College of Social Work, University of South
Carolina, Columbia, South Carolina, United States
Even to your old age and gray hairs, I am he who will
I have made you and I will carry you:
I will sustain you and I will rescue you.
Isaih 46:4 (IBS)
The church has not kept its promise to older persons as stated
in this scripture passage. The church has abandoned its historical
role of community care for its members. Societies are experiencing
a gap in services for persons of all ages. If devolution evolution
proceeds, states will be freer to devise and implement welfare
and health programs for poor people, but they will have up
to 20 percent less federal support to do so (Sherman-Videka,
L. & Viaggiani, 1996). National, state, and local agencies
are not adequately providing social supportive services to
persons of all ages and especially not to caregivers of older
adults with Alzheimer's disease. Thus, religious organizations
should fill the gap. The roles of religious leaders and religious
organizations in community involvement have changed over the
decades and must be reexamined if we are to meet the needs
of today's older population.
Interorganizational community collaboration is not new. Bailey
& McNalley Koney (1996) suggest that many earlier collaborative
efforts were voluntary partnerships, whereas more recent collaborations
are being mandated (p.604). In this paper organized religions
(churches, synagogues, and other religious associations) are
referred to as the church. The population of older adults
is increasing worldwide. The church can fill the gap for social
services that public agencies are not offering especially
to older adults.
The Importance of Religion in Late Life
For centuries famous works of art depicted the importance
of religion in life"s transitions. One of these famous
works is Thomas Cole's paintings Journey of Life, in which
an angel leads man in his travels through each of life's stages,
from birth to youth, middle age, and old age (Cole, 1992)
The importance of religious organizations to Americans is
indicated by the numbers of Americans listed as members of
Jews (includes Orthodox, Conservative, and Reform =5,981,000
Old Catholic, Polish National Catholic, and American = 950,000
Roman Catholic = 58,568,000
Protestant (includes latter-day Saints, and Jehovah's Witnesses)
Eastern = 3,976,000
Buddhist = 19,000,000
A Gallup poll reported that 71 percent of Americans claim
to be members of a church or synagogue and 41 percent report
having attended church seven days prior to the survey (Cnaan,
1997). How long we live, when and how we die seem to be within
the realms of science, medicine, and law more than religion.
However religion is still important in the lives of most Americans
generally and plays a major role in the lives of older persons
(Taylor, 1993). Gerontological studies find that religioous
affiliation is positively correlated to life satisfaction
in older adults (Tobin, 1985). According to Tobin, Ellor &
Anderson- Ray (1986) in Enabling the Elderly: Religious Institutions
within the Community Service System:
1. Three out of four of persons more than 60 years old report
that religion is important in their lives.
2. Four out of five of persons more than 65 years old attend
church or synagogue regularly.
3. Evidence suggests that people maintain their religious
beliefs throughout their lives and that the current cohort
of older adults have been religious throughout their lives
and continue to be so as they age.
In religious gerontology spirituality is defined as the state
of being spiritual or relating to the nature of a non tangible
spirit, and religiosity is defined as membership or attendance
in a religious organization ( Tobin et al. 1986). Spirituality
may be more important to older adults than to younger people
(Hooyman & Kiyak, 1993). The National Interfaith Coalition
on Aging defines spiritual well-being or spirituality as the
"affirmation of life in a relationship, with God, self,
community and environment that nourish and celebrates wholeness"
(Tobin et al. 1986, p. 371). They equate well-being with the
wholeness of life and with physical, psychological and social
good health. The spiritual well-being of the person cannot
be separated fully from physical or psychological well-being.
