Catholic theologian Dorothy Day once said, “those who cannot see Christ in the poor are atheists indeed.” A similar sentiment can be applied to all of those who exist in the margins, including older adults. As the United States hurdles irreparably into late-stage capitalism, its grip on our culture has never been more apparent. Profit and productivity are innate American values, embedded into almost every aspect of our culture. Instead of family or community, our lives are centered around our work, and our success is measured by the labor we provide. The invisible hand shows no signs of loosening its oppressive grip, leaving more and more older adults to struggle and suffer. How should the church respond to and resist capitalist moral failings revolving around the care and welfare of our elders?
Religious and community organizations used to dominate the field of hospice care, but this is no longer the case. According to the Washington Post, for-profit hospice care is a $17 billion industry. Those in favor of for-profit hospice care argue that commercial hospice companies are more efficient than nonprofit organizations and make care more accessible and affordable. However, this couldn’t be further from the truth. For-profit hospice corporations tend to spend less on nursing per patient, are less likely to provide higher levels of care, are less likely to provide nursing staff during a patients last days of life, and have a higher rate of patient dropout, which is often an indication that the cost of care has become too expensive for a patient to afford. Nonprofits, on the other hand, are more likely to provide more intensive care during a patient’s last days, and spend about 17% more money per patient than the average for-profit hospice corporation. Unlike non-profit hospice organizations, for-profit corporations have to have a bottom line in mind when providing care, often to the detriment of patients. Corporations can widen their profit margin by providing fewer services, which often means that services not covered by insurance or Medicare are left out. Because Medicare provides a flat fee per patient, providing more intense (and therefore more expensive) care is simply not economical. The reason for this is, arguably, an ideological one. A for-profit business and a nonprofit religious organization have different values and different goals. Helen Zebarth, cofounder of a Virginia nonprofit called Blue Ridge Hospice, questioned whether or not the goals of a profit-oriented business can really be aligned with that of a person living out the end of their life. Unlike a nonprofit or religious organization, which tend to value the life and comfort of the patients they serve, Zebarth said, “if you think as a businessman and you want to make money, you will cut and cut and cut.” One example of the glaring discrepancies in quality of care is a treatment called palliative radiotherapy. Palliative radiotherapy is a treatment capable of easing pain among cancer patients by shrinking their tumors. According to a 2009 study from the University of Minnesota, for-profit hospice facilities are 2.5 times less likely to offer this service to patients because of its exorbitant cost. While hospitals are often more likely to weigh quality of care against financial motivations, hospice facilities are still not there yet. By 2030, the elder population will be almost twice what it is today, only creating an even greater need for long-term care facilities. Millennials, and by extension, millennial clergy, will have the responsibility as the new largest generational group of deciding what these long-term facilities look like. Will they be for profit or nonprofit? Care-centered (Christ-centered) or cash-centered? A Christian person should be able to see this unethical practice for what it is: a grave injustice, and a grave sin.
Christians who have eternity in mind should know that every chapter of life, even the last chapter, or especially the last chapter, is a meaningful preparation for life beyond the grave. Christianity also teaches that each person has inherent value, and that vanity is useless. Why then, do Christians allow capitalism to exploit our fear of aging? Margaret Morganroth Gullette discusses this in her book, Aged by Culture. In it, she claims that “anti-aging is commercial.” Everywhere in all kinds of media, books, TV commercials, social media, and health magazines, Americans are being bombarded with advertising aimed at “youth restoring” and “age-defying” products. This, Gullette points out, is paradoxical to one of capitalism’s core messages that age should equal progress. “Americans wouldn’t need such ‘hopes’,” she said, “if aging really equaled progress.” Youth is symbolic capital (as described by Pierre Bourdieu), or value an individual holds within their culture that allows them easier access to certain resources. More and more Americans are undergoing cosmetic procedures to maintain an appearance of “youthfulness” which shows that youthfulness is symbolic capital, and that many fear “decline” because they fear the loss of that capital. The loss of this capital is strongly tied to race, gender, and class. For example, middle to upper class white men are more likely to be seen as being in “the prime of their life” at older ages than women and racial minorities of lower economic standing. Gaps in healthcare only exacerbate this, as wealthier people may avoid the onset of certain diseases for as much as 30 years longer than those of lower socioeconomic status. In all class levels, black Americans receive inferior healthcare when compared to white individuals of the same class. Scientists may boast about the progress being made in the science of living healthier and living longer, but it begs the question, progress for who? As Christians, we should be disturbed by all forms of inequality, but inequality in age-related care often falls to the wayside.
