contributions and gifts of ethnic minority elderly persons;
(d) acknowledge that ministry by, with, and for older adults is needed in congregations of all sizes;
(e) support, equip, and train lay volunteers with a dedication for this important ministry;
(f) develop a barrier-free environment in which the elderly can function in spite of impairments;
(g) develop an intentional ministry with older adults that:
(h) recognizes that older persons represent a creative resource bank available to the church and to involve them in service to the community as persons of insight and wisdom (this could include not only ministry to one another, but also to the larger mission of the church for redemption of the world, including reaching the unchurched);
(i) relates to secular retirement communities within its boundaries;
(j) fosters intergenerational experiences in the congregation and community including educating all age groups about how to grow old with dignity and satisfaction;
(k) ensures that the frail are not separated from the life of the congregation but retain access to the sacraments and are given assistance as needed by the caring community;
(l) provides support and information for adults caring for aging parents;
(m) cooperates with other churches and community agencies for more comprehensive and effective ministries with older persons;
(n) accepts responsibility for an advocacy role in behalf of the elderly; and
(o) develops older-adult ministries responsible to the church council. A staff position or older adult council may be needed to facilitate this ministry with older adults.
(3) Each annual conference is called to:
(a) provide leadership and support through its council on ministries or alternative structure for an intentional ministry to older persons in its local churches, with special attention to the needs of women and minorities;
(b) develop a program of job counseling and retirement planning for clergy and lay employees;
(c) share creative models of ministry and a data bank of resources with the local churches and other agencies;
(d) define the relationship between the annual conference and United Methodist-related residential and non-residential facilities for the elderly, so that the relationships can be clearly understood and mutually supportive;
(e) recruit persons for professional leadership in working with the elderly;
(f) serve as both a partner and critic to local church and public programs with the elderly, promoting ecumenical linkages where possible;
(g) support financially, if needed, retired clergy and lay church workers and their spouses who reside in United Methodist long-term care settings;
(h) promote Golden Cross Sunday and other special offerings for ministries by, for, and with the elderly; and
(i) recognize that older persons within the conference, both lay and clergy, represent a significant and experienced resource that should be utilized in both the organization and mission of the conference.
(4) General boards and agencies are called to:
(a) examine the pension policies of the general church and their impact related to the needs of those who are single (retired, divorced, or surviving dependents of pensioners);
(b) create specific guidance materials for ministry by, for, and with the elderly;
(c) prepare intergenerational and age-specific materials for church school and for other special studies in the local church;
(d) promote advocacy in behalf of all the elderly, but especially those who do not have access to needed services because of isolation, low income, or disability (this might include advocacy for health care, income maintenance, and other social legislation);
(e) assist institutions for the elderly to maintain quality care and to develop resource centers for ministry with and by the elderly;
(f) create a variety of nonresidential ministries for the elderly;
(g) coordinate general church training in ministry with the elderly;
(h) provide for formal coordination on aging issues;
(i) advocate the special concerns and needs of older women and minorities; and
(j) utilize older persons as a creative resource bank in the design and implementation of these objectives.
(5) Retirement and long-term care facilities related to the church are called to:
(a) develop a covenant relationship with the church to reinforce a sense of joint mission in services with the elderly;
(b) encourage the provision of charitable support and provide a channel for the assistance of the whole church; and
(c) encourage both residential and nonresidential institutional settings that emphasize the spiritual, personal, physical, and social needs of the elderly.
(6) Finally, seminaries and colleges are called to:
(a) provide seminarians with instruction on aging and experiences with older persons in the curriculum;
(b) prepare persons for careers in the field of aging;
(c) develop special professorships to teach gerontology, and to provide continuing education for those who work with the elderly;
(d) engage in basic and applied research related to aging, and communicate the findings;
(e) develop a system for sharing research results with the church; and
(f) enable the elderly to enroll in courses and degree programs and to participate generally in the life of educational institutions.
Older adults deserve respect, dignity, and equal opportunity. The United Methodist Church is called to be an advocate for the elderly, for their sense of personal identity and dignity, for utilization of experience, wisdom, and skills, for health maintenance, adequate income, educational opportunities, and vocational and avocational experiences in cooperation with the public and private sectors of society.
The aging process is part of God's plan for life, with the good news of Christ's redemption giving hope and purpose. United Methodists are called to live this message through words and deeds in the church and in society.
ADOPTED 1988, REVISED AND ADOPTED 2000
See Social Principles, ¶ 162E.
From The Book of Resolutions of The United Methodist Church — 2004. Copyright © 2004 by The United Methodist Publishing House. Used by permission.