Assessment of spirituality is considered essential to the
health of individuals by nursing professionals (Hungelmann,
Kenkel-Rossi,Klassen, Stollenwerk, 1996). Spirituality and
religious activity are positively correlated with the health
of older persons in several studies (Koenig, Smiley &
Gonzales, 1988). After age 60, religious beliefs/spirituality
tends to increase but it is not clear from the research if
this is an aging effect or a cohort effect. Religious activities
are positively associated with morale and among some individuals
ages 75 years and over, religion was second only to health
in its relationship to morale (Koenig et al. 1988). Older
adults are happier who have a belief in some spiritual being
or a connection to some church /synagogue activity. Only recently
religious affiliation of older adults is recognized as an
influential force that can be positively used to enhance their
well-being (Hungelmann, Kenkel-Rossi, Klasser, Stollenwerk,
Church and synagogue attendance is lowest among those in their
30's, peaks in the late 50's and early 60's (60% of this age
group attends religious services), and slowly declines in
the late 60's and the 70's. Older adults exceed any other
age group in attendance, with more than 50% attending religious
services. People over age 65 years are the most likely to
be affiliated with church groups or fraternal associations
(Koenig, George, & Seigler, 1988).
Data from the National Survey of Black Americans indicate
a high degree of religious commitment among older black adults
(Taylor, 1993). For African American older adults, the church
provides social services, counseling, and transportation as
adjuncts to the religious activities. Older black adults have
a higher probability of being religiously affiliated, of having
attended religious services as an adult, and of being a church
member than their white counterparts (Taylor, 1993). Social
and political functions have been attributed to the church
in the African American community. Some writers suggest that
during slavery the church functioned as an agency of social
control (Smith, 1993). During the civil rights era the African
American church served as an arena for political functions,
and today, African American churches function as social service
agencies in some communities. Mexican American older adults
were found to be more religious than white older adults as
measured by church attendance, self-rated religiousness, and
In spite of the noted involvement of ethnic and white older
adults in their churches, the church offers little adult ministries
in many congregations. Tirrito and Euster (1994) asked older
adults what services their churches provided for them. The
responses were as follows: home visiting for the shut-ins
or sick, bingo, group healing services, support groups, senior
adult choirs, trips, and even a senior prom. A small number
reported having formal social service programs such as adult
day care or group support programs. However, an unexpected
finding was that more than 40% of congregations did not have
any special programs for their older adults (Tirrito &
Euster, 1994). It is in this context that it is important
to examine how churches and public agencies can collaborate
to develop models for social service delivery.
Religious Leaders and Religious organizations: Past and
The roles of religious organizations and their impact
upon the lives of people have changed. In America, the role
of religion changed from community involvement to one of spiritual
guidance Historically, religious organizations served many
community functions, such as helping the poor; housing the
sick, the old, and the disabled; providing food; and providing
shelter to families. Charity and almsgiving can be traced
to references in the Bible. The Book of Genesis frequently
offers reference to hospitality ( Hastings, 1910). In the
Book of Proverbs, the poor are regarded as oppressed, ill
treated, and the relief of the needy is an act of merit bringing
down upon the performer the praise of God and the favor or
man ( Hastings, 1910). The influence of churches upon governing
rulers during the Middle Ages contributed to persecutions
of innocent victims in the name of religion and the separation
of church and state became a powerful focus. In the 15th and
16th century, colonization created countries that demanded
freedom of religion and freedom from persecution due to religious
affiliation. The role of the religious organization changed
dramatically after the Reformation period when the separation
of church and state became a focal issue between governments
and churches. During the Reformation period the church become
less important as a community and the secular state became
the primary source of authority over people's lives (Peterson,
1993). The separation of church and state was a major issue
in Colonial America. Americans insisted on a government that
was free from specific religious ties and continue in this
tradition through the 20th century. It is in this context
that churches abandoned many of their traditional community
functions. In the 20th century social services previously
provided by religious organizations became the responsibilities
of governments especially after the passage of the Social
Security Act of 1935.
