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1991 / 3
Aging
Editorial
It is simplistic to speak of old age in the singular and considerably more accurate to speak of it in the plural — to speak of the many ways and stages of growing old, in the world’s many cultures. The meaning of age and its phases varies widely with factors such as class, gender, family structure, employment opportunities, retirement opportunities, and available health care. Yet, although every society of the world includes elderly members, the twentieth-century goal of the medical conquest of malnutrition and disease has effected the creation of a newly enlarged class of elderly persons, especially in Western societies. Various demographic, medical and economic factors have converged to create an elderly population which is twenty to twenty-five per cent of the total population of industrialized countries, replacing the small number of isolated individuals previously easier to assimilate in a younger population. Many older persons will confront an extensive period of retirement (withdrawal from economically productive labour before the onset of disability), lasting for fifteen to twenty, and occasionally even for twenty-five to thirty, years. Many more live for decades within a process of physical decline which poses for them questions of social contribution and dependency, as well as the confrontation with their own mortality. While it is still far too early to foresee the global consequences of a prolonged aging process, it is likely that the elderly population in the developing nations will also continue to grow and to pose cultural questions as serious as those now confronted by the industrialized nations.
The aging process presents not only medical and social questions, but also religious and spiritual ones. The elderly are not only a problem, a responsibility, or a resource for ‘the younger generation’; to age is a task and a challenge for each one of us personally, as we grow older ourselves, listen emphatically to the experience of those who are going before, and enter the final stages of our own lives. Present Western approaches for confronting problems related to aging are limited and inadequate. An often untapped resource in the quest to deal with ‘the problem of aging’ is the insight of elderly persons themselves who reflect on their orientation and [viii] sense of meaning. Several authors in this volume make reference to their own engagement with the aging process and share wisdom about the intrinsic value and the moral and spiritual potential of that process. Moreover, non-Western cultures have much to teach the so-called ‘developed’ nations about the value of a long life and about the social integration of elders.
The first part of this issue will attempt to describe selected aspects of the phenomenon of aging as well as to broaden awareness of its dimensions. The second part will present theological, spiritual and pastoral reflections on aging. A third section will introduce some cross-cultural voices into the discussion. Although we make no pretensions to offer definitive conclusions on aging, we hope that a specifically ethical perspective will inform the issue: the evaluation of the goals, meaning, value and social consequences of human action and of social institutions, in an international forum. How can human communities recognize both the problems and the intrinsic value of old age, and shape institutions such as the family, employment and health care in ways that enhance the significance of the lives of elderly persons, and integrate them successfully into society and church? What does a specifically Christian perspective have to offer on these questions? While aging is clearly an ethical concern, it is also undeniably a concern of other areas represented in Concilium: pastoral and practical theology, spirituality, feminist theology, Third World and liberation theology. These other theological dimensions will complement the ethical in our quest for a more integral Christian understanding of the human aging process.
The first section of this volume describes aging and sets it in its social context. Rosa Fernández Herranz provides a physician’s view of aging, not limited to biomedical data, but sensitive to the relational aspects of medical interactions with the aged and their families. She illustrates that it is not always easy to define the borderline between ‘normal’ and ‘pathological’ consequences of age. In any case, the physical degeneration which age represents inevitably carries repercussions for the most intimate identity of the self. The aged require a team approach to therapy in order to enable them to function most effectively in their environment. Gerardo Hernández Rodrfguez substantiates the quantitative increase of the elderly population in industrialized countries in the present century and also differentiates demographically between women and men. The former are not only more numerous, but are more likely to spend their declining years in the single or widowed state. Elisabeth van der Lieth, including herself among three case studies of older women, explores issues of widowhood, dependency and health in Western society. She also raises questions about the agenda of medical ‘progress’ in defining the cultural response to [ix] aging and the accompanying decline of physical well-being. Daniel Callahan develops an analysis of the special problems which the availability of technology poses in health care for the elderly in industrialized nations, and questions attempts to extend the life span indefinitely, even when quality of life is vastly impaired. Callahan urges readers to balance ‘curative’ with ‘caring’ medicine, and to incorporate the health needs of other age-groups and additional social goods (education and housing) as considerations relevant to social policy decisions about medical care for the elderly.
