You will notice that God does not promise to keep us free from trouble. Rather, He promises to be with us whenever we face peril and menace in our lives. Surely, this short reading inspires us to look steadfastly upon God as our one, unfailing, tower of strength in all of the changes and chances of our lives.

As a specialist physician in geriatric medicine, a subspecialty of internal medicine, with more than thirty years experience in the field, I can assure you that even normal aging does bring with it change, uncertainty and an increased probability of risk. This is, after all, the final involutional phase of the human life span and it is associated with inevitable transformations and deterioration in function.

Such changes may, for convenience, be considered under a number of headings – although considerable overlap occurs.

1. Biological and medical changes

Patho-physiological alterations in the form and function of the cells, organs and systems of our physical bodies occur with aging. The special senses are obviously affected. Our eyesight diminishes, our hearing deteriorates, our senses of smell and taste also undergo significant change. Our bones become lighter and our muscles become less strong. Our cardiovascular, respiratory and neurological systems undergo change, as indeed do our renal, endocrine, and all other systems of the body.

In summary, it may be said that these changes lead to a reduction in our adaptive capacity to stresses and an increased vulnerability to disease. Illness in the elderly, therefore, often presents atypically and one witnesses a modified response to treatment.

2. Psycho-social changes.

With increasing age, one typically sees a reduction in activity and overall productivity and this can lead to a diminished sense of self-worth and falling social status in the community. There is financial insecurity, social constraint and a reduction in employment and leisure opportunities. These frequently cause a change in the locus of control, which in turn leads to enhanced dependency upon others. Multiple losses are common as spouses, peers and possessions disappear. Such a diminished total health status may be associated with a reduced expectation in life goal achievement and an increased realization of one’s own individual mortality. As you can see, however, the employment potential for an aging geriatric specialist is very good indeed!

3. Spiritual changes.

Some work has been done in this area, mostly by social-gerontologists - for example, the work of Mandel and Vaughan for the World Health Organization - in the Western world. The findings would suggest that with increasing age there is generally a reduced involvement with ‘formal’ religious institutions and practices - that is, in church worship and attendance. However, increasing age does appear to be associated with an increase in personal, or ‘informal’ spirituality – that is, in private prayer, meditation, religious reading and Bible study, listening to religious programmes and music on the radio and television. An increase in personal ministry, unaffiliated with formal religious bodies, has also been described. It has been noted that this shift from more ‘formal’ to ‘informal’ religious activity was directly and positively correlated to a decline in physical health status especially to the presence of true handicap.

I think that it is useful to identify certain distinct patterns of response among aging Europeans and North Americans. The following classification I, personally, have found to be of some help.

As a geriatrician and a priest, I have always been particularly interested in the religious activities of the patients that I consult upon and /or treat. About fifteen or sixteen years ago I undertook a small research project with a sample of my patients. In all 419 people were included in the study, all of whom had identified themselves spontaneously as Christians. It should be pointed out that this was far from being a randomized sample but was highly selective since it comprised patients, their family members and their friends and other attendants who came to the Geriatric Clinic with them. These persons were all seventy years or older. Thus, this was a group in which sickness, frailty and disability were far more common than in the general elderly population. Amazingly, I found 72% of them did Bible reading or study, either individually or in group situations. 68% of them had a self-described “significant prayer life” which, in most cases, included intercession for others. 7% considered themselves to have a distinct “personal ministry” as counsellors, advisors or intercessors outside their immediate families and circle of friends. This was facilitated by the use of telephone ‘trees’ or by specifically targeting recently bereaved or relocated people. 4% of this group had, what they described, as other “special formal religious activities” in association with church organizations. This included transportation services; meal preparation and delivery; church involvement as Elders or vestry members – indeed, some were Synod delegates. Many of this group also helped in church offices, and with other administration duties (which included book-keeping, sidesman duties, stewardship campaigns and counting money and banking).

This last sub-group was invited to further identify those needs, which they considered were not adequately met by their preferred formal religious institutions. The issues identified included poor transportation to church; a need for large print books; a need for improved outreach by telephone, mailings or visiting; a need was perceived for improved acoustics within the church; better access, not only to church buildings, but also to the altar; inadequate or difficult access to washrooms; and there was an (unsolicited) dissatisfaction with more modern forms of worship! On one occasion an individual identified the need for improved temperature control within the church building itself.