Older Adults Expectations from Their Religious Organizations
A study by Tirrito & Spencer-Amado, (1996) found that
older adults expected and desired social services from their
religious organizations. A sample (n=106) randomly drawn from
a population of 5000 found that older adults would use social
services if provided by their churches. The study found that
older persons identified many services that they desired from
their faith organizations such as: support groups, meals,
transportation, nursing services, availability of social workers,
help with medicines, housing, help with housing repairs, friendly
visitors, companions, legal advice, family support groups,
recreational activities, volunteer work, help to find paid
work, educational programs, intergenerational programs, help
with abusive family members, help with family members with
mental illness, or developmental disabilities, or alcoholism
and help with elderly parents.
Wilson & Netting (1988) suggested the church as a potential
resource for bridging the gap between formal social service
agencies and the informal services of churches. Essential
public social programs are not being adequately handled by
public social service agencies as evidenced by long waiting
lists. These include meals on wheels, respite programs, volunteer
chore programs, mental health screening, legal and financial
planning, retirement planning, and support groups for families
and for adult children. Tirrito & Euster(1994) report
what one elderly parishioner wrote about her church:
"My church is not fulfilling this need, but I have
found some senior centers that are church sponsored and are
an alternative for activities and programs for those 55 and
older. I believe that churches should recognize and support
programs for older adults."
The roles of church leaders have changed from leaders in
community affairs to primarily spiritual monitors. Historically,
church leaders had teaching and leadership responsibilities
in the community. They were not only spiritual leaders but
teachers who offered guidance and help in all aspects of life.
Ethical issues were debated and decided by spiritual leaders.
Life and death decisions were made with religious leaders.
Today, the priest is called to administer the last rites at
the time of impending death; the minister may visit in times
of serious illness; the rabbi may be asked to help with the
difficult decision of placing a family member in a nursing
home. Religious leaders are no longer involved in making ethical
and legal decisions in the community. The professions of medicine
and law now have primary responsibility for the policy development
regarding life and death issues. Medical personnel (physicians
and nurses) make decisions regarding the use of life supports
for dying patients, and the courts decide to remove life supports.
Individuals who are facing painful deaths need spiritual
comfort but they also need help in dealing with psychosocial
issues to make end of life decisions. Helping family members
deal with the suicide of a loved one often becomes the religious
leader's task. Bullis ( 1996) reports that ministers remain
on the front line of mental health care provision (p.156).
He cites studies that found that Americans use clergy as their
primary source of mental health counseling but that most are
ill equipped to provide this service. The spouse faced with
a partner with Alzheimer's disease requires support, community
assistance, and spiritual comfort. The parent whose adult
child has AIDS needs consolation but also needs supportive
services and/ or home health care services. The older person
whose adult child is abusing or neglecting him or her may
confide in the spiritual leader rather than report abuse to
police or social agencies. The abused elder may also need
legal help and a protective place to live. Religious leaders
encounter changes in the mental and physical condition of
older adults at early stages but are not gerontologically
trained to provide essential information and referral to community
Tirrito and Euster ( 1993) examined gerontological training
of religious leaders, of whom more than 69% reported that
they did not have any training in aging issues although memberships
in some churches have from 30% to 80% elderly members. More
than 74% of the church leaders (n=57) stated that the proportion
of older adults in their churches/synagogues had increased
in recent years and yet only 26% (n=22) of clergy were very
interested in any gerontological training, 49% (n=41) were
somewhat interested, and 25% (n=20) had very little or no
interest at all in gerontological training. In a national
study sponsored by the Association for Gerontology in Higher
Education, Payne and Brewer ( 1989) examined accredited seminaries
in the United States to detect the status of gerontology in
theological education and found that only recently has gerontological
content been taught in schools of theology .
Collaboration and New Opportunities
Collaboration between social agencies and religious organizations
can offer new opportunities to meet the needs of persons of
all ages especially older adults. Organized religion has concentrated
its outreach programs upon youth and families and churches
continue to develop youth ministries and are concerned with
increasing the number of families and children in their congregations.
