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Search for meaning

Spirituality:
The Older Adults' Search for Meaning

Gwendolyn de Geest RN, BSN, MA

Introduction

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 may be defined as, “the witness of a lifetime of experience” (National Advisory Council, 1992 b).

This paper addresses the importance of the older adults’ need to attach meaning to life within the spiritual realm, and how this is shaped by the social context in which it occurs. The paper defines the sociological and nursing approaches, accepting that there are similarities and differences in meeting this need for the older adult. In reviewing the literature, sociology of religion, social well being, and the value of spiritual well being is discussed. Some of the non–traditional religious practices are examined, as well as the older adults’ need to interact with others in supporting their spiritual integration.

In recognizing the importance of this spiritual literacy for the older adult, there are several benefits to be attained, not only for the individual, but also for society. These benefits include quality of life for the older adult, bridging the generational gap, and meeting older adults’ needs. Finally, the paper discusses innovation to assist the older adult to attach meaning to life within the spiritual realm.

The Sociological Approach

Later life provides a unique time for the older adult’s spiritual growth. The social system must understand and respect the religious traditions of the people in the society. Through this understanding, then, assistance may be offered to help the community provide support to older members. This support may take the form of outreach religious services or car pools to places of worship. Novak (1997) and Hooyman & Kiyak (1996) offer some suggestions for social programs, including:

  • implication for development for new directions for geriatric policies/programs
  • increased emphasis on health promotion
  • development of social services, including counseling, transportation, in–home visits, advocacy for older adults
  • adult day care centres
  • education, i.e. retirement training

In other words, there is a need for formal as well as informal support through families, neighbours, and friendships in contributing to the older adult’s sense of health and well–being. Indeed, this support may very well encourage the older adults’ spiritual growth, by offering advocacy and education.

The Nursing Approach

Nurses may avoid dealing with spiritual needs because they feel they are too personal. It is important for the nurse to create a climate of trust and rapport for the older adult. Through gathering a brief history and assessment of the patient, it soon becomes evident if the older adult is seeking spiritual assistance, or has attained their own level of peace and understanding. Ebersole and Hess (1994) offer several strategies and nursing interventions to assist in meeting the older adult’s spiritual needs:

  • create a therapeutic environment
  • assess support system
  • assess past methods of decreasing distress ie. prayer, music, reminiscence therapy
  • refer to clergy
  • evaluation of medications and their interactions
  • activation and evaluation of appropriate community referrals
  • techniques to assist client and family in reducing spiritual distress

This emphasis on the nurse creating a therapeutic environment with the patient is vital, especially if the desired outcome is for the patient to maintain a sense of well being. In other words, nurses must no longer avoid dealing with these spiritual needs. It soon becomes evident to the nurse if the patients have attained their own level of peace and understanding in this spiritual realm. The nursing approach identifies the need to examine the spiritual beliefs in order to understand the health behaviors of the older adult more fully.

Sociology of Religion

Religion is a social phenomenon and is in an interactive relationship with the other social units that constitute a society (Johnstone, 1983; Wilson,1987). Religion qualifies perfectly as a field of sociological study and analysis, both in explaining group dynamics and in explaining group influence (Johnstone, 1983). In other words, religion answers the question, “Who am I?” for individuals, and “Who are we?” for groups. Religion exerts influences not only on its members, but also on nonmembers and on other groups and institutions. These groups have at least the potential for influencing people just as do groups that centre around one’s family, peers, or workplace (Wilson, 1987).

This influence may especially impact on older adults, as many may be disengaging from formal group connections. In other words, the older adult still may require some form of group connection and may find it through religion.

As these older adults are disengaging from formal connections, are they becoming more religious with age? Studies differ in their answers to this question. Studies find that poor health and the lack of transportation lead to declines in formal religious activity. Hooyman & Kiyak (1996) and Novak (1997) agree that although religion appears to be very important to many older people, they probably also valued it when they were young.

