Hania, Honor

Hill, Robert J.

McKinney, Stephen J.

English

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Care for the elderly: some perspectives from Scripture

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      McKinney, S.J., Hill, R. J. and Hania, H. (2017) Care for the elderly: some perspectives from Scripture. Pastoral Review, 13(4), pp. 58-63.     There may be differences between this version and the published version. You are advised to consult the publisher’s version if you wish to cite from it.    http://eprints.gla.ac.uk/142902/            Deposited on: 25 September 2017                       Enlighten – Research publications by members of the University of Glasgow http://eprints.gla.ac.uk  1 Care for the Elderly: Some Perspectives from Scripture. By Stephen J. McKinney, Robert J. Hill and Honor Hania  Abstract  This article is focused on the care for the elderly and some Old and New Testament perspectives on this care. We explain that the population of elderly people is increasing in the UK and discuss five key factors that can adversely affect the lives of older people and prevent them from participating fully and meaningfully in contemporary communities. We then briefly examine some perspectives on the elderly and the care of the elderly from the Old and New Testaments. We identify some congruence between the five key factors and the scriptural perspectives and conclude that honour and care of the elderly is an integral part of the Christian vision of life.  Introduction  The care for the elderly in the UK has become an important concern. There has been a growth in the number of the elderly: the percentage of people over 65 has increased from 14.1% in 1975 to 17.8% in 2015.1 The Office of National Statistics calculates that this percentage is projected to grow further, to a quarter of the overall population by the year 2045. The life expectancy of the population is increasing as a result of improved healthcare and, in some cases, healthier lifestyles. There has been an increase in the number of people who are sixty-five or over and a marked increase in the number of people who are eighty-five and over.2 There are, of course, significant differences in different parts of the UK: the poorer the area the more likelihood of illness and disability for older people and the more likely an earlier mortality rate. The increase in older people does create pressure for the Health and Social Services and there has also been a rise in the number of unpaid carers (care from family and friends) and these carers are providing care for more people with complex needs. Many of these carers, as spouses or partners of the elderly, are likely to be older people themselves. One of the more serious challenges is that older people are more susceptible to mental health problems. This can mean the widely publicised serious condition of dementia caused by diseases such as Alzheimer’s but also an increase in levels of anxiety and depression for many elderly men and women. Age Concern and the Mental Health Foundation have identified five key factors that impact on the general health and well being of older people.3 These are (1) physical and mental health; (2) poverty; (3) relationships; (4) participation in meaningful activities and (5) discrimination.4  This short article aims to examine these five key factors and provide a concise overview of the perspectives on the elderly that are contained in the Old and New Testaments.  Five key factors  The World Health Organisation (WHO) defines health as: ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’.5  The promotion of healthy aging, good physical and mental health, is important for older people as are strategies to deal with the mental effects of serious or persistent physical illness or disabilities. Poverty or low income is a major source of anxiety for many older people. Age UK reports that there are 1.6 million  2 pensioners living in poverty (14% of UK total) and this is a result of causes such as a history of poorly paid employment and low pensions, unemployment or caring responsibilities. There are concerns that many pensioners do not claim the income benefits that they are entitled to claim. Relationships with families and friends are very important for older people and regular contact is an important part of their lives. This helps to avoid the dangers of loneliness and isolation. This can be especially important when a spouse or partner has died and an elderly person has to adjust to living on his/her own. Older people need to participate in meaningful activities. These can help old people retain a sense of purpose and enjoyment in life.  Older people can experience discrimination in society in healthcare and employment and they can be represented in a stereotypical way in the media and in the entertainment industry. There are reports that some elderly people can be denied some medical treatment because of their age, despite a ban on age discrimination in the NHS.6 This age discrimination can inhibit participation by the elderly in social activities and can have a large impact on their confidence and feelings of self-worth and mental health.  The issue of age discrimination is troubling because the Equality Act 2010 (relevant in England, Scotland and Wales) recognizes that this is a form of discrimination and states that people cannot be discriminated against because: they belong to a certain age group; they are perceived to belong to a certain age group or they are connected to someone of a certain age group. 