Recently some churches and synagogues have recognized their
responsibility to develop ministries for older members as
well. Some community services offered by churches are counseling,
adult day care, in-home services, nutrition services, retirement
preparation, and transportation. Socialization activities,
such as trips or bingo, are no longer adequate to meet the
needs of the older adult community especially the needs of
an increasing older population. We need more than bingo, games
Religious leaders and social agencies can share knowledge,
work together in advocacy and community planning, collaborate
in policy making and ethical decisions, develop joint programs
and services, and provide assessments, information and referrals
for community members. It is well documented in the literature
that many older adults underutilize the services of mental
health clinics (Turner, 1992) because public agencies (especially
mental health clinics) have a stigma attached to their programs.
Older adults are reluctant to use these services even when
they are available in communities. Koenig, George, & Schneider
(1994) report that low Medicare rates are causing some mental
health professionals to turn away elderly patients. How will
our society provide mental health services for older adults
in the year 2020, when 80 million baby boomers pass age 65?
Religious organizations do not have a stigma attached to them.
For example, a support group for newly bereaved men is more
acceptable if group meetings are sponsored by a church or
synagogue than by a local mental health clinic. An older adult
who is severely depressed may be reluctant to seek treatment
at a local mental health clinic, but may accept treatment
from a mental health therapist who is affiliated with his/her
church/synagogue. In rural areas transportation is a problem
for older adults.
The diversity of the aging population and the variety
of churches and synagogues in various communities demand programs
that are unique for each community. Moberg (1991) suggests,
"Every church needs to study its own community to determine
the specific needs of its older people, and to identify the
services that are already available to them, and to discern
which are feasible but lacking" (p. 191). A sharing of
knowledge about services and programs that are effective is
simply a matter of communication between religious leaders,
organizations, congregants, and community providers. Religious
organizations must again take on community, teaching, and
Advocacy and Planning
How can religious organizations collaborate with government
and community agencies to enhance the well-being of today's
and tomorrow's older adults? Religious leaders can function
as gatekeepers and sources of referral and information. Together
they can provide counseling, offer support groups sessions
and develop community specific programs. They can be involved
in legislation, policy making, advocacy, lobbying, consultation,
referral, program planning, and community development. Religious
leaders are frequently aware of community issues and can influence
leaders and advise planners of the needs of their constituents.
Ethical Decisions and Policy Making
Religious organizations can collaborate with public agencies
to find solutions to ethical dilemmas and develop policies
to address issues confronting older adults and their families.
Clergy of various denominations should be involved in making
decisions and passing laws regarding medical ethics: Should
assisted suicide be legalized? In an aging society, long life
is a blessing for some, for others death is a welcome relief.
Joint Programs and Services
Joint programs, such as family centers, can be developed
and resources shared to provide community services for children,
teens, and older adults. Some religious organizations are
involved in senior centers or day care centers (for example,
the Shepherd's Centers in the United States). Some churches,
such as in African American communities, offer transportation
to doctors' appointments, hot meals, supportive groups for
caregivers, and so forth. However, these programs are sporadic
and not available in every community. Religious leaders can
collaborate with community providers to create programs such
as screening for depression by mental health professionals
in church/synagogue buildings or education by neighborhood
pharmacists regarding drug interactions. Nutrition programs
are available in some churches/synagogues but should be offered
in all communities.
Assessment, Referral and Information
Religious leaders, frequently, are aware of the psychosocial
problems of the members of their congregations. As one minister
said, "When I look at my congregation on Sunday, I am
sad to look at each face and think about the difficulties
each person is dealing with in his/her life" (Private
communication, 1996). Alcoholism, drug abuse, elder abuse,
caregiving, depression, and mental illness are some of the
problems that religious leaders encounter in their congregations.