Therefore, even though some older adults are no longer attending a formal church service, they may very well remain strong in their faith. In other words, contrary to popular stereotypes, we do not necessarily become more religious as we age. But when the religious practices of older individuals are conceptualized to include patterns of belief, religious orientation, and stability of religious attitudes, rather than only activities within the formal association of the church, the importance of religion remains stable over time. The few longitudinal studies available on this topic suggest that cohort differences may be more important than the effects of age (Hunsberger, 1985). And although religious convictions appear to be more salient over the years, this may be a generational phenomenon captured by the cross–sectional nature of most of the research.

In other words, the older adult may very well maintain their faith and belief system, even though they are no longer able to attend formal church activities. It would be most interesting to conduct a psychosocial community based research, depicting the journeys these aging adults are taking in search of meaning. Sharing the lived experience of our elders in this spiritual realm would enhance the understanding for sociologists and gerontologists.

On the other hand, religious beliefs, as contrasted with church attendance, appear to be relatively stable from the late teens until age 60, and to increase thereafter (McFadden & Gerl, 1990). In fact, while attendance at formal services declines with age, older individuals apparently compensate by an increase in internal religious practices through reading the Bible, listening to religious broadcasts, praying, or studying religion. Thus, some older people who appear to be disengaged from religious organizations may be fully engaged non–organizationally, experiencing strong and meaningful subjective ties to religion (Stuckey, 1990).

But Baril and Mori (1991) disagree with this. In fact, Canadian social trends from the period of 1985–1990 indicate that the percentage of older adults attending religious services at least once a week actually increases with age. And women tend to be more active than men in church activities. Widowed people are the most frequent church attenders (Baril & Mori, 1991).

There has been then, much evidence to suggest that the older adults’ religious beliefs remain stable, although the church attendance is declining. Unfortunately, the majority of the research has been of a cross–sectional nature, and therefore has not made evident the effects of the cohort differences, as opposed to effects of age.

For some, the declining church attendance may be attributed to the older adult’s poor health and the lack of transportation. But studies find that religious attitudes remain stable throughout old age (Novak, 1997). Blazer and Palmore (1976, cited in National Advisory Council 1992b) say that people aged 75 and older show some of the strongest religious belief. This may, in part, reflect their upbringing at a time when religion played a bigger part in people’s lives. It may also reflect the role that religious faith can play as health, income, and social supports decline in old age. Religious belief can help a person find meaning in the face of despair (Novak, 1997, McFadden, 1996).

This last point is important to note. When faced with despair, religious faith can help a person find meaning. This may be significant to gerontologists and sociologists; another significant point is the social well being of religion.

Social Well Being

Social well being is related to the degree of satisfaction of mainly two closely related types of needs: the need to feel worthwhile and deserving respect from society, and the need to feel a useful and integrated member of society (World Health Organization, 1989).

The older adult may view the church as providing the perfect venue to meet these two needs. The older adult’s participation in the religious community could increase their sense of self–worth and provide a rewarding experience that may help them to grow in pride and self–confidence. Throughout our lives, we are nourished and sustained by communities. They fulfill our yearning for support, solidarity, and meaning (Brussat, 1998). Also, the older adult’s work in the church could help to increase in others’ respect for the aged. Being in a group setting can provide opportunities for friendship and sharing, and thus increase the feeling of belonging. Religious experience may allow the elderly individual to transcend his/her loneliness (World Health Organization, 1989).

This emphasis on the need for community for the older adult is not always considered, when many are disengaging from active participation in the community. One needs to consider other ways to nourish and sustain them. The need for attaching meaning to their lives becomes evident, and often is viewed as seeking a purpose in life.

For some older adults, the search for a good old age includes the moment for questioning the purpose of life, and assessing the meaning of one’s life. It is the moment for wondering whether one has really been successful as a human being. The ideal old person is someone with a sense of control, someone who is able to take charge, someone who has come to terms with life (World Health Organization, 1989). Religion may assist the older adult to make sense out of what appears as senseless and to bring the life cycle to a fine completion through this understanding.

