Caregiving and “The New Old Age”


Last week, my mother-in-law joined the celebration of the 100th birthday of one of her neighbors at her retirement community. More than 100 of the residents there are over 90. We are in a demographic shift, with adults over 80 as the fastest growing segment of our population. Eighty is “the new 70.” The New York Times runs a blog devoted to “The New Old Age” and its particular challenges.[1] Many elderly and chronically ill people require help with day-to-day needs, a task that falls most heavily on their spouse or children. More than 65 million Americans care for a chronically ill, disabled, or elderly family member.[2]

Caring for a dependent family member is not easy. It can be lonely, isolating, and stressful. In fact, many caregivers struggle with their own depression or health problems caused by the emotional and physical demands of caregiving. Even worse, when several family members get involved, tensions can arise over “who’s responsible for what.” Disagreements over how to take care of Mom can drive siblings crazy.

Caregiving can be especially difficult when the patient has mental challenges like dementia or Alzheimer’s and cannot make their own decisions about their medical care. The spouse or children must pick up the role of surrogate decision-maker in addition to their other responsibilities. Making these decisions can be overwhelming, especially when they involve hospitalization, the use of psychotropic drugs, or whether to try feeding tubes and other life-support.

Caregivers may be tempted by medical decisions that could make life easier for them, but that might not be in the best interest of their family member. A feeding tube is easier than hand feeding, but might not be better for Dad. Basic ethical standards make it clear that Dad’s wishes should be followed, if he has expressed those. If we don’t know, we should seek Dad’s best interest. Remember, even patients with dementia may still be able to communicate their wishes and should be allowed to participate in medical decisions as much as possible.

Any of us may be called to assist in the care of a chronically ill or elderly family member. That’s why understanding the difficulties faced by caregivers is “everyday bioethics.” As a Christian community, we should make special efforts to support those who are serving as caregivers. Consider offering respite help, or a listening ear. Pastors, be attentive to the emotional and spiritual needs of the caregivers in your church community, especially when the hard decisions need to be made. There are two new books that can guide pastors and families: The Art of Dying and Finishing Well to the Glory of God.[3]

Caring for those in “the new old age” may be exhausting, but it should not be isolating. Both patients and caregivers are made in the image of God, and should be treated with honor and dignity.

[1] “The New Old Age,” New York Times,

[2] National Alliance for Caregiving and AARP, “Caregiving in the U.S., 2009: Executive Summary,” November 2009, 4, available at

[3] Rob Moll, The Art of Dying: Living Fully into the Life to Come. 2010 (Downers Grove, IL: IVP Books). Cf. John Dunlop, Finishing Well to the Glory of God: Strategies from a Christian Physician, 2011 (Wheaton, IL: Crossway Books).



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