AGING, SPIRITUALITY, AND RELIGION:
A HANDBOOK (Vol. 2)

Melvin A. Kimble and Susan H. McFadden (Editors)

To be published by Fortress Press, Minneapolis, MN
1 November 2002

Introductory Chapter

Introduction to the five sections of the Handbook

Part One: Late Life Spiritual Potentials

The metaphor of "pilgrimage" weaves in and out of many chapters in this Handbook and thus it is most appropriate that for the first chapter, Lynn Huber has chosen it as her guiding theme. Unlike the popular metaphor of development in childhood and youth as an energetic hike up a hill to the "prime of life", with aging as a gradual and then precipitous slide into dissolution, Huber's understanding of spiritual pilgrimage embraces the notion that losses and gains occur throughout life as one casts off the false self and journeys toward the true self of authentic wisdom.

But what if that journey carries one into the land of dementia where the spiritual potential to become what Huber calls a "wisdom person" is clouded by confusion and disorientation? Jane Thibault addresses this life crisis with deep sensitivity borne of her many years of counseling with families coming to terms with the dreaded diagnosis. By creating an imaginary journal written by a woman wrestling with her God and her doctors' verdict, Thibault affirms that God remains a source of comfort and grace.

The shadow of suffering lengthens with aging, for nearly all older people know at least a few friends and loved ones who slip into frailty. Despite these nearly inevitable experiences, and perhaps because of them, late life holds rich opportunities for spiritual development as Robert Atchley so compellingly reveals. In his chapter, he describes three levels of "spiritual elderhood", from elders in training, to actualized elders, and finally to transcendent spiritual elders. Spiritual elders populate our ordinary lives, if we have eyes to see their goodness and ears to hear their wisdom. Atchley shows readers of his chapter how to recognize spiritual elders in our midst and suggests that our lives together might be transformed by encouraging aging people to enter training to increase the numbers of spiritual elders among us.

Susan McFadden begins her chapter by lifting up images of ordinary, older people undertaking many mundane tasks in their religious congregations. These common activities offer opportunities for expressing and sharing emotions ranging from sorrow to joy. McFadden urges both researchers and parish clergy to pay close attention to the richly patterned emotional lives of older people revealed in the worship, prayer, study, and intergenerational social interaction that occur within religious communities. In particular, she stresses the significance of older people's love for other persons and for God.

In the preceding chapters, little is made of gender, for both men and women can undertake a spiritual pilgrimage, suffer from dementia, become spiritual elders, and experience emotions in faith communities. Nevertheless, we know that in Western cultures, social scientists have generally found that older women are more likely to acknowledge their spiritual lives and become involved with public expressions of religious faith. Christy Neuger explores the reasons for this and reveals the way gender training in our culture produces different ways of being spiritual for men and women in later life. This has important implications for ministry with older persons, especially in times of bereavement and the process of dying.

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With Jon Stuckey's chapter, we turn again to spiritual challenges of Alzheimer's disease. It is interesting to compare this volume of the Handbook with the preceding volume and to realize how much more attention is now paid to dementing illnesses of old age. Dementia is "out of the closet" so to speak, and those who study and encourage late life spiritual potentials must not marginalize the many older people who suffer from it. Stuckey affirms both the cruelty of Alzheimer's disease, but also the fact that the presence of the Divine within all of life - even on the dementia unit - offers meaning and hope.

The final chapter in Part One functions as a transition to part Two, as in it, Henry Simmons examines the ebb and flow of stable periods and transitions in many older people's lives and the implications of this for ministry. He creates a "matrix" of these expected life events laid out against the backdrop of what social scientists would call demograqphic variables of gender and sexual orientation, socioeconomic status, cohort, ethnicity, and geographic location. Simmons notes how various pathways to spiritual growth may take different forms depending upon the combination of factors that form the individuals who converge in religious communities where they worship, serve others, teach, proclaim their faith, and witness to the possibilities of late life spiritual growth.

