Rebecca J Frey. The Gale Encyclopedia of Senior Health: A Guide for Seniors and Their Caregivers. Editor: Jacqueline L Longe, Volume 4, Gale, 2009.
Prayer and spirituality have attracted considerable attention since the 1980s as complementary and alternative (CAM) health-related practices. One longstanding difficulty, however, in understanding the importance of religious and spiritual practice among seniors is the lack of an agreed-upon definition of prayer. The National Center for Complementary and Alternative Medicine (NCCAM) has offered a tentative definition: “prayer is defined by NCCAM as an active process of appealing to a higher spiritual power, specifically for health reasons; it includes individual or group prayer on behalf of oneself or others. Spirituality is broader; it is defined by NCCAM as an individual’s sense of purpose and meaning to life, beyond material values. Spirituality may be practiced in many ways, including through religion.”
Practices other than prayer that are considered spiritual by NCCAM include meditation, yoga, t’ai chi, qi gong, and Reiki (a form of energy medicine that originated in Japan). Other researchers would also include such Native American healing rituals as smudging, consulting a tribal healer, or the use of a sweat lodge as spiritual practices. In any case, all these religious or spiritual approaches are grouped together under the larger category of mind/body interventions, along with biofeedback, relaxation techniques, autogenic training, visualization, hypnosis, and cognitive-behavioral therapy (CBT). Mind/body interventions are defined by NCCAM as those that focus on “the powerful ways in which emotional, mental, social, spiritual, and behavioral factors can directly affect health.”
One of the recurrent difficulties in defining or even describing prayer is the variety of styles of prayer and the range of practices that incorporate prayer. Prayer may be either individual or corporate, either public or private. It may be part of a worship service or small-group ritual, as when a Christian clergyperson or lay leader takes Holy Communion to a homebound senior. It may involve the reading of scriptures and the recitation of memorized prayers, such as the Lord’s Prayer for Christians, the Shema for Jews, or the mantra Om mani padme hum for Buddhists; or it may be informal and spontaneous, as when someone asks for God’s help during a sudden health crisis or other emergency. Prayer may involve the use of physical substances or gestures (oil, holy water, the laying-on of hands, the sign of the cross, the use of incense, or a specific prayer posture), or it may be only verbal or it may be silent.
In addition to the wide variety of prayer and worship practices, people’s views of God or the divine vary widely. While Christians and some Jews think of God as personal, most Buddhists do not; for them, prayer is offered to an impersonal cosmos or universe. This variety of understandings of God (or the Creator or the Absolute) explains why the NCCAM definition of prayer uses the phrase “higher power” rather than a more personal term. Larry Dossey, the former director of NCCAM, prefers to think of prayer as “communication with the Absolute,” a definition that he considers adequately inclusive.
A survey that NCCAM conducted in 2002 reported in 2004 that prayer and spiritual practice are by far the most frequently used CAM interventions in the United States. The researchers found that 45 percent of those who replied to their survey had prayed about health concerns during the 12 months preceding the survey; 43 percent had prayed for their own health; 25 percent had asked others to pray for them; and 10 percent had participated in prayer groups or prayer meetings.
As of 2004, Caucasians appeared to be somewhat more likely than either Hispanics or African Americans to use CAM interventions, including prayer (36 percent of Caucasians, compared to 27 percent of Hispanics and 26 percent of African Americans). Asian Americans, however, had the highest rates of all ethnic groups—48 percent. Demographic factors that were consistent across racial/ethnic groups were being female, being between the ages of 35 and 54, having a higher level of education and a higher level of income, having a regular physician, and visiting a health professional within the past 6 months. This survey confirmed Larry Dossey’s studies of prayer from the 1990s, namely that seniors (and younger adults) who pray for healing typically do so in addition to mainstream medical treatment, not as a replacement for it.
The NCCAM survey reported that the health conditions for which adults in the general population were most likely to use prayer were cancer, back pain, colds or flu, neck pain, arthritis, lupus, or fibromyalgia, anxiety and depression, stomach disorders, migraine headaches, sleep disorders, and chronic pain.
Other studies have looked more closely at seniors in particular. Interestingly, a study done at Wake Forest University School of Medicine reported in 2006 that seniors over 65 are less likely to use prayer and spiritual approaches for mental health concerns than for physical ailments. The researchers suggested that this lower use of prayer for anxiety and depression was not because the seniors doubted the effectiveness of prayer in treating emotional conditions but because many older adults regard depressed feelings as a natural or normal part of aging. In contrast, older adults with such physical problems as cancer, diabetes, or diagnosed hypertension were more likely to use prayer and other CAM therapies than those who did not have these disorders.
