Weird Wild Web
as a Group:
A Theological Analysis of Care of the Elderly in Nursing Homes"
for the Elders in Our Society
Reflections: On caring for the “individuals” in nursing
Theological Analysis: A vision of caring through mutual knowing
What is “a valuable life”?: A theological poem
References for this project
vision of caring through mutual knowing
Your love declines.
You, thinking little lines
around my eyes are fallen lashes, try
to brush them off. I do
In this autumn of my being, parts of me
fly, like tossed and wintry-blasted leaves.
I don’t regret their passing. I
to make a clean and crystal-perfect form.
I, the alchemist, and I, philosopher’s stone,
have sacrificed the fat, and froth, and fur
of youth, to walk through fire, leap in the dark,
swim inward rivers, pray at a wailing wall.
The wrinkles, sags, the greying hair are earned.
You mourn like a child over a broken doll.
Only the core of this crone was ever real.
I Don’t Understand
C. Mary Austin
(written in the aftermath of the tragic death of a teenager)
This fragile humanity
So very alive
Suddenly no more
What meaning in life
Where is God?
Young life so cruelly extinguished
Old life vacuous
What were you years ago?
You who sit and gesture
Torment on your face
You grasp my hand
and I am helpless
In the face of your anguish
Where is God?
Where is God in your confused mind
Your inability to communicate
You pluck obsessively at your skirt
Revealing stocking tops
Skirts that once children tugged
Legs that once danced and ran
Where is your life?
Where is God?
Young life extinguished
Old life lingering?
Is your life meaningless?
Do you know pleasure?
I only see torment in your toothless face.
So where is God?
I don’t understand
I only know that he is here
With the depth of my being
I know he cares and
That Christ is in you
Nailed to a cross
But I don’t understand.
Where is God?
is difficult to make sense of aging, both as an elder and as a loved one
or caregiver. Elders feel
estranged from others and from society, and loved ones also feel isolated
and estranged from the experiences of their loved one.
Can God be present in such despair and isolation?
Karl Rahner describes God, the God which we understand, as distant
and unattainable. This must
be the feeling of an alienated elder, or a confused caregiver. The God who we have conceived in our minds somehow is not
present for us in these struggles; in our search for meaning and in our
isolation from each other and from the familiar we feel isolation from
God. However, Rahner
encourages entering fully into this despair, and embracing it.
There, he believes, one will find and know the presence of the true
God. (Rahner, “God”, 218)
This theology, it seems, is “good news” for individuals who are
isolated in nursing homes and who suffer from dementia.
These folks have lost most of the aspects of their material life
which were important to them: family, friends, home, life roles, income, and sometimes
memory and ability to communicate. These
losses seem to distance us from the God we are familiar with, the God we
worshipped and prayed to our entire lives.
For Rahner, this very distance is what can free us to truly know
God’s presence, if we are able to free ourselves from anxiety (which can
be difficult in a setting with little control and so much loss and
also presents experience of God as unified with experience of self.
He presents self realization as occurring in the context of
relationships with other people. “The original objectivity of experience of self necessarily
takes place in the subjectivity of its encounters with other persons in
dialog, in trustful and loving encounter.” (Rahner, “Experience”,
225) For Rahner, experience of self, of neighbor, and of God are
three parts of a whole. These
three aspects “mutually condition” one another.
(Ibid., 226) If one
has lost or found oneself in a neighbor, then one has found God.
Hewitt Suchocki is a process theologian who also sees the possibility of
meaning, and finding God, in being alone.
She has a different idea of the nearness of God.
For Suchocki, God’s self is represented in the totality of the
world and as the world changes the changes become a part of God, so that
the world and God are always in relation, both in its present form and in
its possibilities. This makes
God an intimate part of the past, present, and future of the world.
(Ibid., 36) This
intimacy does not assume that we can feel the constant presence of God.
Suchocki acknowledges that we have three levels of relation.
We relate on a “daily” level to others, yet we have a
“depth” level of yearning and loneliness, which these daily
relationships somehow cannot fill. This
loneliness can be the point at which the “hidden” God, which we do not
experience in everyday life, can enter into one’s awareness.
(Ibid., 50) She does
differentiate “aloneness”, which can be meaningful, from
“loneliness”, and recognizes that loneliness can create a lack of
meaning, and can accompany “devaluing relationships” and isolation
even while in the presence of others.
(Suchocki, 52) Even in
this negative, isolating experience, Suchocki believes that the contrast
between the infinite nature of God and the “variable finite relations”
of loneliness can bring the hidden presence of God into awareness. As in Rahner, this perceived distance from God can lead
to increased awareness of God.
for Suchocki God is in our future – the “aim” of our existence.
Her relational view of God includes the view that we are being
“pushed” by God to relate to others and to our world, thus sharing our
“inward” God. “the
inward presence of God turns to the outward presence of God, for the God
who is present to us is present to others as well.
The God who guides us guides others also; the God who cares for us cares also for others.
The whole world is touched by God, and therefore the world can
mediate God’s presence to us. Divine presence pervades finite presence, launching us into
the world again, for its good and for ours.
Meaninglessness fades, crowded out by presence, and presence-human
and divine –insists upon and achieves the meaning of love.”
also focuses upon the importance of relationships to others, especially
for the sick. He places some
responsibility upon the individuals receiving care, viewing illness as a
“task”. “..I think it
is both hard and at the same time liberating to regard the sick person as
open to an appeal, as capable of action, and to tell him that he can still
give his heart in confidence, resignation, in love for the other, even in
the midst of his distress, and, if he does so by God’s grace, it will
liberate him and alone make his sickness what it really ought to be.”
