Issues in Pastoral Care and Counseling for the Fourth Quarter of Life

Abstract

Issues and risks for pastoral care and counseling from the perspective of old age (here, ages 75 to 100) include identification of old age as a “problem” and its association with death in a death-denying culture. Two elements are fundamental: existential experiential deficits between the old and their younger caregivers (e.g., age cohort experiences, health status, gender, culture, privilege, etc.); and boundary issues that push the old, and pastoral care, to the edge of experience, where choices must be made between creativity and negativity (e.g., moving to dependent living, disability, etc.). Loss of doing (versus being) as a viable option is a major edge experience. The resulting sense of “emptiness” carries with it the potential for a sacramental awareness in which absence of doing becomes an outward and visible sign of an inward and spiritual grace.