Part Two: Aging in Faith Communities

Part One documents many possibilities for spiritual pilgrimage in later life. Traditionally, faith communities have offered the necessary resources and support for such a pilgrimage. Today, however, many people are challenging this tradition and are seeking alternative outfitters for the journey toward meaning and purpose in later life. Indeed, some argue that faith communities have become impediments to spiritual growth by providing outdated "equipment" and indecipherable maps. The chapters in Part Two refute the notion that late life spirituality can be self-invented in solitary pursuit. Rather, these chapters argue for the essential role of the faith community in nurturing spiritual growth through worship, study, and service. This is not to say, however, that these chapters approach the role of faith communities in older adults' lives uncritically. These communities cannot be complacent about the challenges and opportunities that lie ahead in a rapidly aging society.

Anne Wimberly's chapter focuses on the particularities of the black church and its traditional support for older persons and at the same time, offers a generalizable model of congregational care. Grounded in a clearly articulated theology, this chapter claims that black congregations engage in "soul care" as an intentional way of sharing the Spirit of Christ so that both individuals and communities are strengthened. Wimberly's functional approach to congregational care as involving "attending", "mediating", and "advocating" can be seen as a foundation for the chapters that follow in this section. Together, these chapters address issues related to worship and ritual, assistance to elders (often in the form of connecting them with other social services), and advocacy and consciousness raising to address the well-being of older persons.

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As documented by several chapters in Volume One of the Handbook and in a rapidly proliferating body of literature appearing since its publication, engaging in public and private religious activites appears to be related to the physical and mental health of older people. DuWayne Battle and Ellen Idler review recent findings about older adults' attendance at religious services and reflect upon some of the reasons behind the connection between worship and well-being. They discuss the rest and celebration experienced in Sabbath observances, the importance of various sensory, emotional, and intellectual components in worship, and the ways worship opens up possibilities for other important social connections for older people.

Dayle Friedman continues the discussion of communal opportunities for spiritual deepening by examining the meaning of ritual, especially for older persons. Rituals connect people to the past and simultaneously, to the future, but unfortunately, few rituals specifically address the losses and gains of later life. Friedman suggests how several Jewish rituals can provide great blessing to aging persons as together in community they celebrate their transitions, grieve their losses, and look to the future with hope. She ends her chapter with specific suggestions about constructing rituals of transition that could be adapted for use in many types of faith communities.

Strengthened and supported by their experiences in worship and other communal celebrations of life's important transitions, members of faith communities may be challenged to search for ways they can articulate the values of their faith through service to others. One approach to this is to enter into "cooperative alliances" with various social ministry programs in the community. Doug Olson and Mark Holman explain the opportunities and constraints such alliances offer to congregations that have made a commitment to improving the lives of older persons. The formation of these partnerships offers a rich array of possibilities for both congregations and agencies and in coming years will surely take on greater urgency as more people live longer.

Just as congregations and social ministry organizations may have to conduct an "inventory" of their values, resources, and the needs that must be met in their communities, so too do individuals benefit from a sustained examination of their efforts to live faithfully through the years. For some, the process of writing and discussing spiritual autobiographies in group settings can provide important insights about sources of meaning, release the burden of old conflicts, and create a closely-knit, supportive community of people aging together. Richard Morgan offers concrete examples of the formation and function of spiritual autobiography groups in faith communities where people discover how their individual narratives connect to the central narratives of their faiths.

One of the outcomes of the spiritual autobiography process can sometimes be a deeper commitment to service to others. In his chapter, James Seeber details the many opportunities for ministry by and for older persons in faith communities. Seeber notes that older adults currently represent a large percentage of persons who volunteer in the US. With a large, healthy, and active cohort of elders anticipated in the near future, older people will have numerous outlets for service. Faith communities can provide the necessary structure and training for these volunteers. Seeber describes several established programs that specifically address the needs of older persons, and he also provides information about programs like Stephen Ministries that serve all ages.

