Aging, Spirituality, and Pastoral Care

A Multi-National Perspective

James W Ellor

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781136402593
• Edition: 1
• Topic: Médecine
• Subtopic: Soins infirmiers

How can you foster spiritual growth in older people? This multidisciplinary work re-examines issues of aging with dignity and spiritual meaning. Aging, Spirituality, and Pastoral Care: A Multi-National Perspective brings together chaplains, pastors, counselors, and health care practitioners in all walks of gerontology from around the world to present a fully rounded picture of the spiritual needs and potentialities of this fast-growing population. It also includes a study of the spiritual awareness of nurses working in six different nursing homes, as well as a model for a parish nursing practice that focuses on the aged. Aging, Spirituality, and Pastoral Care addresses urgent issues for older people, including:

• social and spiritual isolation
• the wisdom of the aging
• the need for intimacy
• sexuality among older people
• living with dementia
• the spiritual dimensions of caregiving

---

SECTION 1 : ETHICAL, THEOLOGICAL AND BIBLICAL DIMENSIONS

---

Ethics and Ageing in the 21st Century

Laurence J. McNamara, CM, PhD

Dr. Laurence J. McNamara, is a Catholic Priest of the Congregation of the Mission (Vincentians) and Senior Lecturer in Christian Ethics and Deputy-President of The Catholic Institute of Sydney.

Address correspondence to: Dr. Laurence J. McNamara, Catholic Institute of Sydney, 99 Albert Road, Sydney NSW 2135, Australia (E-mail: [email protected]).

SUMMARY. This article insists that a cautious view of population data about ageing is necessary. Against this background three questions of meaning are explored, namely, what does it mean to grow old? What does it mean to be healthy or ill when one is old? What does it mean to care for aged persons in an age of chronic illness and disability? These questions raise justice issues about distribution of resources and quality of life and bring into focus theological insights about the human person, human solidarity and human virtues in a way that contributes to public discourse about ethics and ageing. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: <[email protected]> Website: <http://www.MaworthPress.com> ©2001 by The Haworth Press, Inc. All rights reserved.]

KEYWORDS. Ageing, ethics, meaning, justice, quality-of-life, person, solidarity, virtue

INTRODUCTION

Over the last one hundred years the journey of life has extended significantly for an increasing proportion of our Australian population. The experience of increasing longevity brings with it important human questions of meaning, together with questions about the justice and quality of life to be expected as we age. These three issues constitute the central part of this paper. To appreciate their importance it will be necessary to introduce, if only briefly, relevant demographic factors and ethical considerations that influence any response that might be made to the matters in question. By way of conclusion three sets of values grounded in Christian theology will be discussed for they contribute in significant ways to ethical reflection on issues arising from human ageing and the ageing of our society.

DEMOGRAPHY AND ETHICS

The Population Question

Many who think about the 21st Century portray the greying of the population as one of the major global hazards to confront humanity. The combination of greater longevity and lower birthrates will trigger a crisis, they claim, that will engulf the world. During the next decade a trickle of “baby boomers” will be heading into retirement but by 2015 they will become a flood.¹ This scenario appears in newspapers and magazines frequently in reference to difficulties associated with allocating resources be they health care, housing, pensions or community care.

Those who resist this bleak view of the future argue that we should look beyond mere statistics. They point to the three underlying factors that influence the proportion of older people in society-namely birth, death and immigration rates. For many in Australia today much greater concern is expressed about the possible economic consequences for workers and tax payers that will result from an increasing proportion of ageing persons. This relationship between productive and non-productive sectors in the population (the so called dependency ratio) must be viewed with caution. It may be portrayed in terms of age alone, on the basis of those of working age (viz. 15-64 years), or more accurately in relation to labour force figures. When the latter perspective is taken current concerns have no basis.² Equally important, however, is the fact that private expenditure on dependent groups is much higher for children than for the elderly in our society. Parents provide the greater part of support to children whereas government expenditure dominates in the case of aged persons. In spite of this some have concluded from available data that the dependency ratio will increase at a slow rate in the coming decades.³ Demographic data also indicate that throughout the early years of the 21st century Australia will continue to have a large proportion of the population of workforce age and relatively small groups in the categories of young and old. Australia’s high birth and immigration rates of the post-World War II years will produce larger numbers of people who are retirees in 2011. This group will have entered the ‘old’ old group (80 years and above) by 2031.⁴

In light of this demographic profile it is possible to indicate a number of implications for ageing Australia. First, the nation is not experiencing nor will it experience acute population ageing, at least by world standards. This realisation should ground any ethical analysis. Secondly, during the next decade elderly persons from non-English speaking countries, many of whom came to Australia in the 1940s and 1950s, will be entering old-old age. This will necessitate the provision of culturally appropriate health, community and aged care services. Thirdly, indigenous Australians (Aborigines and Torres Strait Islanders) have not shared the increasing longevity of other Australians throughout the 20th century. High mortality among the young and middle-aged has resulted in a diminished proportion of indigenous people among our ageing population. Fourthly, social, economic and political factors must be included with any consideration of demographic factors associated with the ageing of the Australian population. Financing retirement and old age, housing, urban planning, transport and local amenities, health care and community services will have to be given increasing importance in any analysis of ageing in the 21st century. To think comprehensively in this manner confronts the prevailing economic rationalism dominating current public policy. Finally, ageing people are immersed in a world of rapid change. Because of this elderly Australians are not quarantined from the “crosscurrents, contradictions, uncertainties, ambiguities and paradoxes that characterise Australian attitudes at the end of the 20th century.”⁵ The task ahead for all Australians is to develop metaphors and patterns of meaning for the experiences of ageing in a fast changing world.

