Aging in our Communities

Last week I had a public conversation about aging at our local library with Dr. Michael Pass, a local physician who has helped establish a very fine hospice program and facility in our county. We were discussing Atul Gawande’s fine book, Being Mortal, which I wrote about earlier. The small auditorium was full, with about 75 people from various health care professions and the general public. Their interest was intense and, for many of us, existential.

We were examining the medical and ethical dimensions of the way our society cares for an increasingly older population who need help navigating their long tenure as old and able citizens. In particular, we older people want to remain in the homes and habits we have created over the previous six decades of our lives. Even more important, we want to remain in the communities where we enjoy friendships, community activities, and familiar services.

However, our society is set up to provide resources for us that are predicated on models of illness and cure. They provide nursing “homes” when we just need some help, structured “communities” when we only need a handyman and some younger friends.

Medical science and public health advances have enabled us to live longer, but we don’t have the social structures to enable us to live more fully. And living more fully is not an individualistic accomplishment. It occurs in communities over time.

Now, this observation does not belie the need for skilled medical and nursing care when our bodies really give out and our minds wander off, never to return. I know of some wonderful facilities and people who exercise this care with dignity, respect, and professional love. My brother-in-law is in one. And we are grateful. But the majority of us seek to navigate the bumpy downhill ride of our last decade or so with a suitable vehicle and some guides along the way.

Now, what would that look like? Mike and I pointed out the rise of many home health and home assistance programs that are beginning to emerge so people can live in their own communities and homes. Gawande points to some of these near the end of his book—places like Beacon Hill Village, in Boston, and Athens Village, in his home town in Ohio.

What struck me is how important churches and other religious congregations can be in mobilizing resources for older people who might need help ranging from cleaning out a gutter to helping with food, cleaning, or personal care.

Most of these resources can be found or created in our local communities, but typically, and I am talking about myself here, we don’t know how to mobilize, monitor, or negotiate the help we need.

At this point our churches can be used as networks for tracking these things down, but the churches don’t see this function as intrinsic to their mission. No one questions the importance of youth programs for the mission and vitality of a church. Shouldn’t the same be said for those at the other end of life’s journey?

I know that churches have launched “parish nurse” programs in years past, but my impression is that they had a more medical and clinical focus. What if they now supported a pastoral professional who would function as an ombudsman of sorts for older members of the parish?

Rather than directly providing this care, they would be liaisons between members and the often confusing array of services in the wider community. They wouldn’t have to move away to find a specialized retirement community. They could stay in the church and community that has nurtured them.

I’m talking with other people in my own church about this. I’d be interested in what you know from your own experience. This is definitely NOT part of my expertise, so I’m just generating a more public conversation. I’d love to hear from you as well.

4 thoughts on “Aging in our Communities”

  1. Bill, your thought process is correct. I think the very people to help train are those of us who are retired social workers and have spent a career in facilitating change for all ages. All of the things you mentioned are important and can be done! Mike Pass is great and is super with end of life care. But when people aren’t quite there the church is a very positive forum for facilitating extended family connections, etc. There is a book floating around somewhere within the social service community that has a list of all services in Haywood county

  2. Amen, brother. The elder coordination you speak of is a natural twin to youth ministries. The key is community, building not only a community resource, but an elder community with which seniors can identify. Certainly, one’s church is a natural place to start. Maybe a broader theology of church might even emerge. At The Windhorse Center we keep finding how important belonging is as we age. I think Hospice understands this at end of life, but we need it long before.

  3. I’m so pleased to have this subject up for discussion and hope we can establish locally the sort of community program Bill describes. My experience with two friends who died recently showed me how that process can be embraced with open hearts and deep wisdom, as well as practical assistance. Both were supported by the wonderful services of Center for End of Life Transitions (, I think). As described on their web site, they offer guidance for everything from power of attorney forms to caregiver support to home funerals. Participating in the latter convinced me that this is what I want for myself. The founder, Caroline Yongue, has a TED talk online, and she has recently opened Carolina Memorial Sanctuary, a “green” burial preserve in Mills River ( I’d be happy to talk with anyone who is interested in this group.

  4. Excellent post. I have watched my friends age and as I reach the age where I have to find people to help me if I want to stay in my home, I think it would be a huge service for us if there were churches or some organization that could help out. I read once about a service where seniors worked at helping other seniors who needed help. I don’t know if they worked as volunteers or were paid, but I like the idea of another older person coming to help with meals or cleaning the kitchen because that helper of the same or near the same generation understands what is needed and why. Young people I hire to help me often don’t understand why I need help putting on a fitted sheet. I need help getting my garbage and trash out to the where it is picked up. That is not a big job and only takes a few minutes, but it is a big job for me. Older people don’t always know when they are going to feel too bad to get up and do for themselves until they wake up and find they are in pain or too stiff and sore to do much of anything. A friend of mine had to get her husband who has dementia to Asheville for an eye exam and it was an emergency. She called her pastor and he found someone who would drive her and her husband. That is the kind of things I wish churches would concentrate on doing. An 88 year old friend of mine said no one in her church has ever offered to help her take care of handy man duties. She thought the church should have a committee of men who would volunteer to help widows like her. That is what a church could do to help their community and help elders stay in their homes until they can no longer live alone.

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