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Support for caregivers is a much-needed service that faith communities are in an excellent position to provide. Marty Richards offers a sensitive account of the needs of people who give and receive care. She notes the importance of proper training lest good-hearted persons fail to understand issues of dependence and independence, ways "helping" can harm, and complicated conflicts that almost inevitably arise within caregiving families. In addition to providing training and support for volunteer service with caregiving families, Richards argues that faith communities must educate persons of all ages about "bearing one another's burdens".

Part Three: Pastoral Care with Older People

Although the title of Part Three suggests that it may be addressed only to ordained persons, in actuality, the chapters in this section provide useful information and wise perspectives that should also be useful for laypersons preparing to undertake volunteer ministries with older adults. For example, Nancy Devor and Kenneth Pargament present four cases that demonstrate how religious faith can be a positive source of support in challenging times, and how it can also be a detriment to healthy coping. Based upon Pargament's well-known empirical research on religious coping, the chapter could serve as an important component of training for volunteer service with elders. In addition, its careful delineation of different forms and outcomes of religious coping ought to remind parish clergy about the many pathways religious people take in the search for meaning in times of crisis and transition.

Lois Knutson's contribution could also be an important part of any training program for volunteer ministry or for clergy education in pastoral care. She suggests numerous goals for pastoral care with elders, including affirmation of their value, honoring them as important to the faith community, comforting and helping them accept the love of God and other persons. Knutson describes the dynamics of visiting with older persons in their homes and lists a number of concerns that typically arise in such visits. She also connects this kind of individual caring response to elders' needs to a large number of congregational programs that serve older persons and their families.

Not all of the issues with which aging people and the families wrestle are public and obvious. For example, addiction to alcohol and other drugs may be a deeply held, destructive secret that prevents persons from realizing their spiritual potentials as depicted in Part One. Richard Albers' chapter offers practical, sensitive, theologically grounded advice for pastors and lay volunteers working with older persons struggling with addiction. He catalogs common attitudes about addicted elders that may prevent them from obtaining treatment and he argues that pastoral caregivers - both ordained and lay - have some culpability in reinforcing these attitudes among parishioners. He also states that pastoral caregivers have a wonderful opportunity not only to assist addicted elders and their families in receiving tratement, but also to educate the faith community about the social attitudes and religious prejudices that can undermine people's efforts to be released from addiction.

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Alcoholism and other addictions are often deeply hidden in the elderly population. In fact, the public often assumes that most "bad habits" and unsavory character traits diminish or disappear by the time a person reaches later life. Paradoxically, uncritical assumptions that all old people are wise, serene, gentle, and good can reinforce their marginalization. Robert Rost understands this, and argues that older people must be given permission to explore issues of sin and grace. He writes about how pastoral caregivers can journey with elders as they courageously explore dark corners of their lives. He notes the pain these elders sometimes experience when all through their lives they have felt an undue emphasis on sin without assurance of God's abiding grace. Tragically, in later life, some persons come to believe that their suffering is punishment and that God has turned away from them. Thus, Rost speaks of the need for elders to understand and accept a theology of grace-"beholding grace" as he puts it.

Older people who do not perceive the evidence of grace in their lives may fall into despair and sometimes into a clinical depression. This is the focus of the chapter by Elizabeth MacKinley. In particular, she addresses the problem of depression experienced by persons living in long term care. Pastoral caregivers who visit in nursing homes and other facilities for older people need to be able to recognize the signs of depression that sometimes intertwine with physical conditions that produce frailty. These caregivers should know that depression is a highly treatable psychiatric illness but that it can also be a signal of an existential crisis of meaning in later life. Thus, the pastoral caregiver can be an important member of the treatment team by helping a depressed elder come to terms with sources of meaning-especially ultimate meaning. Pastoral caregivers can also journey with long term care residents as they respond to loss, renew a sense of intimacy with God and other persons, and experience hope even in the face of frailty and impending death.