The second part of this issue provides explicitly theological interpretations of the meaning of the aging process and of old age itself. Robert Martin-Achard demonstrates that the Hebrew Bible, without avoiding the burdens that old age can also bring, especially sees long life as God’s gift and reward. The commandment to honour one’s parents, while susceptible of many interpretations, today implies a responsibility to protect and succour the old. Christians are reminded that God brought forth the people Israel from an elderly couple without children, without hope, and seemingly without future. From a personal experiential foundation, Lady Oppenheimer confronts the almost universal human fear of old age; explores the interrelated aspects of old age as fruition, as decay, and as continuity in changing circumstances; and concludes that, for the Christian, old age can epitomize the mandate to ‘live in the end time’. The task for the elderly is progressively to let go of all one’s possessions.
Paul Schotsmans investigates the manner in which human beings can best realize their potential, and locates the total development of the elderly within this context. The grounding anthropological principles are the necessity of recognizing the uniqueness of each person, of having social relationships with God and others, and of participating in some form of community living in which personal independence is guaranteed. Eugene Bianchi (a layman), and Walter Burghardt, SJ (a priest), outline the prospects for a fruitful old age from two complementary directions: action, motivated by an altruism enhanced by one’s life experiences and directed toward peace and justice (Bianchi); and contemplation, which arises from kenosis or ‘self-emptying’, and consists in ’a long loving look at the real’ (Burghardt). Martina Blasberg-Kuhnke places the phenomenon of aging in the Christian community, as she argues not only that church ministry must reach out to the elderly, but also that the elderly can be a catalyst for the identity of the Christian community: a koinonia between young and old, who achieve solidarity in praxis.
A final section offering cross-cultural perspectives includes Asian, [x] African and Latin American representatives. These three illustrate the greater importance of village and kinship networks in defining the place and role of the elderly, while a fourth North American representative attempts to recreate in a ‘First World’ context some of the structures which have traditionally supported aged persons within the family. Mary John Mananzan, OSB, contributes an overview of cultures in North Asia, South Asia and Southeast Asia, showing how indigenous religious systems have generally supported veneration of the elderly and their wisdom; how Asian societies have included them in a sense of group belonging; and how the present generation still maintains a high level of respect for old people. At the same time, aged women and especially widows can be quite disadvantaged, particularly if they have no sons to care for them. Writing from Brazil, Ivone Gebara makes it clear that the reverence for age which characterizes traditional societies must not be romanticized, particularly when such cultures have been eroded and exploited by the values and the economies of their rich neighbours. Old people in the less developed nations, especially women, can also suffer extreme burdens of poverty and be reduced to dependency, alienation and marginalization. Under the influence of capitalist culture, these nations, too, harbour a norm of productivity and an ideal of youth. Gebara recommends a popular theology and ethics of old age in which age is accepted as a part of one’s own humanity, and in which to love and serve the old would be to love and serve one’s own future as well as God. Bénézet Bujo emphasizes that in Africa elders are part of an integrated and hierarchically ordered community which has its source in God. A special function of the elderly is to enable the generation of today to live out of the memory of previous generations. One of the tasks of African culture is to preserve the history of past values, while moving into the modern world.
Drew Christiansen, SJ, searches for a way to reinstitutionalize in the ‘First World’ the family-centred approach to aging still typical of Asia and Africa. The ideals of the young are autonomy and freedom, but other sources of human dignity are physical care and social cultivation -continuing needs of the old best provided within the family. Christiansen urges social and financial supports for families engaged in ‘eldercare’. A family-based model of care could not only meet the physical demands of the elderly, but could also provide intergenerational friendship for older people who strive to integrate their lives, face up to loss, and prepare for death.
The contributions to this issue of Concilium reflect the continuing strong influence of European and North American cultures on Roman Catholic theology and ethics. We hope nonetheless that these cultures [xi] have been brought into productive dialogue with theological reflection and social analysis emerging from some of the world’s other cultures and social realities.
Lisa Sowle Cahill
Dietmar Mieth