On the other hand, the older adult may very well lose this desire to explore and understand the world. In fact, research indicates that motivational goals of elderly individuals vary with different sociodemographic variables. Lapierre et al (1993) state that elderly participants of higher economic status will mention more frequently aspirations of self–realization, whereas elderly participants of lower socioeconomic status will express more often aspirations of possessions. In this same study, Lapierre et al (1993) states that aspirations of health preservation and the transcendental domain (religion and death) will increase with age.

There is, in other words, varying methods that the older adult will utilize, searching for the good old age. This good old age may be found through preservation of health, self–realization, or it may be found through the spiritual realm. The next section will discuss the value of this spiritual realm.

The Value of Spiritual Well Being

Spiritual well being is the affirmation of life in relationship with God, self, community, and environment that nurtures and celebrates wholeness (National Interfaith Coalition on Aging, 1975). Gerontologists are cognizant of the significance of religion and spirituality in the adaptational capacity of elders. Life satisfaction, happiness, morale, and health have all been studied in relation to religion (Ebersole &Hess, 1994). However, spirituality has not yet achieved the central focus it merits in the study of aging.

It is unclear as to the reason why spirituality has not achieved the focus it merits. If the older adult is to be thought of as a holistic human being, with physical, psychological, social, and spiritual needs, then this spiritual realm becomes one of a more central focus, receiving the merit it deserves. Gerontologists and sociologists must appreciate this fact, when assisting older adults to attach meaning.

Remembering, identifying meanings, and grasping one’s own connection to the universe are the realities of the human spirit (Brewer, 1986). Meanings are inexhaustible, according to philosopher Victor Frankl. He writes, “We need to develop our intuitive sense that allows us to smell out meanings hidden and dormant in life situations.” Perhaps this is why the real self never feels old until the spirit is crushed. Victor Frankl (1990) wrote most eloquently of facing the transitoriness of human existence that is aging. Being old is not the centrality of the self– spirit is. Spirit synthesizes the total personality, provides integration, and energizing force. Later life provides a unique time for this spiritual growth.

Some older adults express this spiritual growth outside traditional religious channels. Hooyman and Kiyak (1996) differentiate spiritual well being from organized religion to include:

  • self–determined wisdom in which the individual tries to achieve stability in his or her environment
  • self–transcendence or crossing a boundary beyond the self in which the individual adjusts to losses and rejects material security
  • achievement of meaning and purpose for one’s continued existence
  • acceptance of the wholeness of life. According to this perspective, people can be spiritual without being religious in the sense of organized religion (Fischer, 1985).

If this is true, then what meaning does this have for sociology? Spirituality has been identified as an important factor in an individual’s perception of quality of life, and in maintaining a healthy lifestyle (Levine, 1983), and has been defined as a way of being in the world. Relationships with other people form the spiritual web of our lives, with crucial strands being marriages, partnerships, family, and friends. According to many religious traditions, our deepest values are expressed through these essential bonds (Brussat, 1998).

In other words, there are many ways that people can be in their world. Sociologists study these ways in relation to lifestyle and quality of life. The continuity theory of aging offers perfect meaning to the older adults’ spiritual journey. It states that people feel most satisfied if they continue the roles and activities of their middle years (Novak, 1997; Hooyman & Kiyak, 1996). As the older adult continues to maintain typical ways of adapting to the environment, they will maintain inner psychological continuity as well as the outward continuity of social behavior and circumstance (Hooyman & Kiyak, 1996). It occurs to me that people will choose the lifestyle in old age that is most like the pattern of life they lived in middle age. For many older adults, this may include the relationships they have developed through religious activity, and when this is no longer possible, these individuals then turn to other relationships ‘that form the spiritual web of their lives’ (Brussat, 1998).

High levels of spirituality have been found to be associated with mental health indicators, such as purpose in life, self–esteem, and social skills (Paloutzian & Ellison, 1982). Some gerontologists and theologians maintain that the person who aims to enhance spiritual well–being and to find meaning in life will have a reason to live despite losses associated with aging (Thorson, 1983). An ageless self, that is, a person who is not preoccupied or discouraged by his or her aging, has an identity that maintains continuity and is on a spiritual journey in time. Despite age–related physical and social changes, for such an individual, being old per se is neither a central feature of the self nor the source of its meaning (Kaufman, 1986).

