Guest Editorial
Aging and the Meaning of Life

In the many years of thinking and research on well-being in later life, it has become apparent that well-being involves something more than good physical health, financial security and social support: people who are content experience meaning and purpose in their lives. Having a meaning in life is associated with optimism and with the ability to overcome hardships; in the words of the philosopher Friedrich Nietzsche, “He who has a why to live can bear almost any how.” It stands to reason, therefore, that seniors and those who are concerned with seniors' well-being
should recognize that the subjective dimension of 'meaning' is as important as the material and social conditions of their lives. What gives life meaning varies from person to person: human relationships, work, individual goals and social causes are typical sources of meaning in day-to-day life. In a very broad sense, people who are spiritual are those who are sensitive to the dimension of meaning. They may articulate their reflections in terms of personal values and goals or they may take a philosophical or theological perspective on a universal 'Meaning of Life'.

For many seniors, meaning in
life is expressed in religious beliefs, values and practices. Besides offering hope in the face of death, their faith provides consolation and strength during difficult times and a guide for daily living.
Being a valued member of a congregation of believers also is a source of social support and of self-esteem.

In a society that has become increasingly multicultural and non-religious, the spiritual
needs of many seniors may not be met adequately. Family members and service-providers who do not share the same belief system may avoid discussing concerns that are expressed in religious terms, or they may overlook the importance for seniors of engaging in religious practices or going to services.

Seniors may have difficulty adapting to changes in beliefs
and practices within their faith: religious leaders must be sensitive to all persons in their congregations, provide guidance to understand changes and respect the differences in members' expressions of faith.

Religious leaders have a crucial role to play in ministering to the needs of a growing senior population, both in the community and in institutional settings. More training is required in theological schools for working with seniors. Because senior members can be counted on to participate in religious activities and services perhaps more so than younger persons-fewer efforts may be made to include them fully in the activities of the congregation and to make the message of faith relevant to their life circumstances.

There are encouraging research developments linking research on developmental potential in later life with ideals of spiritual growth that are common to all religions and to secular humanistic ideologies. According to many developmental psychologists, the senior years offer the greatest possibilities of expressing a selfless love of others and of acquiring tolerance, wisdom and serenity. Whether we are religious or not, we applaud persons whose 'spirit' or dedication to meaning can transcend the limitations of the body and the material world. To the extent that individual seniors develop these qualities, they serve as models of spiritual maturity.

In this perspective, seniors have much to offer to their faith communities and, indeed, to all persons who recognize a spiritual dimension to human life. I agree with Bill Hughes, of theOntario Advisory Council on Senior Citizens, who writes:"I'm convinced older people have an immense store of undiscovered talent and life in their souls. But like the flower that shyly blossoms deep within the woods, does it fully exist if no one knows it's
there?"1

Wilma Mollard,
NACA Member,
Saskatchewan

Spirituality and Meaning

At the heart of every religion and of contemporary growth psychology is the conviction that human life has a spiritual dimension, that life must be dedicated to the fulfilment of meaning. According to psychoanalyst Erich Fromm, there is a fundamental human need for "a frame of orientation and an object of devotion." In his words, "All men are 'idealists' and are striving for something beyond the attainment of physical satisfaction." 2
For psychologist Paul Wong, personal meaning has three components:
intellectual beliefs which help the individual make sense of life experiences; motivation to pursue goals consistent with one's values; and an emotional state of satisfaction because one's life is worth living. 3
In a broad sense, to be spiritual is to be sensitive to the dimension of meaning in one's life.

Aging and the need for Meaning

Having a strongly-felt meaning to life contributes in many ways to seniors' well-being. Better morale, less loneliness and a positive attitude towards aging are found among seniors who have a sense of life purpose. They also are more likely to be satisfied with their healthand to become less depressed if their health deteriorates. It appears, too, that having a meaning in life helps prevent stress-related illnesses. Similar patterns of well-being are found among those whose life meaning is expressed through a religious faith and those with a sense of life purpose that is not necessarily religious.