(Rahner, “On Illness”, 143)
these theologians, we begin to understand that there can be some meaning
in isolation and in suffering. We
also learn that it may be a mistake to focus only on how the caregiver
relates to the resident. Perhaps
the key to healing caregiving relationships lies in the mutuality of the
A Vision of Mutual Caring
Buber, in I and Thou, defined two types of relation:
I-Thou, and I-It. I-It relations are subject to object relations, where a
subjective being relates to an object.
I-Thou relations is a relationship between two subjective beings,
who are active subjects. In
this relationship, the two subjects don’t just “know about” each
other, but “know” each other in a mutual, reciprocal way.
Buber refers to God as the “Absolute Thou”, and his examination
of relationships also explored this as a way to relate to God.
(McGrath, 247) Somehow, even the most well-intentioned caregivers fall into
the I-It pattern of relating to residents of nursing homes.
For Buber, the I-It knowledge is “indirect, mediated through an
object, and has a specific content”.
(Ibid.) In nursing
homes, we often know about the resident we are caring for through the
chart or through the change of shift report.
We have specific tasks and responsibilities which we must carry out
within a certain amount of time, and we must be goal-oriented in order to
succeed. There is usually
little time for more than the “specific content” our jobs define.
It takes commitment to shift to an I-Thou framework, for several
reasons. To know the resident we care for (vs. knowing about the
resident) we may be opening ourselves up to experience some of their pain
and suffering; it is a
frightening prospect. If we
view the resident we care for as an active subject, it may mean that care
will take longer, and may be performed differently.
Most caregivers want to keep their jobs, and part of the
requirement is being able to manage the workload which is assigned.
It takes a special individual in a supportive environment to make
the shift from I-It to I-Thou.
acknowledge the resident as “Thou” is the first step to reciprocity.
Paul Tillich referred to objectifying recipients of care as harming
“their self-awareness as person”.
In his discussion of pastoral care, John Patton refers to Paul
Tillich’s The Theology of Pastoral Care.
Patton’s view is that it is important to understand each
individual’s context before providing pastoral care.
He supports his view with Tillich’s perspective that care is
“essentially mutual”. “In
most acts of taking care of someone, it is possible for the person who is
the object of care also to become a subject…(Caregiving) is one act, not
two, and only because it is one act is real care possible.”
What does this analysis mean for Mary?
(Please refer to “Reflections”.)
Is it possible that Mary came to know the God which is hidden from
those of us who are caught up in the many aspects of our finite lives?
Could the loneliness and emptiness of her existence as she was
restrained in her room have had some meaning?
Did her lack of social relationships interfere with her knowing
God? Her life was not
entirely devoid of interaction, and I do remember one experience of
mutuality which I had with Mary, during that lonely time.
Sweet, cheerful Mary had become very withdrawn, and was essentially
non-verbal, but I would often sit by her side and talk to her as I worked.
She rarely responded, but she would usually look at me or met my
eyes. I sat down on her bed
in the midst of my chores for that afternoon, to prepare her toiletries
and towels for her evening care. I
was blue, for some reason which has escaped my memory, and I was not very
talkative. Mary reached out, touched my face, and softly sang,
is the last time I remember her verbalizing anything, and it was in the
context of providing care for me.
What about Joan?
(Please refer to “Reflections”.)
She experienced some I-Thou relations, with the staff who
recognized her personal needs, and in her positive interactions with the
Director of Nurses, who frequently conversed with Joan with a sincere
interest in her journey and her experiences.
The Director of Nurses learned from Joan, and grew from her
experience of knowing her. This
relationship was truly reciprocal, and Joan did provide care for the
Director of Nurses. Joan also
experienced many dehumanizing, distancing and loneliness-producing
interactions with overworked an hurried staff members.
Is it possible that God, who was present in both circumstances,
reached and comforted her in her final days?
have presented the landscape of nursing home care as vastly improved, but
not perfect. I deeply desire
a “more perfect” system, and I become frustrated with the situation
which exists. I wish for an
environment which provides more opportunity for mutuality and reciprocity,
where God can be more perfectly known in relationality.
Is it possible that God’s power and perfection still reaches
these residents who are in an imperfect system?
Could it be that the “windows” of the experiences I have
described are enough for God to “shine through”?
I view these nursing home residents through the assumptions of my
experience. The varieties of
experiences of God, in so many varied contexts, is so much greater than my
own that I must not restrict God’s power.
this society learn from the lessons of mutuality and I-Thou relationships?
Can we as a group learn to see the elderly and institutionalized
members of society as individuals with richly varied experiences and
circumstances? Can we learn
that these people may have experiences in their lives today that we can
only dream of someday attaining? Would
this influence the debate over who in our society is valued, who is worth
our resources, and who should control the decisions regarding the future
of our elders?
may seem farfetched, but the lessons learned from theology can be applied
to “real life”. Every
group, whether it is a group of nursing home residents, nursing home staff
members, elderly individuals, policy makers, or the general population,
every group is made up of individuals.
One individual caregiver can make all of the difference in the life
of a nursing home resident; that
caregiver can represent God in their reciprocal relationship.
One individual in society can be the voice for the unrecognized
population; that individual
can remind the others of where we can find God.
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