THE ETHICAL IMPERATIVES WHICH EMERGE FROM A THEOLOGICAL PERSPECTIVE ON DISINTEGRATION AT THE END OF LIFE (FRAIL ELDERLY)

For aged people the end of life can be expected to include a period of physical and sometimes mental disintegration. In America these people are often isolated; they become social outcasts. Their plight has grave consequences for the maintaining of community and creates dread of the future in all the community's members. Physiology studies, social science research, and biographical accounts suggest that social attitudes toward disintegration of the frail elderly worsen their morale and physical condition, diminishing the potential of their lives. In Judaeo-Christian doctrine persons are to care for one another universally, regardless of condition. This universalism has not been adequately extended to the end of the life span. Judaeo-Christian doctrine also teaches that all human beings are alienated from the divinity of which they are a part--an alienation which calls for continuous reconciliation with the Creator and with fellow creatures, even to the end of life under physical and mental limitations. Reconciliation is here translated as homecoming, a term which has both a transcendent and worldly significance. The Judaeo-Christian doctrines of universalism and of reconciliation establish an imperative to create an environment for the elderly in which reconciliations can take place. Analysis of space, time and interpersonal needs suggest that the best site for very old people is the good home. A barrier to providing this environment for the frail elderly is identified as a misunderstanding in American society of the values ascribed to intellect and to vocational achievement. These values are valid, but not as criteria of human worth across the life span. A realignment, placing greater value on family, home, homemaking and home-sustaining, would result in different decisions in the care of the disintegrating elderly, and a shift in the focus of technology to support families caring at home for an elder which would allow for a better chance of homecoming, of belongingness, and of greater contentment at the end of life. It should also result in reducing the guilt and anxiety of those charged with care of the elderly and reassurance about their own future