Do not cast me off in the time of old age! Do not forsake me when my strength fails,’ wrote the Psalmist. But many older people find that they are quickly forgotten when they are too frail to get about independently. If you’ve been a pillar of the local church, relationships with Christian friends, family and fellow church members will sustain you in old age, you might think. But church links are often the first break with the community when an elderly person becomes frail, according to care homeowner Andrew Orr. “Older people are not followed through when they stop going to church,” he says. “Someone provides transport for a few weeks, but if they can’t continue the person is forgotten.” In his 15 years of running a care home, the only resident followed up by a faith group was a Jehovah’s Witness. Clergy have been reactive, making a pastoral visit on request, but not one has been proactive, maintaining contact with older members who have become too frail to attend church meetings. Isolation from church life is made worse by the fact that some residents have moved out of their communities and are too far away for regular contact. Others have been unable to attend church for several years, their close friends have died or moved away and they are forgotten by a younger congregation. Many elderly people have never had close church links. Andrew chairs a pioneering project in East Sussex, which provides ‘Pastoral Action in Residential Care Homes for the Elderly’. Parche, as it is known, aims to help meet the spiritual needs of every elderly person in residential care, Christian or not. They do this through churches of all denominations working together, holding monthly church services in each home, offering pastoral help to any resident and linking each care home with a church. But, even before Parche was formed, Anglican communion services were a regular feature in the care home Andrew runs. It began with a few residents in the privacy of one of the larger bedrooms. They then moved to the sun-lounge where they could be seen by other residents, some of whom asked to come along, simply to sit and watch. Now, 12 of the 20 residents attend regularly. In the Eastbourne area, Parche trains church groups to lead services sensitively for care home residents. The vision for Parche came from Buddy Reeve whose mother became a Christian at the age of 80, but the following year moved into a nursing home. Buddy says, “I rapidly became aware of how little provision there was for the encouragement and support of an individual’s faith, and there was rarely an opportunity for corporate worship.” In response, Buddy became a care assistant in a home and took a team in each month to lead a service. She then contacted people in other churches to talk about the need and, in January 1997, she gave up her job to launch Parche, which was featured on the BBC’s Songs of Praise in August 2003. Parche has grown to work with 35 Eastbourne churches, which are linked to 61 of the town’s 71 care homes. They have also formed links with 11 sheltered accommodation schemes. Research has shown that religious faith promotes psychological and physical health. According to a report by Kenneth Howse for the Centre for Policy on Ageing, meeting people’s spiritual needs should be a priority for carers and residential homes: ‘Religion may help people to continue to find meaning and value in their lives at a time when losses and diminishments of various kinds threaten to undermine their sense of meaning and value,’ he writes. ‘Secular providers really do have something to learn from the way in which religion helps people to discuss or cope with the distressing and burdensome aspects of ageing.’ Spiritual care Care homeowners are required by law to produce a statement of purpose, which must include arrangements for residents to attend a religious service of their choice. Spiritual care must also be part of the care package offered by each home. However, Buddy has not noticed a significant change in care homeowners’ attitudes since the law came into force. Parche provides a spiritual training seminar for care home staff at only £5 per person for a half-day course, but only three of Eastbourne’s care homes have run the training course for their staff and no one has taken up the offer of a pastoral care visitor, a visiting shop selling Christian books and cards or a Christian video lending library. “I don’t think they take spiritual care very seriously,” Buddy says. Parche has had more success in training church members to get involved as visitors to care homes. Around 300 local Christians are involved in visiting homes to hold a monthly Christian service. In several homes, this regular contact means they become well known faces and are given the privilege of visiting people in their rooms. “We aim to build up friendships by caring, listening, and, where appropriate, praying to encourage the faith of each individual,” Buddy says. Over the years, Parche visitors have seen many residents come to faith in Jesus, as well as others renewing the faith of former years. To safeguard residents and visitors, Parche is working with clergy and Social Services to provide accreditation for visitors once they have been trained. Buddy is also developing a pilot scheme to reach isolated people in their own homes. Again, accreditation will be necessary and individuals will be referred by GPs, Social Services and other caring agencies. The Parche project is now being duplicated in other areas in Sussex and Surrey, but in many regions, there is no coordinated church approach to elderly care home residents. Pastoral needs Paul Endersby has been a care home inspector for the past 14 years. As each home is inspected twice a year – with at least one visit being unannounced – Paul has lots of experience in this area of growing need. As a church elder, he is becoming increasingly aware of the needs of older people in his church when they become frail and need residential care. He also has the insight of personal experience: his mother is 87 and, although she still lives independently, she is becoming dependent on Paul and his family for help. Even simple tasks like moving a plant pot or taking the lid off a bottle of Aspirin can prompt a call. With his elder’s hat on, Paul recognises that he needs to care for older and younger people alike. “I’ve met many old people who say, ‘I’m the last of my generation’. Their family and friends have died or moved away and they don’t have any visitors.” Arranging a rota of visitors for church members in care can work well for a