The Biblical View of Elder Care

By Alice Trebus

Recent statistics show that one out of every eight Americans is 65 years of age or older. Advances in medicine, surgery, science, and technology have resulted in an ever-increasing population of the aged. As of 2013, the average life expectancy of a U.S. citizen was 81 years of age for women and 76 for men. Unfortunately, chronic disease is on the rise and many seniors find themselves diagnosed with multiple maladies. Advancing age and declining physical and mental health prohibit them from being able to care for themselves effectively. Consequently, their children must find a way to do it for them.

Many people view old age in terms of the problems associated with it, instead of the blessings. In fact, old age can be a sign of God's favor, a reward for living an upright Christian life, and/or a reward for those who honored their parents. "Follow the whole instruction the Lord your God has commanded you, so that you may live, prosper, and have a long life in the land you will possess" (Deuteronomy 5:33; see also Exodus 20:12, Ephesians 6:1, Proverbs 16:31). Old age is also part of God's plan for a normal life (Genesis 25:8, I Chronicles 29:26, 28, Job 42:17).

In the Bible, the aged are often shown to be resourceful people with valuable gifts to share for the good of everyone. Wisdom is a particular gift associated with age and is promised to those who ask for it and are reliant on God (James 1:5). In fact, giving wise counsel to those who are younger is a duty of those who are older (Proverbs 3:13; 15-16; Joel 1:2-3; Deuteronomy 32:7). One's age does not eliminate his/her moral obligations (Titus 2:2-5).

God is fully aware of the numerous problems   physical, mental, emotional, social, spiritual and familial   that confront the aged. He assures them   and therefore their families   of His continuing presence (Isaiah 46:3-4). He gives strength to the elderly to endure suffering and infirmities (1 Peter 4:1-2; 1 Peter 4:19). He also delivers the aged Christian from the fear of death (Romans 8:38-39, Revelation 21:3-4, I Corinthians 15:54-57). Children of believing parents can take comfort in knowing their deceased loved ones are spending eternity with God.

So, how do we decide who cares for our aging parents? The Bible passages that follow give us some background information that will be helpful as we examine what are our responsibilities are.

Biblical Matters

One of the many ways God intended the children of Israel to distinguish themselves from other nations was by the way they treated their parents. Not only does the fourth commandment mandate honoring one's father and mother (Exodus 20:12, Deuteronomy 5:16), but the Levitical laws addressed this issue as well (Leviticus 19:1-3). In Mark 7:5-13, Jesus chastised the Pharisees for fixating on a minor point of ritual law when they were cheating their own parents out of the right to be cared for.

In the above passage in Mark, the Pharisees upbraided the disciples   and by implication, Jesus   for not participating in ceremonial hand-washing. Jesus chastised the former for focusing excessive importance on the rules found in a separate book of instructions called the halakah. This book interpreted and added to the Old Testament Law. In practice the Pharisees gave it greater authority than the law itself. (See also Matthew 15:1-9.)

The Corban tradition (Mark 7:11) was probably a practice in which a man could give or lend his money to the temple. In so doing he could say to his parents that he had no money left over to look after them. It may have been that, when they died, he could redeem this money for his own use. Jesus adamantly condemned this practice. He said that it defeated the purpose of the law and was tantamount to cursing one's parents. At the very least it revealed a selfish lack of appreciation for all they did for their children. Jesus also implied that honoring one's father and mother includes the obligation to provide for them financially if needed.

This passage in Mark also calls us to examine the excuses we or other relatives sometimes make to get out of our family responsibilities. Today's society and culture make it even harder for us to navigate the dichotomy of care at home vs. care in a facility for the aged. Medical and technological advances allow us to prolong the life of a loved one, often artificially. These factors force us to make increasingly difficult decisions regarding end-of-life care. We want to make sure that the choice we make does not clash with Biblical teaching. That said, we'll look next at what the apostle Paul says in I Timothy 5: 1-16. This chapter deals with instructions for the church   and reflexively, the individual   concerning the care of dependent relatives.

In Old Testament times (see Deuteronomy 14:28-29) special arrangements were made to provide necessities to those who would otherwise have no way to obtain them. The local religious community acted as an extended family of sorts, seeing to the needs of the fatherless, widows and so on. However, in New Testament times, church resources were being drained because of large urban populations. Here, Paul had to reaffirm to the Greek Christians that it was first and foremost the responsibility of the family to provide for dependent relatives.

Paul was writing to Timothy to clarify how he should run the Church. In their new urban environment, Christians were neglecting responsibilities to elderly relatives and arguing that such responsibilities should be shouldered by the Church rather than by themselves. The church was to provide aid primarily for those who were unable to care for themselves, if no family members were alive or able to do so. Otherwise, the responsibility of care of for dependents belonged to the family.

Today there are several groups who fall within the category of being dependent   not just economically, but often physically, spiritually, emotionally and socially: the widow, the orphan, the single parent, the unemployed, the disabled, those with special needs, and the elderly. In many cases, responsibility for the care of these people has been taken over by state or voluntary bodies. Perhaps, like Paul, these institutions are justified in challenging the family to consider its obligations to the dependent members of our society. When these people are members of our own family we have a particular responsibility to care. First Timothy 5: 8 says, "But if anyone does not provide for his relatives, and especially for members of his household, he has denied the faith and is worse than an unbeliever."

