Overcoming Our Negative Perceptions of Elder Care

The fact that culture takes dignity as a serious factor in policy conversations is a victory for any Christian who is pursuing a more-just social order. However, the majority of conversations I have as a young professional center on just that: being young and professional. In many discussions, it seems as if those two descriptors are key elements of my identity. They are not. One day I will be neither young nor a working professional—and at the risk of stating the obvious, the same is true for every other person. Yet, I can’t remember the last time I engaged in a conversation about the elderly and the issues related to them.

My own apathy is, perhaps, symptomatic of an all-too-common issue: We tend not to care about what we perceive as not affecting us. Issues pertaining to the elderly are neglected because of a prevailing sense of their "otherness," their irrelevance to matters that seem more real and pressing.' Laws related to elder care are created by lawmakers and supported by voters to whom the issue does not seem relevant. But it is relevant—uniquely so. Elder care inevitably will apply to every person as he or she ages, giving every person—whether voter or policymaker—incentive to create and support policies that promote just treatment of the elderly and support their dignity.

Of course, that’s easier said than done. Learning to care about elder care requires that we change our perceptions of what it means to be old. In a literature review titled “Dignity in the Care of Older People,” author Ann Gallagher details how some ethicists—and many people—“define dignity in relation to the interplay between capabilities and circumstances.”

This is especially true in health facilities, where any individual may find him or herself in what would otherwise be embarrassing or inappropriate situations, such as wearing an open-backed gown or requiring assistance to use the restroom. When we are young those embarrassments may be temporary, but many elderly people slowly lose permanent control over their physical and mental capabilities. If we define dignity as related to our abilities, we fail to grasp the fullness of dignity as something inherent. As Gallagher states, “This perspective focuses on whether a person feels dignified or undignified, rather than on whether others perceive them as having dignity, thus making dignity a subjective experience.”

Similarly, professor Luke Gormally of the Linacre Centre for Healthcare Ethics, notes that Western culture prizes autonomy and self determination. As a result, society maintains a “pervasively negative” perception of the elderly, especially those who are medically incapable of living alone or caring for themselves. He writes,

"(That perception) denies value to the lives of those elderly who have lost control of their lives in the sense of having lost the capacity for self-determination. This denial of value is equivalent to a denial of dignity. For to possess human dignity is to possess a value which commands respect in the sense of commanding acknowledgement of the human rights which belong to a person."

Those human rights are rightly displayed in the International Council of Nurses’ Code of Ethics, which has served as the standard for nurses worldwide since it was first adopted in 1953. The preamble to the code states, “Inherent in nursing is a respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect.” Dignity, as it is rightly conceived here, is not paired with any qualifier.

And that’s just a secular conception of elderly dignity, not even taking into account Scriptural precedents. For Christians, the Bible sets a higher standard, referring to old age as being a "splendor" (Proverbs 20:29). Similarly, Psalm 92:13 and 14 states that "those who are planted in the house of the Lord shall flourish in the courts of our God. They shall still bear fruit in old age; they shall be fresh and flourishing.” Those descriptions all but fly in the face of our culture’s belief that we become decrepit and useless in old age.

The Bible also weighs in on the issue of caring for the elderly. The Bible says in1 Timothy 5:4 and 8, children’s “first responsibility is to show godliness at home and repay their parents by taking care of them. This is something that pleases God very much. ... But those who won't care for their own relatives, especially those living in the same household, have denied what we believe.” Of course, not every elderly person needs—or wants—to live in his or her children’s homes, and if we think that’s the point, we miss it entirely.

Justice for the elderly is part of the bigger picture of a just, flourishing society. We begin by viewing the elderly with dignity. But we cannot end there. Scripture says that we serve God when we honor and care for the elderly: If they are sick, we should help them, and if they live a nursing facility, we need to assess their living conditions to make they are being properly and lovingly cared for. Public justice asks that we consider policies regarding elder care with the same attention we would afford to issues that affect us—because in the end it will.

-Melissa Steffan is the assistant editor for 1776 in Washington, D.C., and is a 2012 graduate of Seattle Pacific University. She previously interned at the Washington Post and the Center for Public Justice, and was the 2012-13 Editorial Resident for Christianity Today magazine. You can follow her on Twitter at @melissasteffan.