A strong sense of life meaning plays a positive role in helping seniors cope with life problems. In the NACA consultation on the strategies used by seniors to cope with barriers to independent living, several seniors reported that they prayed for strength or tried to accept some difficulties as being 'God's Will'. 4
Psychoanalyst Viktor Frankl survived five years in a Nazi concentration camp in the hope of seeing his wife again and with the desire to write a book.5

According to Dr. Edward Stieglitz, "Having a purpose distinguishes those persons who grow old from those who get old.” 6

Religious Meaning

Inasmuch as religion, as a shared system of personal meaning, is a social reality, religious symbols and rituals form the basis for common values, for social support, for celebration and for mourning. Religious people are propelled by an awareness that there is an ultimate purpose in the Universe in which they participate, or a Higher Power with whom they have a unique relationship. Religion creates solidarity among believers and makes life special.

According to researchers Dan Blazer and Erdman Palmore, the ink between emotional well-being and religious commitment is strongest among seniors aged 75 and older. 7

A plausible explanation offered by Harold Koenig, James Kvale and Carolyn Ferrel is that as health, social and financial resources diminish in the later years of life, religion remains a durable source of support and comfort; for seniors 75+, religiousness contributes more to well-being than financial status or social support. 8

As a resource for overcoming problems and for adapting to situations over which a person has little control, religious faith works well. Religious seniors afflicted with serious diseases seem to have better chances of recovering, prolonging their life or suffering less physical pain than do people without a sustaining faith. As far back as 1910, Sir William Osler, the famous physician, wrote about 'the faith that heals.'9

Comparing religious and non-religious ways of coping with stressful events, researchers Harold Koenig, Linda George and Ilene Siegler observed that religious coping behaviours were mentioned most frequently. These behaviours included prayer, faith and trust in God, reading the Bible and seeking help from the minister, from church friends or from church activities.10

Religious Practice in Later Life

Although not all seniors claim to have a strong religious faith, many more seniors are religious than any other age group. Moreover, seniors who have been religious in the past tend to become more committed their faith as they get older. Attendance at services and other organized religious activities remains high until many seniors reach their mid-seventies, after which health problems may limit their ability to engage in activities outside the home. Nevertheless, these seniors remain committed to their faith and continue to engage in private spiritual activities, such as prayer, Scripture reading and listening to or watching religious programs on radio and television.

Modernisation, Multiculturalism and Faith

The influence of organized religion is less extensive than in the past in Canada and other modern industrialized societies. Greater educational opportunities and mobility, the presence of mass communication, the weakening of family and community structures, and the enhanced values placed on individualism and on science as a basis for knowledge have led to a transformation of religious belief and practice. Some religious traditions have adapted their teachings and practices to make their spiritual message more relevant to the modern world A number of persons claim a religious affiliation but seldom practice their faith; still others meet their spiritual needs in non-religious ways. Moreover, our society has become increasingly multicultural and multireligious; many new Canadians espouse faiths such as Islam, Hinduism, Sikhism, Confucianism, Buddhism and Taoism. Spirituality holds a special place inthe traditional aboriginal cultures in Canada. A poem by Anna Lee Walters, painted at the entrance of Wanuskewin Heritage Park, north of Saskatoon, testifies to the importance of the spiritual dimension in the lives of aboriginal Canadians:

The nations live!
My spirit lives'
The spiritual world is everywhere!
If you listen, you will hear!
In the distance,
I hear one of a thousand songs of
an ancient spiritual man...

For seniors who hold to the religion in which they were raised, religious change and multiplicity can be bewildering. They may feel isolated within their own place of worship, their communities, and even within their own families. Respecting generational and cultural differences in religious belief and communicating about important life matters with seniors whose beliefs, values or religious practices are different pose a challenge to families, faith
communities, religious leaders and service-providers.