In addition to using prayer and spiritual practice alongside mainstream medicine rather than as an alternative to it, many Americans do not restrict themselves to one form of prayer or spiritual practice. Many Christians, for example, participate in interfaith prayer and meditation groups or practice Reiki, t’ai chi, or yoga without feeling that these practices are contrary to church membership. Some Protestants as well as Roman Catholics make pilgrimages to holy places, including two well-known healing shrines in North America—Sainte-Anne-de-Beaupré in Quebec and Chimayo in New Mexico. Most Native Americans who participate in tribal cleansing ceremonies or consult healers are also members of various Christian churches. A number of Jews who still identify with Judaism in some sense are also interested in Buddhist meditation practice. It is therefore important to recognize that prayer and spiritual practice appear to open people in all age groups to the wisdom of traditions other than their own rather than making them narrow-minded or sectarian.
In terms of traditional religious practice (church and synagogue attendance as well as personal prayer at home), seniors are more active participants than are members of any other age group. In addition, older adults are more involved in church- and synagogue- related activities than in all other voluntary social groups combined.
Research into the effectiveness of prayer and other spiritual practices has generally moved beyond experiments designed to test whether these practices are effective—literally hundreds of studies indicate that they are—into studies of specific health benefits for seniors. Some specific disorders that have been studied include:
- A number of studies have shown that religious and spiritual practices have a protective effect against depression in seniors. Interestingly, a Harvard study reported in 2006 that this protective effect is stronger in older men than in older women.
- High blood pressure. Seniors who identify themselves as religious or spiritual have lower blood pressure and less risk of death from coronary artery disease than nonreligious seniors.
- Post-traumatic stress disorder. Older Native American combat veterans who participated in traditional cleansing rituals for warriors have lower rates of PTSD and faster recovery from it.
- Recovery from surgery. A study done at the Dartmouth Medical School in New Hampshire found that seniors who were religious were three times less likely to have died sixmonths after cardiac surgery than those who were not religious.
- Meditation, prayer, and other spiritual practices were found to be more helpful than herbal medicines or melatonin (a hormone that appears to regulate the body’s sleep/wake cycle) to seniors with insomnia, according to research done at the University of Pennsylvania.
Researchers have proposed several different possible explanations for the positive effects of prayer and spiritual practice on seniors’ health:
- Faith communities typically encourage members to abstain from substances or behaviors known to be harmful to health or to adopt practices that are beneficial to health. For example, Mormons are not allowed to use tobacco or alcohol, and practicing Mormons have been found to have lower rates of head, neck, and lung cancers than other Americans. Similarly, Seventh-day Adventists, who follow a vegetarian diet and also abstain from alcohol and tobacco, have a 60 percent lower mortality rate from cancer and a 66 percent lower mortality rate from heart disease than the general population. A group of epidemiologists at the National Center for Health Statistics reported in 2008 that the association between religious faith and health-related behaviors lowers the risk of mortality for members of mainstream churches as well as for the smaller groups.
- Religious commitment is a powerful factor in the prevention of substance abuse as well as its treatment.
- Prayerand spiritual practices foster belief systems and attitudes that increase the body’s resistance to stress. These include faith, hope, and the ability to forgive others rather than holding on to anger and resentment. Chronic anger releases such stress-related chemicals as adrenaline and cortisol, which can build up in the bloodstream and weaken the immune system or lead to heart disease.
- Prayerand spiritual practices bind seniors to faith communities that offer them love and social support. Religious seniors are significantly less likely to be socially isolated than those who are not. Many churches and synagogues have vans or other forms of transportation to help seniors get to worship services and lay leaders who visit seniors in their homes. In addition to the beneficial effects of love and friendship on mental and emotional help, faith communities can also monitor the physical wellbeing of their older members; some large congregations have parish nurses who offer periodic health checkups for seniors.
Research projects as of 2008 sponsored by NCCAM in the area of prayer and spirituality include studies in spiritual practice in the context of chronic illness (including HIV/AIDS) and research into the connection between prayer, the immune system, and emotional wellbeing. Other institutions, such as the Institute for Religion and Health, were conducting research as of 2008 into the effects of meditation and prayer on recuperation from heart attacks, the role of spirituality in living with cancer and other chronic diseases, and the influence of prayer on the mental health of seniors facing open-heart surgery.
Seniors as Spiritual Leaders
One of the more interesting aspects of critiques of prayer and spirituality is their tendency to dismiss the spiritual practices of older adults as proof of loss of intellectual power. For many skeptics, religious faith or practice on the part of seniors is a form of second childhood or even senility. For most of human history, however, older adults have been regarded as valuable sources of spiritual wisdom and insight. In many religious traditions, such as Tibetan Buddhism and Islam, clergy or other spiritual leaders had to pass through long periods of apprenticeship and maturation before they were considered ready for leadership. In others, old age itself was thought to confer spiritual gifts—on women as well as men. Many revered Native American healers were (and are) older women.
Various revered ancient texts refer to the elders as the leaders of the people; elders were usually older men but not necessarily priests. In the New Testament, for example, the elders are referred to not only as teachers and administrators of the early Christian churches but also as healers. The writer of the Letter of James (5:14) says, “Are any among you sick? They should call for the elders of the church and have them pray over them, anointing them with oil in the name of the Lord.” Perhaps a youth-oriented culture needs reminders that seniors can offer spiritual help and wisdom to those around them as well as receive care.