short time, but contact is more difficult to sustain as weeks and months turn to years. Maintaining regular contact with older church members who have moved into residential care would be Paul’s first priority for churches. For those people in care homes who have never been part of a church, Paul says, “It would be good if churches could contact the homes in their area to ask if there is any resident who has no visitors. Befriending them may well lead to an advocacy role as older people need someone to stand up for them.” Simple tasks like shopping when they need a birthday card or new pair of shoes are also vital. “There are rewards,” says Paul. “I’ve met some fascinating people, like a former West Ham player, one lady who had played tennis for England before the war and another who was in service with the Earl of Dundee.” Paul is aware of the pressures church members face. “I don’t want to induce a guilt trip. I am conscious that we live in a very busy society and people can be squeezed by the needs of aged parents, their children and grandchildren. But it is good for churches to be aware of elderly people’s needs. “Churches can offer to hold short worship services in a local care home or collect a resident to take them to church for the Sunday service. Other outings might also be welcome, but some elderly people don’t want to go out much, not even into the garden, Paul explains. It is often better to be spontaneous than make elaborate plans, only to find the person doesn’t feel up to an outing that day. Care options When an elderly person becomes frail, there is a variety of options for future care. Care homes are divided into four categories, two providing standard care or nursing care for elderly mentally infirm (EMI) people and two providing standard nursing care for other over 65s who are not in the EMI category. Lifeline is an automatic alarm system operating in many areas of the country, which allows frail elderly people to stay in their own home, and sheltered housing provides a warden assisted environment. Loneliness is the prevailing problem whatever option is taken. The needs of lonely people were what led to the launch of the Abbeyfield Society in 1956 when army Major Richard Carr-Gomm became concerned at the number of sad elderly faces staring fixedly from windows, during a visit to Bermondsey. He moved to a bed-sit in Abbeyfield Road and became a home help. During his home-help visits, he found that loneliness was the main problem, so he bought a house and invited four lonely people to join him, becoming the very first Abbeyfield housekeeper. Abbeyfield houses still work on the same principle with eight to 12 residents, usually over 75 years old, living as a household in their own community with a paid housekeeper and a network of support from local volunteers. Pearl Rendall chairs the volunteer house committee for an Abbeyfield house in Purley where the Anglican, Baptist, URC and Catholic churches have each started a house since Abbeyfield Purley was launched in 1962. Meeting the cost of improvements to comply with legislation forced the sale of one of the houses, but the remaining three now accommodate 21 elderly people in family-sized groups. Pearl and her committee manage one of the houses, employing the live-in housekeeper, a part-time gardener and a cleaner. Pearl describes loneliness as “the scourge of the age”. Ideally, she says, individual members of local churches would team up with an elderly person and treat them as if they were family, including them in church and family events. Abbeyfield residents are described as “active elderly” and are encouraged to continue links with the community. One over-80 Abbeyfield resident runs a coffee morning for a dozen other older people at Purley Baptist Church and another holds a prayer group in her room. Lena Woolcock is 87 and has lived in the house for the past 15 years. She is an active member of a local evangelical church. Friends take her to church meetings and she takes her turn with other women in the church to host a ladies’ prayer meeting. Lena keeps active tending the front garden at the Abbeyfield house, with the paidgardener to mow the lawn. She has four sons and 13 grandchildren, but didn’t want to move in with any of them although she has good relationships with them. “I’d rather live here than a granny flat,’ she says. ‘I believe granny flats can be very lonely places. Nobody realizes you still want visitors because they think you live with your family. Here at Abbeyfield we are a little family. There’s lots of laughter.” Abbeyfield-style homes may be the answer for churches wanting to provide care for active older people in their congregations. Pearl says six residents is the minimum to make the home viable, paying for the staff and providing breakfast and two cooked meals each day for the residents. Volunteers like Pearl manage Abbeyfield houses with a committee, but there are a dwindling number of people willing to give the necessary time. So the national society is taking central control of some Abbeyfield houses, a move that Pearl regrets as it could cut the community links and lose the distinctive friendly, family feel. Care homes for more frail residents often rely on voluntary help to meet residents’ social and spiritual needs. For example, Methodist Homes for the Aged, and its sister organisation, Methodist Homes Housing Association supports more that 6,000 older people across the country, employing more than 2,000 staff, with help from more than 5,000 volunteers. Building a relationship of trust with the care home owner or manager is the key for churches wanting to care for elderly people in care homes, Andrew Orr says. Offer to lead a simple worship service; gain the confidence of staff and residents and get to know them individually. If the more active residents are to be included in church life, then transport, access and accessible toilet facilities are key issues, which need to be addressed. Churches are often draughty, echoing, uncomfortable places. Hearing the service is almost secondary, being able to be there, worshipping with others or sitting quietly with someone, means so much. In England and Wales, the 2001 census showed there were 9.4 million people aged 65 and over in 2001. This represents an increase of 51 per cent since 1961. There were 1.1 million people aged 85 and over in 2001, over three times as many as in 1961. The increase in the number of pensioners has policy implications for Government, placing greater demands on health, social services and social security arrangements.