Older adults and their family members often seek counseling
from respected members of the clergy prior to consideration
of the use of formal services. Although it is not expected
that the religious person will take on the role of therapist
or psychiatrist, a spiritual leader can recognize warning
signs and with the help of social workers refer congregants
to appropriate community professionals. For example, it is
well known that elderly men are more likely to commit suicide
than any other group in the United States, and the rate of
suicide increased between 1979 and 1988 ( Kaplan, Adamek,
& Johnson, 1994). Religious leaders can play a pivotal
role in identifying men who are at risk of suicide and referring
these people to community professionals who can help them.
Outreach to individuals in the community who are not affiliated
with religious organizations can be a major contribution of
religious leaders to community public service agencies. These
suggestions are not meant to transform churches/synagogues
into social service agencies but are a reminder that religious
leaders can fulfill a vital community role as referral agents
and sources of information.
Churches can provide a pivotal role and fill the gap. First,
religious leaders must become aware of the influential roles
they can play in the lives of their members, especially the
lives of older adults. Religious leaders have an opportunity
to bridge the gap in social services if they take leadership
roles and become active community practitioners. Second, as
Tobin et al.(1986) said, " to become involved in collaborative
efforts, the church or synagogue must be willing to support
the concept of social ministry" (p.173). Religious organizations
must relinquish the notion of their role is solely to meet
the spiritual needs of parishioners. Social needs are the
domain of the churches.
. As federal policy again begins to shift toward decentralization
and the community is given more responsibility to provide
services for its citizens, new collaborative models are mandated.
The old ways are no longer suitable. We must challenge existing
paradigms(Bailey& McNalley Koney, 1996). New challenges
require new efforts. The church and its resources (its people
) have been overlooked in the provision of social services.
The agenda for the coming decade must include efforts to link
social work with the church to contribute to the development
of a society in which principles of charity are again incorporated.
Bailey, D. & Mc Nalley Koney, K.(1996). Interorganizational
community based collaborative: A strategic response to shape
the social work agenda. Social Work, November, Vol. 14. No.6
Brashears, F.& Roberts, M. (1996) The
Black Church as a Resource for Change. Logan, S. (Editor).
The Black Family. pp. 181-193. Colorado: Westview Press.
Bullis, Ronald K. (1996) Spirituality in
Social Work Practice. Washington, DC: Taylor & Francis.
Cnaan, Ram A.( 1997) Recognizing the Role
of Religious Congregations and Denominations in Social Service
Provision. In Reisch, M. & Gambrill, E. Social Work in
the 21st Century. pp. 271-284 Thousand Oaks, Calif.: Pine
Coates, B. (1991). Older adults ministry
in the United Methodist Church. Unpublished paper.
Cole, T. R. (1992). The Journey of Life:
A cultural history of aging in America. New York: Cambridge
Glover, S., & Sinkler-Parker, C. (1994,
May). A study of African-American churches and their services
for older adults. Paper presented at The National Council
on Aging, Washington, DC.
Hastings, J. Editor.(1910). Encyclopaedia
of Religion and Ethics. Volume III.pp. 376-392. Edinburgh:
T&T Clark .
Hungelmann, J. Kenkel-Rossi, E. Klassen, E & Stollenwerk,
R. ( 1996). Focus on Spiritual Well-Being: Harmonious Interconnectedness
of Mind-Body-Spirit- Use of the JAREL Spiritual Well-Being
Scale. Geriatric Nursing. November/December. pp.262-266.
Hooyman, N., & Kiyak, H. A. (1996).
Social gerontology (4th ed.). Boston: Allen and Bacon.
International Bible Society. (Copyright @ 1973, 1978, 1984).
Scripture quotation from The Holy Bible, New International
Kaplan, M. S., Adamek, M. E., & Johnson,
S. (1994). Trends in firearm suicide among older American
males. The Gerontologist, 34 (1), 59-66.
Koenig, H.G. (1995). Research on Religion
and Aging: An Annotated Bibliography. Westport, Conn.:Greenwood
Koenig, H. G., George, L. K., & Schneider, R. (1994).