Even with compassionate pastoral care and a secure faith, older adults will experience suffering and, as Helen Black so eloquently writes, they need to tell their stories of suffering to caring listeners. Without the opportunity to relate the narratives of suffering, suffering intensifies in loneliness. Black argues that suffering is a form of cultural and religious communication; culture and religion shape the narratives of suffering and at the same time, provide the one who suffers with an interpretive scheme for grasping its meaning. This chapter instructs those who would listen to these difficult narratives in ways of being sensitive to the metaphors that convey the deeper meanings of suffering.

The final chapter of Part Three also asserts that pastoral caregivers need to learn how to listen to elders' stories. James Ellor discusses the process of "spiritual assessment" and the need to be aware of underlying explanatory theories that shape the way such assessments are conducted. This chapter offers a case of an elder whose suffering cannot be fully understood without taking into account its spiritual dimension. Drawing upon the theology of Paul Tillich, the developmental psychology of Erik Erikson, and the logotherapeutic approach of Viktor Frankl, Ellor shows how a wholistic approach that bridges psychology and theology offers the best hope for a counselor to give support to an older person experiencing a crisis of meaning.

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Part Four: Theological Perspectives and Ethical Issues

Theological perspectives on aging and older adults' lives, along with ethical concerns about care and support for people in later life, form a subtext in many of the chapters found in the preceding three sections of this Handbook. In Part Four, theology and ethics are engaged directly. These chapters assert that a vision of old age formed wholly by the biomedical and social sciences is radically flawed and limited in its ability to tolerate the inevitable ambiguities that arise in later life.

Carol Bailey Stoneking's chapter begins this section with a critical analysis of much scientific and theological writing about aging as an abstract problem separate from the lives of real human beings. In addition, she observes that many churches embrace cultural prejudices about late life and split the problems of older people from their potentials. Continuing the theme of narrative begun in the chapters on pastoral care, Stoneking places images of aging before the mirror of the Christian story. This narrative of suffering and redemption powerfully gathers in the paradoxes of later life and places them in the context of sacred time where hope prevails despite the unquestionable facticity of death and where problems coexist with continuing potential for spiritual deepening. Older people who understand this have many gifts to offer by teaching the young about living and dying.

Working from another Christian theological position - that of process theology - Paul Sponheim reflects on what it means to know that life inevitably ends. He depicts three functions of this knowledge: it can define our lives, inspire us to pass love and wisdom on to others, and offer hope for resurrection into timelessness. Sponheim understands that Christians struggle to know what lies beyond death. He counsels acceptance of the notion that in death, "we are indeed with God" and rejection of the desire to take God's place in judging one another's destinies. For older people, drawing close to the end, Sponheim offers a comforting metaphor: we spend our lives rowing toward God, but in old age, we can rest the oars and drift with the current that flows back to the Creator.

If Sponheim's chapter has us drifting with a stream's current, then Richard Wallace's contribution has us on our feet singing. He writes about the special meanings of the African American church where for many generations, elders provided sustenance to the community. He warns that the African American community risks being tainted by the dominant, materialistic, youth-oriented culture of our times and argues that if it gives up its traditional respect for elders, then it will lose its very soul. In the experiences of older people in the African American church and community, Wallace finds a basis for theological reflection on aging. Grounded in the work of George Lindbeck on a cultural linguistic approach to religion, as well Charles Gerkin's narrative hermeneutical model of pastoral care, Wallace finds theological inspiration in several African American narratives of aging and old age. He thus binds the particularities of biography to the generality of his call to African Americans to hold firm the connections in their communities between the living witness of elders and their theological foundations in faith and hope.