Finally, I would like to make some general comments about ministry with, to, and by the elderly. I would, however, emphasize that these comments and observations apply to all age groups.

Disease, disability and despair all detract from God’s intended wholeness and fullness of life for His human creation, and these do increase with aging as I have already indicated. Yet, such pain and suffering is not entirely negative to personal spiritual growth. Christian development and an increasingly mature understanding of our creaturely dependence upon God, can, should and does arise out of adversity. This is made possible by God’s grace, alone. Much of the burden of our suffering and sorrow has its origin in our personal maladjustment to self, to others, to the environment and ultimately, of course, to God Himself. It is here, especially perhaps, that we Christians, both lay and ordained of any age can be effectively used by God – but how?

I believe that Jesus, Himself, gives us much of the answer. He clearly saw healing and nurturing (that is, the restoration of wholeness to the broken) as an integral part of the Messianic mission - However, His greatest contribution to the blind, the halt, the sick, the lame and to the aged - indeed, to all in need - was not as a diagnostician or therapist, nor as one equipped with special knowledge, skills and techniques. Rather, it arose out of His perfect humanity and His perfect divinity. Jesus’ relationship with His heavenly Father was one of perfect obedience. He was able to enter into all situations of human sickness and suffering and grief, with a terrible – even terrifying - intensity. His divine love, justice, wisdom and power enabled Him to support all others in their adversities and in their anxieties and pain. It was this divine personality and His intimate identification with the victims in their plight that overcame all of their disease and inner fearfulness. This too, is our mission as Christians today. As living members of His mystical body, the Church, we are God’s agents today. He uses us in our daily lives to bring the benefits of His grace to others in their times of need. We, therefore, can become outward and visible signs of His inner and spiritual grace. By the grace of God Almighty and through the power of God, the Holy Ghost who dwells within us, we become the outward elements of a sacrament to be made available to those around us. As Christians, we do not need degrees in medical science, psychology, sociology or even in theology in order for us to fulfil God’s purpose in our lives, regardless of our age, health or social status. We need only to live humble, obedient lives with prayer and fasting, faithfully seeking to do God’s will in all circumstances. This is our profession, after all. We must genuinely repent of all of our sins and shortcomings trusting in God’s forgiveness and divine love in all of our situations. We must never ask God for help in our work but pray rather that we might be used by Him in His.

One of our most significant ministries, whatever our age, is to offer intercession for others; especially for those who will not, or cannot pray for themselves. Taking upon ourselves their pain, and even their sin and their guilt, we should go to the foot of Christ’s Cross where He will mercifully and lovingly take all of the burden from our shoulders. Thus, we ourselves, can participate in Christ’s redemptive work. We have all been commissioned, lay or ordained alike, to carry the Good News of the gospel of Christ to all people, showing faith to the faithless and bringing God’s comfort to all those who suffer. As Christians, we go in persona Christi to those who are suffering, grieving and dying.

Remember always that Christianity has a supernatural end. Therefore, its teaching demands that we Christians accept the mysteries of God. All that is unfathomable, inscrutable and ineffable about God does not imply absence of meaning and truth, whatever modern secular society may think. Rather, it implies the presence of infinitely more meaning or truth than we can possibly humanly comprehend. So do not accept the skepticism of this secular age. Do not succumb to its relativism, moral laxity and pagan values. Never strive to make Christ’s message merely more relevant by compromising His ageless divine truth with the fashions of the world. Do not measure God’s revelation in Scripture, in Christ’s ministry or in the Church’s tradition and teaching - by earthly standards, expectations and reasoning. To do so is to replace God’s priorities with our own human preferences. It is to redefine and to explain Him, even as we may profess to believe in Him and to obey Him. This course of action will inevitably end by making ourselves the centre of creation, and our own finite minds the measure of all things. Thereby, we will have only succeeded in re-focussing the revelation of God, re-casting Him in our own image.

So let me complete the loop by reminding you of what God has said to us, as we minister in His name, whatever our age may be. With only slight changes in the person used in the fourteenth to sixteenth verses of Psalm 91.

He continues to say to us:
You have set your love upon me, Therefore will I deliver you; / I will set you up, because you have known my Name.
You shall call upon me, and I will hear you: / yes, I am with you in trouble; I will deliver you, and bring you to honour.
With long live will I satisfy you, / and show you my salvation.