Spiritual Intervention: the Role of Caregiving

When people face crises that challenge their will to live, spiritual support and guidance may be essential. Religious leaders have a special role to play, but they are not the only people who can respond to seniors' spiritual needs. Any sensitive person can assist another in finding a meaning in life to weather the storm. Knowing how and when to respond appropriately may be difficult, however.Paul Wong describes four ways of enhancing meaning in seniors'lives: 11

• Reminiscence. Facilitating, through guided discussion, a review of one's life to resolve past conflicts, affirm accomplishments and skills, and transmit the lessons learned from experience.
• Commitment. Providing opportunities to seniors to invest their time and energy to a task or to other persons.
• Optimism. Offering future events to look forward to and nurturing the hope that something positive will happen. "It is by looking into the future that we have the best chance of surviving present difficulties."
• Religiosity. Supporting religious beliefs and meaningful practices. "When everything is lost, including one's health," writes Wong, "the spiritual capability to reach out to God remains an effective weapon to combat meaninglessness and despair."

Health and social service professionals working with older adults may find it necessary to enter into a religious senior's perspective to support healthy coping behaviours. Consultation with a religious leader of the senior's own faith may be useful in this regard. Many physicians consider that they have some responsibility for dealing with religious issues if requested by their patients. Doctors may be willing to encourage patients' religious beliefs, join in prayer, or if asked, share their own beliefs.

Koenig advises that "prayer may be appropriate with older patients during times of severe emotional distress or sickness or near death.” 12

'Spiritual distress', as a loss of meaning in life, is recognized as a nursing diagnosis, requiring nursing care no less than physical, social or psychological distress. 13

Nurse Elizabeth Peterson advises that providing spiritual nursing care for older persons involves first a willingness to be present and to share in the struggles and changes in their lives. This presence assures patients of their dignity and worth. 14

To Father Antonio De Sousa, chaplain in an Ottawa chronic care hospital, "The acceptance and full attention of the caregiver becomes a vehicle for communicating the love of God." The simplest actions can have a spiritual significance if they help to strengthen the sense that life is worthwhile; in the words of Carter Catlett Williams, even a gentle back rub to a patient with advanced dementia can be "a quiet moment of giving and receiving that approaches the quality of sacrament." 15

In responding to seniors who feel that their usefulness is over when they can no longer 'do', Anne Squire, a senior and a former moderator of the United Church of Canada, advises that "it is important to help them learn that 'being' is as important as 'doing'." Caregivers should assist seniors in continuing meaningful religious practices to the extent possible. They can pray with senior patients,or read scriptural passages to them, if asked. The communal bond a religious service can generate and the power of faith symbols should not be underestimated: even persons in later stages of dementia remain able to respond to religious symbols and rituals. For seniors without a strong religious affiliation, music, art, nature and the confirmation that one is cared for and valued can nourish the sense of meaning.

The Role of Religious Leaders and the Faith Communities

Religious leaders of all faiths increasingly are called to work with older members of their congregations and their families, in the community no less than in institutional settings. These leaders communicate the answers of their faith to the perennial human questions of death and personal suffering. As people get older, these issues are encountered more frequently. Moreover, spiritual leaders may be increasingly called upon to provide guidance to deal with crises of personal meaning in retirement, the stress of informal caregiving or with ethical decisions regarding life-prolonging medical intervention. To provide meaningful theological answers to the life situations of older adults, persons with pastoral responsibilities need to have some knowledge of aging and to be free of negative attitudes towards seniors.

Leaders of congregations may be in a good position to mobilize community support for senior members who experience problems in daily living owing to faltering health. They may assist in finding meaningful roles for seniors within the faith community. They can help to remove the barriers to participation in services, by such actions as making places of worship more accessible or arranging transportation for seniors with impaired mobility and printing large-type reading material. A committee of senior congregants may be helpful in designing 'senior-friendly' places of worship. Outreach efforts by faith communities also benefit lonely seniors by making them less vulnerable to unscrupulous 'preachers' who use the guise of religion for financial exploitation.