Practical Matters

Both the Old and New Testament Scriptures command us to honor our parents, thus underscoring the importance of this mandate (Exodus 20:12, Ephesians 6:1-3). Raising and caring for our own children is typically much more rewarding than looking after parents whose bodies and minds are deteriorating. We grapple with conflicting emotions: love, grief, guilt, a sense of obligation, worry, emotional anguish, etc.

It's extremely important for children of aging parents to be in agreement and work together harmoniously for the welfare of their parents. Sadly, too often one or two siblings wind up shouldering the majority of the burden for care and decision-making. Our parents or siblings may disagree with the choices we make. Resentments can begin simmering when agreement cannot be reached. Parents and other children may feel misunderstood, unloved, or cheated. If there is an inheritance at stake, it can bring out the very worst among potential heirs. When this happens among Christians, it is sad and shameful.

We toe a difficult line when it comes to doing what is in the best interests of our parents' welfare and to ensure that the care they receive is the best possible. If parents have not talked about their wishes with their children and laid out specific instructions for them, decisions must be made when emotions are running high. At times like this it's a good idea to consult an objective third party in the form of a Christian counselor or pastor, with the aid of a medical social worker. Ideally, all family members should meet with objective professionals and try to work together harmoniously to decide the best way to care for their parents.

One way to do this is for each able parent and child to write down what his/her goals, expectations, wishes, etc. are for care when age is advanced. Special needs must be taken into consideration for parents suffering from progressive physical and mental diseases, such as Alzheimer's. If one child is already caring for a dependent relative, other children who do not have this burden should step forward to help. Each child's ability to help care for the parent must be examined impartially. No one child should be expected to shoulder the bulk of the burden by him- or herself.

If the children live far apart from one another, the burden of responsibility often falls to the one living closest to the parents. This is not fair, so the other siblings must try to find a way to ease that burden. For example, one child might be assigned as medical power of attorney, another as property power of attorney, another to do errands and help with housework and laundry, and so on. Finances must be looked at realistically, too. Do the parents have long-term-care insurance or other assets set aside for this time in their lives? Are all the children financially solvent and able to contribute to the cost of care if needed?

Placing parents in a retirement village or nursing home does not necessarily mean the children are selfish or uncaring. It depends on the severity of each parent's physical and/or mental condition and what the children's capabilities and motives are in seeing to their care. There are many factors to consider. If a child decides to care for a parent or parents in his home, how will he manage to juggle that task and still work? How much physical living space is available? Will the living environment be safe? (Is it elder-proofed?) Who will provide respite for the caregiver? Will that child's siblings promise to help, but then become unavailable? If they do help, would the division of labor be fair? How does each family member believe God is moving him to act?

The risk of falls in the aged is one of the biggest reasons for admission to nursing homes. The elderly lose their sense of balance and connections in the brain are lost, not just for cognition but for mobility and coordination as well. Falls can be very dangerous because of fractures, which can lead to blood clots, emboli, head injuries, etc. It is much harder to keep a parent safe when there are only one or two persons available to protect them. It may not be realistic or safe for take care of one's parents at home, especially if they get confused and wander during the night. Make sure you have enough help if you make this decision. Sometimes a nursing home is the only recourse.

If you do decide a retirement village or nursing home is the only feasible solution, visit your parents often. Go at different times and on different days so you can keep a close eye on how well the staff is doing its job. Nursing homes typically schedule frequent activities for their residents throughout the day, to keep them physically and mentally active. Help the program director choose which activities are appropriate for your parents and make sure the staff takes your parents to the activities. Schedule frequent care plan meetings with the director of nursing, the household coordinator, the dietician, the nursing staff, and physical therapy. It will also help if you show an interest in the staff members as individuals. Ask them about their own families, interests and so on.

Adult children can participate in their parents' care by doing the laundry for them, going on walks with them, joining them for a meal, feeding them if necessary, and especially reading the Bible and praying with them. Arrange for them to attend chapel services and hymn-sings sponsored by the center. Even when a loved one has severe dementia and is unable to communicate or does not appear to understand, his spirit will recognize God's Word and welcome the nourishment.

Christian ministry to the aged involves caring for each elderly individual as a person created in the image of God (Genesis 1:27) and as a person for whom Christ cares (Matthew 25:31-46). Both the blessings and responsibilities of aging are to be accepted with gratitude and in a sense of stewardship, "For God has not given us a spirit of fearfulness, but one of power, love, and sound judgment" (2 Timothy 1:7).

It's very hard to watch a parent deteriorate, especially when that parent was once brilliant and accomplished but is now physically and mentally crippled. No matter how devastating the situation may seem, God is completing the good work He began in them (Philippians 1:6) and when they finish the 'race', a crown of righteousness will be waiting for them (2 Timothy 4:7).

The Holy Bible

"Between Child and Parent - Honoring Father and Mother" (Exodus 20:12), Study By: Bob Deffinbaugh;
"The Family Relationship"
"Putting Families First"
"The Bible Speaks on Aging"; The Ethics and Religious Liberty Commission

Published 2-26-14