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Richard Address also reflects upon the end of life by writing about how Jewish tradition and sacred texts offer guidance for decision making in the difficult circumstances that commonly arise when medicine can sustain life but at the same time threaten its "dignity and sanctity". Preservation of this dignity and sanctity represents the core of Jewish ethics yet this core is challenged in our time of increasing longevity. Today, many people facing end of life decisions struggle with what Address calls the "wild cards" of personal autonomy, technological possibilities for life extension, and the search for meaning in life. What happens when the culturally reinforced desire for personal autonomy encounters life sustaining biomedical technology, all in the context of the desire for spiritual significance? Address guides his readers through this thicket of difficult questions and concludes that life's dignity and sanctity are sometimes preserved best by removing impediments to death.

The last two chapters of this section focus on what some believe to be a "living death": dementia. In Part One, Jane Thibault and Jon Stuckey reflected upon the potential for spiritual engagement that persists despite the degradations of dementia. In this section, attention is shifted to those who care for persons with dementia and the often painful ethical challenges they face. Stephen Sapp implores leaders of faith communities to lift their voices in affirmation of the continuing personhood of elders with dementia. This witness is an important-though often overlooked-component of an ethic of dementia. Clergy and chaplains are in a unique position not only to provide ethical guidance to people with dementia and their families, but they also occupy roles in which they can proclaim to contemporary society the dignity and worth of all persons, including those whom dementia so cruelly afflicts. Sapp describes a number of ethical concerns that faith communities will increasingly confront beginning when their members receive the dreaded diagnosis on through to the end when decisions must be made about terminal care.

Writing from the perspective of biomedical ethics, Ladislav Volicer and Paul Brenner continue this discussion of ethical issues raised in the care of persons with Alzheimer's Disease (AD). Their chapter begins with the difficult question of definitive diagnosis and whether persons should be told that in all likelihood they have AD. Volicer and Brenner review reasons why some physicians may not want to tell their patients, but conclude that "telling the truth" has more beneficial consequences than withholding the information. Next they explore the ability of patients to make decisions for themselves and urge that advance planning be done in the face of this progressive illness. This includes planning for the time when the individual can no longer make autonomous decisions and someone else may need to step in to determine when driving must cease, when institutionalization is necessary, when the use of restraints is debated, and when life draws to an end.

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Part Five: Anticipating the Future

During the last two decades of the 20th century, anyone who spoke about demographic projections about an aging population probably pointed to the demographers' touchstone: the year 2030. Now that that 21st century has arrived, that year looms more clearly out of the mists of the future as older people in the wealthy nations of the world experience longer, healthier lives. These final chapters of this Handbook contain what might be called "meditations" on the future, both social and personal. Appropriately, this section begins and ends with chapters by the eldest of the group of authors whose work appears in these pages. These three wise people-James and Betty Birren; Mel Kimble-offer us intimate and courageous personal reflections on aging and dying. Between their chapters appear writings by middle-aged Baby Boomers considering the implications of the "longevity revolution" for research on religion and spirituality, for the church, and for a just and humane society. In many ways, this last section circles back to Part One which spoke of "late life spiritual potentials".

James Birren and Betty Birren begin their chapter by noting that models of aging have not kept up with the actual experience of aging today. These outdated models function in both the social and the personal realm of contemporary life affecting everything from public policy about airline pilot retirement to older people's attitudes about exercise. Old models of aging, based upon expectations created by earlier cohorts of elders, provide few guides for older people today. A key point reverberating throughout this chapter is that older adults need to take control of their own aging; granted health in longevity, they can make responsible decisions about how they use their resources-decisions which have important implications for themselves, their families, and society as a whole. As a way of coming to terms with taking responsibility for one's old age, the Birrens suggest that older people begin by engaging in autobiographical reflection. By articulating the values that have shaped them, older people can make wiser decisions about how they will manage life in old age.