Rather, the older adult often looks “out of oneself” for a source of meaning. As mentioned earlier, this individual may live more intensely in the present moment. Nickerson (1991) discovers that life is enhanced through simple things like buds on trees, flowers in window boxes, a flight of birds, waves on the beach, or across a field of ripening grain, the fragrance of wild roses, music, the sound of rain, and the silence of snow. The older adult may enjoy a dawning appreciation of connection with the natural world.

Brussat (1998) also writes about the significance of this natural world, in that many people find that nature is a conduit to the sacred. Buddha states, “if you wish to know the Divine, feel the wind on your face and the warm sun on your hand.” Spiritual literacy in nature requires that we be attentive, open, playful, and reverent. Our care for the creation leads us naturally to compassion and Earth etiquette. These attitudes and actions are essential elements of everyday spirituality (Brussat, 1998).

And for the older adult, this Communion with nature may take place while walking through the woods, watching a sunset, fishing in a mountain stream, looking at the waves of the ocean, observing the ripples on a lake, or sitting under a tree in a park. Although it may appear that this older adult is merely sitting under the tree, they may very well be attaching meaning to their lives. The question is: how might this information enhance the understanding of older adults for gerontologists and sociologists?

In so recognizing the importance of this spiritual literacy for the older adult, there are several benefits to be attained, not only for the individual, but also for society. These benefits include: quality of life, bridging the generational gap, and meeting older peoples’ needs. The remainder of the paper discusses these benefits.

Quality of Life

Spiritual well being is related not only to quality of life, but also to the will to live (Hooyman et al, 1996). In other words, many older adults seem to have come to a place in their lives where they have achieved peace with themselves and with the world in which they live. They maintain a very strong will to live, but also, these individuals have acquired a coping mechanism that provides a source of strength for themselves in difficult times and stressful life events.

These stressful life events may include a decline in one’s health, or the death of a spouse. I wish to share the lived experience of my neighbour, Bernice who is 82 years old. Bernice lives alone, since the death of her husband two years ago. There are no children as a source of informal support. She does have assistance with maintenance of the house. Due to declining health, Bernice is becoming more house–bound; she can no longer drive her car, thus transportation is an issue, and she is feeling socially isolated. But she maintains her social network through the Internet, sends cards and letters off to friends and family via E–mail. Bernice says, “I love my friendships.” She enjoys her gardening; takes a great deal of pleasure from bird–watching, photographing flowers, wild mushrooms, and other significant snapshots of ‘Mother Nature.’ Bernice would be the first person to tell you that she has a wonderful quality of life. She has acquired a coping mechanism through her spirituality that provides a source of strength for herself.

Societal systems that might further empower Bernice, and enhance the quality of her life include transportation and housing that might better meet her needs, informal support services to allow her to perform her weekly shopping and banking, and adult day care to provide a time of socialization for Bernice. Although Bernice seems to have a fairly good quality of life, having these social systems in place may further strengthen her spiritual connection.

Quality of life is only one example of a benefit for older adults like Bernice. There are other benefits as well, and the next section will discuss bridging the generational gap.

Bridging The Generational Gap

As mentioned earlier in the paper, relationships with other people form ‘the spiritual web of our lives,’ with crucial strands being marriages, partnerships, family, and friends (Brussat, 1998). It occurs to me that as the older adult disengages more and more from these relationships that they may then be searching for other connections or forms of bonding.

The nursing approach provides another form of bonding. The older adult may have suffered many losses through illness, or the death of a spouse, and the family members may live in distant cities. This individual turns in need to the formal caregiver for support and understanding. There is created a mutual bonding, which in turn enhances understanding and the elder’s sharing of experiential wisdom. This sharing of wisdom may be with any sensitive person, not only caregivers. Some ways of enhancing meaning in seniors’ lives include reminiscence, commitment, optimism, and supporting religious beliefs and meaningful practices (National Advisory Council, 1992).

