Health, Aging and Spiritual Well-Being

No one can question that most Americans are living longer, are more active, productive and vital than ever before. Older adults in general are healthier, have greater financial security and enjoy more opportunities for leisure and continuing learning than any previous generation of senior adults. Yet at the same time, the highest suicide of any population segment in America is experienced by white males over the age of 65. Depression and anxiety are ranked number one and number two among mental health concerns of the older adult. Undiagnosed, undertreated and misunderstood, these illnesses often have a significant impact on overall functioning and contribute substantially to physical illness. Unresolved grief is a significant factor in some physical illnesses, depression, late onset alcoholism and suicide in older adults. In the words of Richard P. Johnson, Ph.D., The 12 Keys to Spiritual Vitality, "we suffer from a `meaning crisis' today."

I would suggest that despite all of our medical, technological and economic advances, we have over-looked and/or misunderstood the most critical factor of all: the spiritual dimension of our being. The National Interfaith Coalition on Aging (NICA) in 1972 stated: "Spiritual well-being is the affirmation of life in a relationship with God, self, community and environment that nurtures and celebrates wholeness." They went on to say that the spiritual well-being is not just one factor among many, but is the dimension that underlies and gives meaning to all aspects of life and brings wholeness, integration and health to our total being. The spiritual dimension is therefore not just the province of religious institutions nor is it solely of private concern. One's spiritual well-being (as understood by the NICA definition) has implications for health and general wellness and should be of interest to anyone addressing issues involving the physical and mental well-being of older adults.

Erik Erikson conceptualized the last developmental stage of life, as "Integrity vs. Despair" (meaninglessness). The successful accomplishment of the tasks associated with this stage, results in wisdom and a deep sense that life has been meaningful in spite of unrealized goals and perceived failures. Important to this "integrating" process is Life Review, a structured way of looking back, reexperiencing and sharing with others important life experiences, decisions and relationships.

Gerontologists admit that we have not done a good job in helping older adults address the meaning dimension of their lives. There are very few identified roles after retirement and few expectations that older adults will share their knowledge, experience and wisdom with the younger generation. There are few opportunities to deal with unresolved grief, review one's life experiences, choices and beliefs in a comprehensive, structured and supportive environment.

One would think that churches and synagogues would have the upper hand in helping people to deal with the spiritual (meaning) dimension as they grow older. Yet this is often not the case. Many faith communities, while having a high number/percentage of older adults, have no one expressly trained to deal with spiritual (meaning) issues in the context of aging. Often the heavy emphasis is on travel, games, and fellowship together, and it is assumed the spiritual dimension is "taken care of" with Bible study and a worship service. Now, I do not for a minute discount the value of social activities. But they are not sufficient. The spiritual (meaning) dimension relates to all of life experiences, relationships, activities, choices and beliefs as they relate to God, self, community and environment. These include the impact on faith of chronic illness, loss of life-long friends, or caring for an invalid spouse. They include self-esteem issues experienced with physical decline, or perhaps in a necessitated move to a retirement center or nursing home. Other spiritual issues relate to the meaning and purpose of one's life, feelings of hopelessness, helplessness, loss of independence and loneliness.

I would submit that whether we work in a health care or congregational context or other environment that brings us into relationship with older adults that the spiritual (meaning) dimension is one that must be seriously considered. In the words of the familiar cliche, we have succeeded at adding years to life, but now we must add life (meaningful life) to our years.

For more information on seminars related to aging issues and Congregations of Faith, Chief Support Ministry and Life Review Training, contact Frank Balch, M.Div. at The Institute of Religion, 713-797-0600.

- Frank Balch is a clinical fellow at the Institute of Religion

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©2006 Texas Medical Center

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