One of the recurring themes in Birren's work has been the emphasis on asking good questions. The next chapter in this section poses a question Birren would appreciate: has the scientific study of religion and aging failed to ask the right questions? Jeff Levin believes that by ignoring inner experience, religious gerontology risks becoming superannuated in its efforts to understand late life spirituality. Unless researchers begin to attend to what Levin broadly describes as "mystical" experience, the split between research on religion, spirituality, and aging, and the actual religious and spiritual lives of older people will become profound as Baby Boomers move into old age. This has implications not only for researchers, but also for clergy and religious institutions as they attempt to provide opportunities for spiritual growth among aging persons-aging persons, that is, who still believe that religious institutions retain any relevance for their spiritual lives. Many other aging people will pursue mystical, transcendent experiences outside of "organized religion" and Levin argues that these persons' pilgrimages need to be studied and understood. Levin urges researchers to become knowledgeable about these alternative pathways, to be open to studying consciousness, and to employ qualitative methodologies that can reveal more about numinous experience than what he calls the all too common "bean-counting" of today's empiricism.

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From a researcher who argues that research in religious gerontology risks becoming unable to study the spiritual quests of tomorrow's elders, we turn next to a member of the clergy who claims that his colleagues and the institutions they serve are increasingly perceived as irrelevant by aging Baby Boomers. In what may be the most unusual chapter in this Handbook in that it takes the form of a dialogue between two Baby Boomer ministers sitting at a bar, John McFadden argues that mainline white Protestant churches are so busy trying to "grow" by emphasizing programs for young families that they fail to notice when people whose nests have emptied no longer remain engaged in their congregations. Moreover, some churches fail to hold older people accountable for their spiritual development and offer precious little guidance for growing in faith in late life. In fact, these two fictional clergy agree that religious institutions may be far too smug about the people who do arrive at their doors on Sunday mornings, preferring to reinforce their "extrinsic" religiosity in exchange for an occasional check in the collection plate rather than challenging them to develop a faith that can bear up under the inevitable challenges of later life.

Echoing some of the themes discussed at McFadden's fictitious tavern, Harry R. Moody suggests that aging Baby Boomers face a choice between wallowing in cynicism and narcissism or shedding their illusions and embracing the challenges of conscious aging. Moody describes a movement building in this country to promote conscious aging, not as an elixir yielding unending health and productivity, but rather as a humble embrace of life's vicissitudes and the beautiful possibilities for loving God and other persons in later life. Conscious aging can be nourished within the traditional religious institutions although increasingly, many are turning to groups outside the faith communities that have failed to address the spiritual hungers of this new aging generation. Moody argues that aging persons must learn how to hold the inevitable suffering and loss of old age in creative tension with the potential for spiritual growth and expanded consciousness in late life. Out of this may emerge new appreciation for late-life learning, creativity, holistic health, and spiritual growth. In addition, Moody believes that people who accept the challenges of conscious aging will be equipped to turn outward to help to "repair the world". Surely a vast generation of healthy, active, aging persons who have rejected self-serving spirituality in favor of spiritual disciplines rooted in the world's religious wisdom has great potential to show courage in the struggle for peace and justice in our world.

One finds in the chapters by McFadden and Moody hints of the traps and pitfalls as well as the opportunities inherent in the postmodern world of aging. In Thomas Cole's contribution, the postmodern challenge is confronted directly. Cole carefully delineates the conflicts between postmodern thinkers and humanists that arose at the end of the 20th century and argues that the attack on humanism as falsely preaching immutable "truths" was in error. Rather, he argues for a fresh view of humanism that can be self-critical while retaining valuable insights that are examined in light of current appreciation for diversity. The humanism of which Cole writes is not an alternative to religion or science. Indeed, Cole argues that we can celebrate the advances of Western science while not yielding it authority in the spiritual realm. Likewise, we can appreciate the humanistic impulse for human freedom and creativity without being exclusive humanists who deny the possibility of transcendence. This is why Cole states that a stance of postmodern religious humanism offers to gerontology important intellectual, emotional, and spiritual resources that embrace pluralism, encourage dialogue, appreciate the shaping influence of culture and history, and value the wisdom found in the world's religions.