Programs for senior members exist in several religious denominations. Some churches, such as the Anglican Church of Canada, have established diocesan committees on aging to attend to the needs of seniors in the church community. Holy Trinity Anglican Church in Toronto has established a hospice movement to assist terminally-ill persons; as described in journalist June Callwood's book Twelve Weeks in Spring, this initiative came about from the experience of the congregation in helping senior Margaret Frazer die peacefully at home. 16

A Catholic spiritual movement especially for persons over 55, known as La Vie Montante, has become popular in many francophone dioceses. In Vancouver, some parishes are considering a Pray and Ride service, where people would drive seniors to church and in return, the seniors would say a prayer for the drivers. In Elliott Lake, Ontario, seniors and religious leaders met for a workshop this year to address the spiritual needs and issues of self-worth and self-esteem among older people. 17

The United Church of Canada offers pastoral care workshops that teach volunteers how to visit and how to provide support. An intergenerational program is the Secret Pal project; seniors are matched as 'secret pals' with children in the church school program and letters are exchanged during the year. At the end of the church school year, a party is held where 'pals' meet. In Saskatoon, theUnited Church runs McClure House, an inter-denominational enriched housing complex which allows residents to remain integrated in the life of the local community and of the congregation. Many faiths, as well as non-religious personal growth movements, offer the opportunity of retreats. A few days in a quiet place, often with guidance for personal reflection, is popular as a means of spiritual renewal. Finally, religious leaders can celebrate with the entire community of believers the special spiritual qualities that can blossom fully in later life. In the words of the founder of the Gray Panthers, Maggie Kuhn, "Churches and synagogues have a tremendous opportunity... for creative new ministries, if they take seriously the experiences, skills, and human resources represented in the older members of their congregations.”18

Spiritual Gifts in Later Life

The major religions of the world recognize a special significance to the latter part of human life. In Hinduism, a person who has fulfilled his or her obligations to family and society can dedicate the years of later life to seeking spiritual enlightenment. In Buddhism, old age attests to the transitoriness of the physical world and to the need to find lasting meaning in a participation with the divine Consciousness. According to theologian Brynolf Lyon, the Judeo-Christian tradition also transmits three basic teachings about old age: old age is a blessing of God; it is a period of growth; and old age is marked by a special form of spiritual witness. 19

The later years of life are considered by many gerontologists to be the period when one takes stock of one's whole life to find meaning and to maintain a sense of identity and peace in the face of one's imminent death. This life review can have a spiritual significance, not only for seniors themselves but for everyone in contact with seniors. Old age is the witness of a lifetime of experience. In the words of Viktor Frankl, now 84, "Old people have their possibilities in the past-the deeds done, the loved ones loved, and last, but not least, the sufferings they have gone through with courage and dignity. In a word, they have brought in the harvest of their lives."20 For senior Bill Hughes, "Reaping what you have sown throughout life is a joy in the later years." Younger persons can learn from the life journeys of their elders; says theologian Brynolf Lyon, the lives of seniors can provide "a meaningful horizon for the moral becoming of others." 21

Death becomes more present in seniors' lives, both with the deaths of loved ones and the awareness of the limited time remaining in their lives. For many people, the awareness of death makes life more precious. Theologian Eugene Bianchi suggests that the limits of time in older age can teach us to experience the ordinary as a gift, with emotions of joy and reverence. 22

The present moment can be lived more intensely in old age: the enhanced ability of many seniors to 'smell the roses along the way' can serve as a lesson to younger persons to fully experience the present. Finding the courage to overcome loss and suffering is a challenge to all persons. People who have discovered meaning in their lives are more likely to overcome their suffering; some have realized too that it is possible to find meaning in suffering. A Hindu sage of 72 who had been plagued with chronic illness for many years, reflected that "each moment of suffering enables you to understand what it means when others suffer... There is a grace in this, because it brings a widening of consciousness." 23

Seniors who have endured the suffering in their lives with a profound sense of meaning are a source of inspiration to everyone they meet.

Spirituality and Public Policy

The personal need for meaning is present throughout life, although it may be taken for granted. Certainly, in the modern world, meaning of life questions lie in the private rather than the public domain; it is hard to imagine having a social policy on spirituality, or a Minister of Meaning! In health and social services, spiritual needs may have less precedence; they may be overlooked in planning services or relegated to a minor role. If there is a need to control costs, pastoral care may be sacrificed for more 'essential' services. It is necessary for policy-makers, program, planners, service providers and informal helpers to acknowledge the importance of personal meaning to an individual's health and well-being and to use the most appropriate strategies to promote a sustaining sense of life meaning.