7    There are exceptions and some forms of employment have compulsory retirement ages due to the nature of the work (e.g. the Fire Service and the Police). Nevertheless, there may need to be greater public awareness of this insidious form of discrimination. The UK and Scottish governments have identified the increased (and increasing) number of elderly people as an issue to be addressed and have published strategies to improve services for older people, though there are criticisms of the levels of funding in real terms that have been allocated to the care of the elderly.  The next sections explore some perspectives on old age from the Old and New Testaments.  Reflections on Old Age: the Old Testament It was late in the history of Judaism before the Jews considered the possibility of an eternal life and resurrection of the dead as a reward for a good life on earth. Judaism held little hope of an afterlife until a fairly short period before the time of Jesus.8  In an age when long life was the exception rather than the rule, longevity came to be regarded as a prize for a life well lived. We see this reflected in biblical passages such as Isaiah 65:20: To die at the age of a hundred will be dying young; not to live to be a hundred will be the sign of a curse. Virtue and old age come to be associated with each other, but virtue should not be confused with sinlessness: old age is not a sign of sinlessness. The story of Job provides an account of his great wealth, the loss of this wealth, and the restoration of his fortunes by God after Job has been tested. After this, Job offers sin offerings for himself and his family. Job and his contemporaries assume that no human is sinless.9 Longevity is frequently perceived to be a sign of God’s favour. King David is stated to have lived to be seventy. David is far from being sinless, yet he nevertheless enjoys a close relationship with God. It is interesting to note that the number seventy is the product of seven and ten, both symbols of completeness, so perhaps David’s life span is symbolic.10   3  The elderly were also seen to be frail, and therefore very vulnerable. The elderly were to be held in esteem despite their frailty and this was a value and tradition shared by both the Biblical tradition and the Greco-Roman moral tradition.11  The following passage from Ecclesiasticus (3:14-17) exemplifies this:   My son, support your father in his old age…Even if his mind should fail, show him sympathy…for kindness to a father shall not be forgotten but will serve as reparation for your sins.   The respect for old people was consolidated with the command in Deuteronomy 5:16, to honour your father and your mother. The vulnerability of the elderly would see them added to the list of those who deserve preferential treatment and support in Israel – the widow, the orphan and the stranger (see Exodus 22:21-22).  Reflections on Old Age: the New Testament  By the time we reach the New Testament, eternal life replaces long life as the reward for a life well lived, as many gospel texts attest.12 There is no New Testament view therefore that long life (or wealth and health for that matter) constitutes God’s reward for virtue. Rather, in Jesus’ teaching, the emphasis is on disciples devoting less attention to the self, and concentrating on others and the needs of others. This is reflected in the Son of Man, who himself did not come to be served but to serve (Mk 10:45) and the statement of Jesus in Mk 12:31: You must love your neighbour as yourself. This is illustrated in the Parable of the Good Samaritan in Luke’s gospel and in the Parable of the Last Judgement in Matthew’s gospel:    ‘Come, you whom my Father has blessed, take for your heritage the kingdom prepared for you since the foundation of the world. For I was hungry and you gave me food; I was thirsty and you gave me drink; I was a stranger and you made me welcome; naked and you clothed me, sick and you visited me, in prison and you came to see me.’ Then the virtuous will say to him in reply, ‘Lord, when did we see you hungry and feed you; or thirsty and give you drink? When did we see you a stranger and make you welcome; naked and clothe you; sick or in prison and go to see you?’ And the King will answer, ‘I tell you solemnly, in so far as you did this to one of the least of these brothers of mine, you did it to me.’ (25: 34-40)  In one sense, we can see how the teaching of Jesus builds on the tradition of Israel regarding the absolute (and binding) necessity of caring for the widow, the orphan and the stranger. From Exodus onwards, there is an expression of the need to care for those without the means to support themselves in an agricultural society. 13 Classically, these are designated the orphan, the widow and the stranger. In the teaching of Jesus, concern for others is not limited to these, but extended to all, and in Matthew’s parable of the Last Judgement there is no explicit mention of these three groups at all.  