McFadden, Moody, and Cole all reflect upon contemporary wishful fantasies about perpetual youth and the denial of the vicissitudes of aging. None of them, however, confront the question of death as clearly as Melvin Kimble does in this final chapter in this volume. Kimble's own encounters with the specter of death have granted him hard-won insights about what he calls its "paradoxes". Drawing upon theology as well as drama and poetry, Kimble practices the kind of gerontology Cole encourages-a reflection on aging and dying that respects the awe and fear that humans feel about these inevitabilities. In response to the paradoxes of death, Kimble urges us to be more mindful about the creation of metaphors and rituals about death. These will enable us to locate transcendent meaning in aging, dying, and death-transcendent meaning in the gracious gift of time that comes to an end for individuals but continues eternally in the loving embrace of God.

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Introductory Chapter:

Continuing the Conversation

Melvin A. Kimble and Susan H. McFadden

James Birren once declared that " ... aging is too important to leave to the scientists." It was an acknowledgement that the natural science model in many respects has served gerontology well, but not well enough. It has failed to recognize that a wider frame of reference in the study of aging is needed to allow for the full exploration of the question of the meaning of growing older.

Twenty-five years ago, national gerontological societies seemed to be the exclusive domain of persons from the medical, behavioral, and social sciences. There were relatively few gerontologists who were interested in the relevance and importance of spirituality and religion in the aging processes. That climate has changed. There has been a heightened interest in the role of religion and spirituality in aging, and a general recognition that aging touches all the basic questions of life and dimensions of being. Aging is a multidimensional reality that demands a truly interdisciplinary approach that includes the arts and humanities.

Consequently, there is a growing recognition that a wider frame of reference is required to more fully explore the multi-faceted and complex questions about older adulthood and its meaning. The natural sciences with their positivistic empirical approach are too narrow and unidimensional in their study of aging and its meaning. Insights of the medical and psychosocial sciences need to be brought into dynamic dialogue with religion and theology in order to address the phenomenological and hermeneutical structure of later life and the profound multidimensional issues of aging.

In the 1980s, prescient gerontologists like James Birren and Barbara Payne encouraged several of us to undertake the challenging task of including the spiritual dimension in the study of aging and its meaning. The result was the exploration of some of the uncharted terrain of spirituality and religion and their impact on aging and older adulthood. Volume I of Aging, Spirituality, and Religion: A Handbook, was published in 1995 at a time when there was still very little literature on spirituality and aging. This volume represented a unique collection of essays by a variety of eminent scholars and practitioners from assorted disciplines of gerontology, theology and pastoral practice. Although there was no apparent market for such a handbook, Fortress Press took the risk of publishing this volume. There was considerable surprise when the Academy of parish Clergy in 1996 named this book one of the ten best books for parish ministry, and, perhaps, even more surprise when the handbook continued to record steady sales to both gerontologists and clergy.

The culture and climate for introducing spirituality and religion into gerontology have significantly changed since Volume I was published. The inclusion of the spiritual dimension of aging has been widely recognized as evidenced by professional gerontological societies such as Gerontological Society of America and American Society of Aging creating study sections on religion and spirituality in gerontology. The spiritual dimension is increasingly cited as an important dimension in health today and as a critical component in "successful aging." The "red carpet" has been unrolled! Persons from the religious sector are now encouraged more fully to participate in presentations and symposia at national gerontological conferences.

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Persons from the religious sector, however, cannot come empty-handed to this conversation. They must participate having done their own conceptual reflection and research in the areas such as theology, liturgics, psychology of religion, and pastoral care. Likewise, researchers and practitioners in the biomedical and social sciences need to critically examine their disciplines for their unspoken assumptions about the meaning of human longevity.