Fact File

• The belief that one's life has purpose is stronger among older adults. Reker, G.T. et al. Meaning and purpose in life and well-being: A lifespan perspective. Journal of Gerontology, 42, 1, (1987): 44-49.
• In 1981, there were about 80 distinct religious groups in Canada,
  including approximately 50 Protestant denominations. Statistics Canada. Religion. Catalogue 92- 912, Table 1. 1981 Census. Ottawa: SC, 1993.
• In 1990, 42% of Canadians aged 65+ attended a religious service or
  meeting at least once a week; the proportion dropped to 31% for
  people aged 45-64 and to 18% or less among 15-44 year olds. Baril, G. and G. Mori. Leaving the fold: Declining church attendance. Canadian Social Trends, (autumn 1991): 21-24.
• The proportion of seniors who rarely or never attended religious services declined from 32% in 1985 to 21% in 1990. Ibid.
• Women tend to be more active than men in church activities; in 1990, 40% of Canadian women and 32% of men attended religious services at least once a month. Ibid.
• People in the Atlantic provinces are more likely to attend church weekly (34%) than are those in Quebec (24%), Ontario (25%) or the Western provinces (20%). Ibid.
• Americans are more frequent church-goers, than Canadians: about 42% of Americans attend religious services weekly, in comparison to 32% of Canadians. Ibid.
• 52% of widowed Canadians attended religious services once a month or more in 1990; among married persons, the proportion was 39%; for single persons, frequent church attenders numbered 31%; among divorced persons, frequent church attenders accounted for 23%. Ibid
• Catholicism is the major religious group in Canada: in 1990, Roman
  Catholics accounted for 45% of adult Canadians, in comparison to
  30% who were affiliated with the main Protestant denominations. Ibid.
• 12% of Canadians claimed to have no religious affiliation in 1990, up from 7% in 1981. Ibid.
• Almost half (45%) of seniors who were asked how they coped with
  stressful situations in their lives mentioned a religious behaviour; about 75% of religious coping involved placing trust and faith in God, praying and obtaining help and strength from God to handle the situation. Koenig, H. et al. The use of religion and other emotion regulating coping strategies among older adults. The Gerontologist, 28, 3, (1988): 303-310.

Tips List For seniors

• Engage in activities or projects that give you meaning and pleasure,
  whether or not they are explicitly religious.
• Take time to reflect on the good things in your life, the contributions
  you have made, the people you have touched and who have touched you, and the important lessons your life has taught you.
• Cultivate a positive outlook on life and seek support when your sense
  of hope is faltering.
• Share with people around you how your convictions or ideals have
  helped you overcome difficult periods in your life or cope with suffering.
• Contact a religious leader recognized in your community for religious guidance: be wary of door-to- door preachers and of mass media evangelism.
• Contact your congregation or religious group for information about pastoral programs for seniors.

For service providers

• Listen to seniors when they express a need to find meaning in their experience and answer their concerns in the terms with which you feel most comfortable.
• Encourage religious beliefs or practices that enhance positive coping actions and attitudes.
• Recognize chaplains as important members of the multidisciplinary
  team in health and social care.

For religious leaders and congregations

• Make efforts to reach out to aging members of your congregation, and to address the spiritual needs of people undergoing stressful situations that are common in later life.
• Eliminate barriers that prevent seniors from participating fully in religious services and activities.
• Contact health facilities and community agencies to offer your services as a consultant to service-providers.
• Encourage senior participation in the charitable work and social or
  devotional activities of the congregation.
• Give the congregation opportunities to learn from and to be inspired by senior members, for instance, in intergenerational religious education activities.

For Further Reading...

Please refer to your library for a copy of these publications.

All port, G. The individual and his religion. New York: MacMillan, 1950.