Widow, orphan and stranger are terms which are relevant and applicable to ancient Israel and similar agricultural nations. By the time the gospels were written, there is recognition of a more diverse population and there are many people living within Greek and Roman cities. The concept of care for the vulnerable had to be broadened to include other groups of people. Hence, Jesus cites anyone in  4 need as a person deserving of attention rather than qualification by category. This can be seen in the Gospel of Matthew, which begins to move away from the specific identification of individuals or groups who are to be singled out for preferential treatment. The parable of the last Judgement is a good example of the intention of Jesus that ‘deeds of mercy’ are expected to be shown to all men and women in need.’14   I Timothy chapter 5 comments on the correct way to reprove people in the Christian community, including special mention of older people:  Never speak sharply to a man older than yourself, but appeal to him as you would to your own father, treat younger men as brothers, older women as mothers and young women as sisters with all propriety (1-2)   The chapter continues with a discussion on how to treat widows and elders of the community. Elderly people, then, according to the Old Testament, have to be treated with respect and honoured and the New Testament is in accord with this and adds that they are neighbours and among the people who require care and ‘deeds of mercy’.   The biblical writings that have been reviewed above are coherent with the majority of the five key factors mentioned above: it is maybe not so clear that the biblical passages have much to say about the elderly and meaningful activity. The care for the elderly in the New Testament is an extension of the support that is to be offered to all of those who are vulnerable and in need (beyond the traditional groups of widow, orphan and stranger).  This care should be extended to the elderly, including those with poor physical or mental health, those whose faculties have begun to fail. The elderly are to be supported or assisted, like others in need, with the resources they require which may include financial resource. The passages from Ecclesiaticus and 1 Timothy are very focused on the relationship that should be established with older people: like a father, or mother and a father and mother who should be honoured, even when being reproved. The positive treatment for older people and the inclusion of older people that are promoted are counter to discriminatory attitudes or actions towards older people that can be discerned in contemporary society.   Concluding Remarks  This article is not a comprehensive overview of the contemporary challenges faced by elderly people but does provide some insights into the difficulties that they can face and the discrimination they can face. One of the major challenges is their own recognition of the limitations that physical aging can impose on them and the ways in which they negotiate the resulting changes in their lifestyle. The passages from scripture are quite clear and a Christian vision is that older people are to be honoured and cared for at all stages of old age and through any forms of illness or disability. This would include helping them to adjust to life changes.  Stephen J. McKinney and Honor Hania are at the University of Glasgow. Robert J. Hill is the parish priest of St. Matthew’s Bishopbriggs, Archdiocese of Glasgow.                                                          1 Office for National Statistics (2017) Overview of the UK Population: March 2017.  5                                                                                                                                                               https://www.ons.gov.uk/releases/overviewoftheukpopulationmarch2017 2 Age UK (2017) Briefing: Health and Care for Older People in England 2017.http://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Research/The_Health_and_Care_of_Older_People_in_England_2016.pdf?dtrk=true 3 Mental Health Foundation (2017) Mental health statistics: older people. https://www.mentalhealth.org.uk/statistics/mental-health-statistics-older-people 4 Age UK (2010) Promoting Mental Health and Well-being in later life. http://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Care/Mental%20Health%20and%20Wellbeing%20in%20later%20life_pro.pdf?dtrk=true 5 Age UK (2011) Healthy Aging Evidence Review. http://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Health-and-wellbeing/Evidence%20Review%20Healthy%20Ageing.pdf?dtrk=true 6 Gottlieb, G. (2015) Is the NHS ageist? The Royal College of Surgeons Bulletin. Volume 97 (9), 405-406. http://publishing.rcseng.ac.uk/doi/full/10.1308/rcsbull.2015.405 7 Equality and Human Rights Commission (2016) Age Discrimination. https://www.equalityhumanrights.com/en/advice-and-guidance/age-discrimination 8 Boadt, L. (1984) Reading the Old Testament. An Introduction. New York: Paulist Press. p.250. 9 Andersen, F. I. (2008) Job. Tyndale Old Testament Commentaries Volume 14. Nottingham: Inter-Varsity Press. p. 83 10 Wiseman, D. J., (2008) 1 and 2 Kings. Tyndale Old Testament Commentaries. Nottingham:  Inter Varsity Press. p.1. 11 MacDonald, M.Y. (2010) Kinship and Family in the New Testament World. In Neufeld, D. and DeMaris, R. E. (eds) Understanding the Social World of the New Testament. Abingdon: Routledge. p.41 12 Examples of this can be found in: Mark 8:34; Matthew 25:46; John 11:25-26; Luke 23:43. Also see 1 Corinthians 15:17. 13 Meyers, C. (2005) Exodus. The New Cambridge Bible Commentary, Cambridge: Cambridge University Press, p.186-7. 14 Stanton, G. N. (1992) A Gospel for a New People Studies in Matthew. Edinburgh: T & T Clark. p.221. 

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Care for the elderly: some perspectives from Scripture

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