Mental health care for older adults in the year 2020: A dangerous
and avoided topic. The Gerontologist, 34 (5), 674-679.
Koenig, H. G., George, L. K., & Seigler, I.C. (1988).
The use of religion and other emotion-regulating coping strategies
among older adults. The Gerontologist, 28, 303-310.
Koenig, H. G., Smiley, M., & Gonzales,
J. (1988). Religion, Health and
Aging: A review of theoretical integration . Westport, CN:
Lewis, M. (1994). Religious congregations and the informal
supports of the frail elderly. Project summary. New York:
Moberg, D. O. (1975). Needs felt by the
clergy for ministries to the aging. The
Gerontologist, 15 (2), 170-175.
Moberg, D.O. (1982). Is your church an honest
ally or a friendly foe of the aged? Journal of Christian Education.
Vol. 3. No. 1 Sept. 1982. pp. 2-3.
Moberg, D. O. (1991). Preparing for the
graying of the church. Review and Expositor, 88, 179-192.
Morgan, R. L. (1990). No Wrinkles on the
Soul. Nashville: Upper Room Books.
Nathan, R.P. (1996). The devolution revolution@: An overview.
In Rockefeller Institute Bulletin. Symposium on Federalism.
pp. 5-13. Albany: State University of New York, Nelson A.
Rockefeller Institute of Government.
Neugarten, B. L. (1977). Personality and
aging. In J. E. Birren & K. W. Schaie (Eds.), Handbook
of the Psychology of Aging. (pp.626-649). New York: Van Nostrand
Payne, B., & Brewer, E. (eds.). (1989).
Gerontology in Theological Education. New York: Hawthorne
Peterson, R. Dean (1993). A Concise History
of Christianity. Wadsworth Pub.: Belmont, Calif.
Private communication with a Methodist minister,
Sherman-Videka, L. & Viaggiani, P. (1996).
The impact of federal policy changes on children: Research
needs for the future. Social Work. November, 1996. Vol.14.
Smith, J. M. (1993). Function and supportive
roles of church and religion. In J. Jackson,L. Chatters &
R. Taylor (Eds.), Aging in Black America. Newbury Park, CA:
Statistical Abstract of the United States.
(2000). (113th ed.), Washington, DC: U.S. Government Printing
Taylor, R. J. (1993). Religion and religious
observances. In J. Jackson, L. Chatters, & R. Taylor (Eds.),
Aging in Black America. Newbury Park, CA: Sage.
Tirrito, T., & Euster, G. L. (1993). Gerontological education
for religious leaders: Are they ready for the graying of the
church? Paper presented at the Association for Gerontology
in Higher Education, Louisville, KY. Feb.
Tirrito, T., & Euster, G. L. (1994).
Religious leaders: What do they need to know about planning
for elderly church members? Paper presented at the Association
for Gerontology in Higher Education, Cleveland, OH. Feb.
Tirrito, T.,& Spencer-Amado, J. (1996).
Older adults expectations from their churches.
Presentation at American Society on Aging, Nashville, Tenn.
Tobin, S. (1985). Older Americans as a resource.
In T. Tedrick (Ed.), Aging: Issues and policies for the 80.
New York: Praeger Press.
Tobin, S. S., Ellor, J.W., & Anderson-Ray. S. (1986).
Enabling the elderly: Religious institutions within the community
service system. Albany, NY: State University of New York Press.
Turner, F. (Ed.), (1992). Mental Health
and the Elderly. New York: Free Press
Whitlatch, A.M., Meddaugh, D.I. & Langhout,
K.J. (1992). Religiosity among Alzheimer=s disease caregivers.
American Journal of Disease and Related Disorders & Research.
November,/December. pp. 11-20
Wilson, V. & Netting, Ellen F. (1988). Exploring the interface
of local churches with the aging network: A comparison of
Anglo & Black Congregations. Journal of Religion &
Aging. Vol. 5(2). pp.51-73.
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