The Ethical Landscape

Three aspects of our cultural milieu significantly influence current discussions of ageing: postmodernity, pluralism and secularity. Hugh Mackay puts it well when he writes that

Australia is becoming a truly postmodern society-a place where we are learning to incorporate uncertainty in our view of the world. The absolute is giving way to the relative; objectivity to subjectivity; function to form. In the modern view of the 20th century, seeing was believing; in the postmodern world of the turn of the century, believing is seeing. Conviction yields to speculation; prejudice to a new open-mindedness; religious dogma to a more intuitive, inclusive spirituality. Even the concept of God receives a changed emphasis, from the materialist’s ‘out-there’ being, to a spirit that is more intimately part of us.⁶

In ethical terms there is a “loss of singular certainty about truth and right in contemporary societies.”⁷ The narrow utilitarian calculus of the modern era has the effect of creating winners and losers. Frequently the elderly, women and indigenous peoples are to be found among the latter group. It is the strength of postmodern thinking that the stance of particular individuals or groups is given priority. This accompanies a critical attitude to relationships of power and oppression. A post-modern focus has implications for current thinking on the role of ageing persons in society. Increasingly the place of the spirit and spirituality are being recognised in a way not possible within a scientific paradigm. As will be observed later in this paper this is particularly significant for any consideration of the experience of growing old in contemporary society.

In liberal societies such as our own substantive moral agreement is not required beyond the need for all to agree about mutual toleration of diversity. Pluralism acknowledges there is no one set of moral values and practices acceptable to all members of society such that they might be given the force of law.⁸ A pluralist society rejects all views contrary to its own where individual freedom and mutual tolerance are concerned for these are foundational values in the liberal polis. Here the law is viewed as expressing a social consensus that individual freedom and mutual tolerance form the best basis for a society where many different worldviews and lifestyles exist.⁹ One reaction to this state of affairs maintains that the truth of the post-modern condition is such that everyone must live with fragmentation and pluralism because reason cannot establish for moral strangers a concrete, content-full common vision of the moral life.¹⁰

Two observations are appropriate here. First, a pluralism grounded in notions of liberty and tolerance which sees individuals as moral strangers gives central importance to human autonomy and its corresponding ethic of choice. An ethos of freedom-through-choice and a correlative emphasis on the role of contracts in the ordering of social relations is, at times, at odds with the Christian emphasis on enduring commitments and fidelity. The latter are best characterised by the biblical notion of covenant. Second, a contractual framework of social relations gives priority to equality, impartiality and universality in human relations. As a consequence of this little or no consideration has been given in Anglo-American philosophy to the qualities present in emotional, familial and other relations of friendship. These manifest personal responsiveness and partiality where personal emotions and virtues enable the individual to discern and respond to the needs of others.

The third aspect of our current ethical landscape arises from the secularity of the developed world. From the beginnings of revelation two trajectories may be observed in humanity’s dealings with God. One diminishes the influence of myth, fate or spiritual intermediaries as causes of human events and places at centre stage human responsibility for conduct. This secularisation of human morality is well illustrated in the first three chapters of the book of Genesis. The second trajectory maps the Old Testament struggle for faith in the one God who is holy and completely other.¹¹ In the Word made Flesh this God has “made his dwelling among us.”¹²

Much has been written about the process of secularisation during the 20th century. A persuasive argument has been made that we should no longer view ourselves at the beginning of the 21st century as living in a secular society. Rather we should understand ourselves as immersed in a secular culture. Secular culture is not overtly hostile to faith; rather, it radically undermines it. Our commodified culture assumes we live for pleasure without commitment.¹³ From the religious point of view secular culture has its greatest impact in the areas of imagination, disposition and sensibility. In place of old-style atheism with its militant and angry rejections

the battle ground has moved deeper-into what Newman would call antecedent assumptions, those attitudinal preambles that either make faith existentially credible or incredible. If culture is in part a shared ‘structure of feeling,’ which silently shapes the images we live by, then a dominantly secular culture can quietly marginalize those ways of feeling-towards-God without which faith remains unborn or unreal. Moreover, in so far as the Churches remain within a complacently sacral language, they ignore that their own cultural and spiritual incredibility may be on a ‘pre-religious’ level.¹⁴

As a consequence a secular environment eclipses any sense of need or desire for anything more than immediacy.

Christian faith becomes not so much incredible as unimagined and even unimaginable. This is no longer a merely social or external phenomenon. It involves the secularization of the share...