Millions of working class Americans struggle with financial security, and unfortunately, this insecurity often stays with them until the end of their lives. Katherine S. Newman wrote in her book, Downhill from Here: Retirement Insecurity in the Age of Inequality, that “retirement insecurity is an increasingly serious manifestation of the vast inequality that is eating away at the social fabric of America.” As of 2018, almost half of all private-sector employees in the U.S have no company sponsored retirement plans, which equals about 58 million people. Workers are told that if they work hard now, they’ll reap the benefits later in the form of pensions. However, economists and policy scientists warn that the baby boomer generation, and those that follow, are at serious risk of losing that financial security. Slowly, the idea of retiring at 65 is fading away. Things like Medicare and Social Security are increasingly not enough to sustain older adults through retirement, and working life simply continues. This kind of insecurity isn’t universal at every class level, however. A report titled A Tale of Two Retirements published by the Institute for Policy Studies and the Center for Effective Government shows that “while companies default on pensions and benefits for most of their workers, up in the C-suite the weather is fine. Not only are CEOs socking away millions of dollars in executive retirement plans, but they are enjoying such benefits on a tax-deferred basis.” The pension, which was once considered an unbeatable promise after President Roosevelt’s New Deal, is now a discretionary benefit dangling above the heads of workers, ready to be taken away at the will of their employers. The original purpose of a pension was to provide those in retirement age a stable, fixed income, which they had earned after a certain number of years of loyal work. It is the responsibility of the employer to manage and invest these funds appropriately. For the last thirty years, however, the pension has been displaced by the 401k, in part due to diminishing Union membership. Without workers’s unions advocating for better benefits and retirement plans, guaranteed retirement support is diminishing.
In Downhill from Here, Newman tells the story of a white woman in her mid-seventies named Hazel Lidell who lives in Ogden, Utah, where the poverty rate above 65 is 14.5%. She had worked hard her entire life, yet lives at the poverty level with no money to retire. She has worked numerous low-wage jobs, working nights cleaning offices, delivering newspapers, and even working in a field picking fruit only three weeks after having a C-section. She’s unable to apply for housing assistance, because due to restrictions on how much government aid one can receive, she would lose her SNAP benefits. She said,
“They say they want to help [senior citizens]. You’re not helping. If someone is making less than six hundred dollars a month, or less than a thousand, you’re still in poverty…We’re not asking for a handout, because we paid taxes to the state of Utah for years. So it’s actually our money. But they want to use it for the roads. They want to use it for other things. CEOs want to take the money and give it to themselves… So what’s fair about this?…The greed is unreal in this world. Really, it is very bad. And how much money is it going to take to make you happy?”
Hazel’s seemingly only solace was the support she got from the LDS and surrounding community, a common theme in many of the stories told in Downhill from Here. When the government ignores, the church steps up. Another story comes from Opelousas, Louisiana, and revolves around the Holy Ghost Catholic Church, whose parishioners are predominantly elderly. Opelousas is an impoverished community, so the parishioners of Holy Ghost pooled their resources together to build Section 202 housing right across the street from the church for their elderly congregants to live in. Father Lester Limpele, the parish priest at Holy Ghost, explained,
“Here, in this parish, every week, we have probably five, six, seven people come to ask for assistance…for everything. Light bill, buy food for their children, gas, phone bill, rental…I just helped somebody with a funeral…We keep a record of whom we help this year. So each person can get help only once a year. By doing that, we give opportunity also to other people to come in, to get help.”
Community and family are values that define the Holy Ghost Catholic Church. In light of the rampant poverty in Opelousas, the church takes the responsibility of its elder congregants into its own hands. They take care of the because they feel their faith commands them to do so.
Because capitalism treats people as though they are expendable, it’s become normalized to view older people as leeches, as non-contributing members of the community who do nothing but use up resources once they’ve retired or become unable to work. But what does it mean to contribute? Is working a job the only way to contribute in a capitalist society? Elders provide their stories, their wisdom, their expertise, and their experiences to younger generations. They are beloved matriarchs and patriarchs who add value to our lives simply because they’re in them. Like Hazel’s church, and like Father Limpele’s church, Christian communities are obligated to respond to the cruelty of capitalism with radical love and care. Every church should do the bare minimum of helping their elders, not only because it is right and just, but because it is part of their faith. In scripture, we can see stories like that of Anna and Simeon, two elders who recognized Jesus when others did not. Their inclusion in Luke’s narrative suggests that “radical openness to the redeeming power of God may be found among elders.” Similarly, the story of Abraham and Sarah, who miraculously conceive a child, shows that God had great plans for them, in spite of their advanced age. Verses like 1 Timothy 53 say, “Do not rebuke an older man, but exhort him as you would a father.” The Bible shows that elders are worthy of honor and respect, something that modern society has forgotten. We turn death and dying into profit. We pathologize aging and fear the loss of our youth as social capital. Perhaps worst of all, we fail to care for our elders the way they have cared for us for generations. The Christian moral vision is clear: elder lives are essential. Capitalism is not.
Bibliography
Ellis, Charles D., and Alicia H. Munnell, Andrew D. Eschtruth. Falling Short: The Coming Retirement Crisis and What to Do About it. New York: Oxford University Press, 2014.
Hays, Richard B. and Judith C. Hays. Growing Old in Christ. Grand Rapids: Wm. B. Eerdmans Publishing Co., 2003.
Knickman, James R. and Emily K Snell. “The 2030 Problem: Caring for Aging Baby Boomers,”Health services research vol. 37,4 (2002): 849-84. doi:10.1034/j.1600-0560.2002.56.x
Gullette, Margaret Morganroth. Aged by Culture. Chicago: The University of Chicago Press, 2004.
Newman, Katherine S. Downhill from Here: Retirement Insecurity in the Age of Inequality. New York: Metropolitan Books, 2019.
Whoriskey, Peter and Dan Keating, “Dying and profits: The evolution of hospice,” Washington Post, December 26, 2014, https://www.washingtonpost.com/business/economy/2014/12/26/a7d90438-692f-11e4-b053-65cea7903f2e_story.html.
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