In other words, when the older adult shares wisdom and experiential learning with younger persons, there is a bridging of the generational gap and enhanced mutual understanding.

The sociological approach, on the other hand, provides another form of bonding through policy–making which will empower seniors to find their place in the community. As mentioned earlier in the paper, the older adult needs to feel worthwhile and respected by society, and to feel a useful and integrated member of society. The church may provide the perfect venue to meet these needs. But as poor health and the lack of transportation lead to declines in formal religious activity, the older adult may require assistance. Professionals and lay persons can help provide support to older members, and they can help older members take part in their religious communities. This can take the form of outreach religious services or car pools to places of worship (Novak, 1997). As a result, a mutual understanding between young and old may result, assisting to bridge the generational gap. The enhanced ability of many seniors to feel a useful and integrated member of society can serve as a lesson to younger persons.

As in the case of Bernice, there is a quality of life maintained through her spirituality, and there is a bridging of the generational gap when she is sharing her photographs of nature with the writer. Both of these aspects empower the older adult, and enhance meeting older people’s needs.

Meeting Older Peoples’ Needs

Spirituality has not yet achieved the focus it merits in the study of aging. In fact, older adults have received little attention from psychologists studying religious development. New approaches are needed in order to understand possibilities for religious development in later life ( McFadden, 1996). Aging presents humans with an accumulation of burdens at the same time that certain internal and external resources are diminished (Birren, 1988). Older adults must employ strategies for coping with a wide variety of demands, and the strategy they spontaneously mention most often is religious (Koenig et al, 1988). This coping involves:

  • spiritual support
  • seeking pastoral care
  • participation in organizational and non–organizational religious activities
  • expressing faith in a God believed to care for humankind

Older adults experiencing high levels of stress, report more favorable well–being in conjunction with high levels of spiritual support (Maton et al, 1985).

In other words, even though the older adult may feel bombarded with life’s burdens and stressors simultaneously, they are able to employ strategies through their spirituality that enables them to cope. Many older adults are without any form of formal or informal support and cope entirely through spiritual support.

But the nursing approach often involves avoidance of dealing with the spiritual needs of the patient; many nurses may feel that this is too personal an issue. In providing holistic care for the older adult, it is vital that nurses recognize the spirituality of this individual. By creating a climate of trust and rapport with the patient, the individual will feel more comfortable to share their lived experience. This information enhances the professional’s understanding of the older adults’ health behavior more fully. Nursing interventions may involve calling the clergy, sharing spiritual readings, poems, or music, or even taking the patient out for a walk in the warm sunshine.

From the sociological approach, it is important to address the spiritual needs of people undergoing stressful situations that are common in later life. It is the duty of everyone to eliminate barriers that prevent seniors from participating fully in religious activities, and rather encourage their participation. In this manner one will not only be meeting the older adult’s needs, but also may be given the opportunity to learn from and be inspired by them as well (National Advisory Council, 1992b).

In other words, the nursing approach involves a more intrinsic relationship with the patient, creating an understanding of their health behaviors, in relation to spirituality. On the other hand, the sociological approach involves education, support and advocacy through policy making which ultimately will empower seniors. This is imperative in meeting the older adults’ needs, and also in achieving the focus that spirituality merits in the study of aging.

Summary/Conclusion

This paper has discussed the sociology of religion, social well being, as well as the value of spiritual well being. In examining the older adult’s search for meaning through spirituality, several benefits have been identified, including quality of life, bridging the generational gap and meeting older peoples’ needs. These aspects have been examined from the nursing and sociological approaches.

This paper embraces the importance of recognizing the older adults’ need to attach meaning through spirituality. Gerontologists and sociologists must understand and respect the religious traditions of the people they serve. As a society, we may need to remind ourselves on a daily basis of the importance of this spiritual literacy. As a society, we must be constantly watchful for the meaning the older adult attributes to this spirituality.

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