Blythe, R. The view in winter. Reflections on old age. New York: Penguin Books, 1979.

Campbell, Joseph. The power of myth. New York: Doubleday, 1988.

Clements, W.M. (ed.) Ministry with the aging. San Francisco: Harper & Row, 1981.

Cole, T.R. and J.W. Ellor. (eds.) Aging and the Human Spirit. Thematic issue of Generations, 15, 4, (Fall 1990).

Erikson, E. H. etal. Vital involvement in old age. New York: W.H. Norton, 1986.

Fischer, K. Winter grace: Spirituality for the later years. Nahwah, NJ: Paulist Press, 1985.

Frankl, Viktor. From death camp to existentialism. Boston: Beacon Press, 1950.

Fromm, Erich. Psychoanalysis and religion. New York: Bantam Books, 1967.

Glass, J.C. Jr. (ed.) Religion and aging. Special issue of Educational Gerontology, 14, 4,(1988).

Kushner, Harold. When bad things happen to good people. New York: Avon Books, 1983.

Maves, P. B. Faith for the older years: Making the most of life's second half. Minneapolis: Augsburg Press, 1986.

Powers, E.A. Aging society: A challenge to theological education. Washington, D.C.: American Association of Retired Persons, 1988.

Tournier, P. Learn to grow old. New York: Harper & Row, 1971.

Notes

Notes
1 Hughes, Bill. Seniors' spirit can be rekindled. The Anglican, (December 1989).

2 Fromm, Erich. Psychoanalysis and religion, New York: Bantam Books, 1967.

3,11 Wong, P. Personal meaning and successful aging. Canadian Psychology, 30, 3, (1989): 516-525.

4 National Advisory Council on Aging. Understanding seniors' independence. Report no. 2. Coping strategies. Ottawa: The Council, 1990.

5 Frankl, V.E. From death camp to existentialism. Boston: Beacon Press, 1950.

6 Stieglitz, E. Quoted in Productive Aging News, no. 66, September 1992, p. 6.

7 Blazer, D. and E. Palmore. Religion and aging in a longitudinal panel. The Gerontologist, 16, 1, (1976): 82-85.

8 Koenig, H. et al. Religion and well-being in later life. The Gerontologist, 28, 1, (1988): 18-28.

9 Osler, W. The faith that heals. British Medical Journal, 1470-71, 1910.

10 Koenig, H. et al. Use of religion and other emotion-regulating coping strategies among older adults. The Gerontologist, 28, 3, (1988): 303-310.

12 Koenig, H. Research on religion and mental health in later life: A review and commentary. Journal of Geriatric Psychiatry, 23, 1, (1990): 23-53.

13,14 Peterson, E. Physical... the spiritual... can you meet all of your patient's needs? Journal of Gerontological Nursing, 11, 10, (1985): 23-27.

15 Williams, C.C. Long-term care and the spirit. Generations, 15, 4, (1990): 25-28.

16 Callwood, June. Twelve weeks in Spring.= Toronto: Lester & Orpen Dennys Publishers, 1986.

17 Pilon, C. Caregivers, clergy meet with seniors. Elliott Lake Standard, October 13, 1992, A3.

18 Hessel, D. Maggie Kuhn on aging. Philadelphia: Westminster Press, 1977.

19,21 Lyon, K.B. Toward a practical theology of aging. Philadelphia: Fortress Press, 1985.

20 Frankl, V. Facing the transitoriness of human existence. Generations, 15, 4, (1990): 7-10.

22 Bianchi, E. Aging as a spiritual journey. New York: Crossroad, 1984.

23 Eugene, T.L. Dialogues with three religious renunciates and reflections of wisdom and maturity. International Journal of Aging and Human Development, 32, 3, (1991): 211-227.

Expression is published 4 times a year by the National Advisory Council on Aging,

Ottawa, Ontario

K1A OK9,

(613) 957-1968,
Fax: (613) 957-9938.

The opinions expressed do not necessarily imply endorsement by NACA. [ISSN 0822-8213]

Research: Louise Plouffe
Editing: Francine Beauregard
Renée Blanchet