Some of the questions that need to be addressed include the following. How can a theological hermeneutics reshape the pervasive biomedical model of aging? What are the unique roles of the faith community in promoting wholeness and health as well as spiritual growth and maturation for persons in the last stage of the life cycle? How do religious communities and pastoral caregivers respond to the implications of an expanding older adult population nearing the fourscore years envisioned by the psalmist? What are more creative ways to implement older adult ministries with both mobile and frail elderly? What metaphors and symbols are needed in order to emphasize the transcendent meaning for life at all stages including older adulthood? What forms do religious and spiritual development take in later life? How do faith and spiritual focus affect older adults' thinking, feeling, and acting? How are social behaviors affected by late life religious and spiritual commitments and what are the implications of these commitments for compassionate service to others? The findings from such research and scholarship must be disseminated in scholarly papers and publications that advance the understanding of the relevance of religion and spirituality in the field of gerontology.

Fresh breezes continue to blow in current gerontological theory, research, and practice that value and include spirituality and religion and their impact on aging. Because of the significant outpouring of interest, the editors proposed to the publisher a revised version of Volume I. It was suggested, however, that we keep Volume I in print and publish a fresh collection of essays as Volume II that would continue and expand the interdisciplinary conversation begun in the first volume. Therefore, a core of scholars and practioners was enlisted to contribute essays to this new volume. This volume, although not without substantive theoretical essays, includes more essays that reflect praxis. It contains many examples of how religion and spirituality are encountered in the growth experiences and life crises of older adults and their families.

Interestingly, several new themes arise in this volume that were absent in the previous work. For example, very little mention was made of Alzheimer's and other dementias in the first volume. Volume II contains four chapters entirely devoted to issues related to dementia and others engage the topic by addressing concerns of caregivers. Similarly, the noisy Baby Boomers were relatively silent in volume I, but now several chapters focus on the ways they are reshaping expectations about religion and spirituality in aging persons. Reflecting an emerging vision for inquiry in gerontology, the need for narrative explorations of late life emerges as a strong theme in this volume. Authors in this volume are also more ready to take on the challenging discussion of dying and death, topics that did not receive much attention previously. Finally, one finds in this volume a much stronger emphasis on older adults' opportunities for service to others and the ways their love for their neighbors and for God may heal the brokenness in this world.

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Although James Birren suggested that " ... aging is too important to leave to the scientists," he also wisely added, "but it is also too important to leave to the theologians and scholars in the humanities." He underscores the necessity for inter-disciplinary and multi-dimensional approaches. Spirituality at first viewing is an ambiguous, vacuous term open to range of interpretations and meanings. It is a part of the human experience that displays manifold facets that cut across many academic disciplines. The role of religion and spirituality in gerontology requires meaningful dialogue built upon mutual understanding and respect for disciplines that are usually not in dialogue with each other.

The area we have entered by introducing an examination of religion and spirituality and its impact on aging is a borderland between two often conflicting paradigms, namely that of the natural sciences and the humanities. Those of us who work in this realm must realize that we are under surveillance from two sides. Suspicious and cynical glances are to be expected, but the result of this continuing dialogue appears to be very worthwhile and important to pursue in order for spirituality and religion not to remain marginalized or excluded from the study of aging and older adulthood. It is sincerely hoped that this volume advances such a dialogue and moves beyond unexamined assumptions and uninformed discourse.

It would be remiss of the editors not to express appreciation for the creative and scholarly contributions of our distinguished group of chapter authors. A number of these individuals are treasured friends of the editors as well as respected colleagues. Many of us have journeyed together the last two decades in creating a space within gerontology for the discussion of religion and spirituality. Other authors are less well known to the editors, but their contributions are no less valued. We also want to express appreciation to Henry French of Fortress Press for his encouragement to publish Volume II and to Michael West and Beth Wright for their helpfulness in bringing this volume to print. Finally, but in no way least, we especially want to express appreciation to Mee-Ock Park for her patient and competent work as the Editorial Coordinator.

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