Gather

As a hospice chaplain in long-term care and assisted living communities, I get to see residents’ faith up close.

Elements of Barb’s experience are typical: Since moving into the facility a year ago, Barb has not attended church. But, the facility puts on a weekly service with the help of local ministers, her pastor visits her monthly and brings communion, church friends come by occasionally, and the children’s choir performs for the residents at Christmastime. Barb receives the monthly church newsletter and a quarterly devotional in the mail. 

Compared to most, Barb is well supported in her faith. She has many of her social and spiritual needs met. But missing from her experience is an ongoing relationship focused on discipleship. 

Relationships based on service are, at least initially, primarily one-way relationships. In contrast, discipleship relationships are on-the-way relationships.

Service asks, “How can I meet your needs today?”

Discipleship asks, “Can we join up in following Christ?” 

Typical Discipleship

In this article, we’ll be thinking about discipleship broadly rather than a particular method with specified goals. (Think about Jesus and his band of disciples, doing life together while on mission.)

Ministry with older Christians needs to respect that they are still very much “on the way” in their lives with Christ. 

Those residing in facilities are not just “bundles of needs” but full participants in God’s kingdom, with gifts to offer the church and the world. To this end, our ministries will likely require reframing and reconfiguring to go beyond care and tip toward discipleship.  

Here’s a thought experiment: Consider a church whose discipleship pathway is summed up as “Connect, Grow, Serve.” What might this look like for a young family in the congregation? Perhaps joining a small group, going to Sunday School, and serving in the nursery. 

Now, imagine what the discipleship pathway might look like for a widow from your congregation who resides in a nearby nursing home.

Whatever ideas you come up with, they can’t look like the steps the young family takes. 

If the church is still to be “on the way” with the facility resident, then it must either expand its offerings or adjust its vision. 

Resident Realities Create Discipleship Opportunities

The realities of aging and facility life create unique needs for older adults—and these challenges present opportunities for discipleship. 

Dislocation and Spiritual Hunger

Barb was an active member in her church. She spent her entire life in the same denomination. She led Bible studies, went on mission trips, and sang in the choir. But that lifelong participation came to a halt once Barb moved into the facility. 

Unfortunately, church is just one aspect of the dislocation that older adults face as they enter facility life. The towns they lived in for years suddenly become the “outside world,” and they increasingly feel disconnected. Family gatherings at “Mom and Dad’s” are replaced by visits to go “see Mom.” Grandchildren tend to be seen more by photograph than in person. 

The silver lining of dislocation is that it often births a new spiritual hunger in older adults.

A facility chaplain I know was struck by how eager residents were at his hiring: “We have a pastor!” (Imagine getting that kind of reception at your church!) 

Many of the residents do still identify closely with specific denominations. But now that they reside in a facility, the conditions and expectations for church community have changed. Their options are limited to whatever the facility offers. As a result, one can hardly find a more ecumenical group of Christians. In a time when cultural and societal division runs rampant, this unity illustrates both the spiritual hunger and opportunity that exists within facilities. 

So what can satisfy this hunger? 

While helpful, the typical spiritual offerings at a facility (worship services, communion, and occasional visits) are not enough to satisfy the average believer. A necessary ingredient to sate the spiritually, socially, and emotionally hungry is relational discipleship. While they might find this, in part, with other members of the facility community, they still need ordinary people from their churches to continue to be “on the way” with them in a meaningful way. 

Simplicity and Spiritual Availability

We live in a culture of chronic busyness. Pastors often lament having only one solid hour per week—the Sunday worship service—in which to pour into their people (especially when compared to the many hours that work, youth sports, and Netflix get). More than funding, time is the single biggest limitation on ministry. 

But in a residential care community, life is lived at a different pace. Facility life is structured around mealtimes, with optional activities between them. Residents sitting quietly in communal areas or their rooms with the TV on is a common sight. Facility life is simple and unhurried. 

An older person who didn’t have margin during their working years suddenly finds their time completely discretionary. At the same time, due to the constrictive nature of facility life, and perhaps poor health, options for how to spend their time are limited. For some people, this is a recipe for restlessness.

And yet, taken together—discretionary time, limited options, restlessness—we see conditions conducive to discipleship: both the spaciousness and desire for more purposeful activity. We would be remiss if we ignored the spiritual opportunity these conditions create. 

Transition and Spiritual Openness

Young adulthood and older adulthood are seasons of profound transition. They prompt crises which create opportunities for spiritual growth. However, they are different: as young adults transition into a long stage of independence, older adults begin to diminish. During this time, older adults’ dependency increases and they grapple with life at “the beginning of the end.” 

Perhaps you lived in a dorm as a young adult. Now imagine living on a “dorm floor” where somebody is having a life-altering health event every week, someone dies every month, and students forget more than they learn. Though care facilities really do share several characteristics with dorms, the absurdity of this imaginative exercise reveals just how qualitatively different the transition is at the far side of life. 

Contrary to what we might assume, older adults are markedly less anxious about death than other cohorts.¹ Still, declining health is enough to prompt reflection in anyone. And for those residing in facilities, death is part of the rhythm of their community. There, the perennial questions surrounding death are always open and never far from view.

“Gerotranscendence” is the theory in gerontology (the study of older adults) that proposes that “the aging process involves a shift in perspective from materialistic concerns to a more cosmic outlook, characterized by transcendence in cosmic, personal, and social dimensions.”²

We should not be surprised if we see souls in this season primed for spirituality in new ways. Some may experience openness to matters of faith; others may experience a reawakening that feels brand new. In any case, this spiritual openness is best met by people committed to being “on the way” with them until the end. 

Toward Discipleship

A young woman at Barb’s church, Sarah, took an interest in her, and they eventually put a standing coffee date (at the facility) on their calendars. Barb doesn’t know it, but her steadfast faith while facing declining health is a source of spiritual encouragement to Sarah, who is a young mother. Sarah doesn’t know it, but the laughter and tears the two share are a source of healing to Barb. The women pray together, often for one another’s children. And when the timing works out with their pastor, they receive communion together.

1. Gary Sinoff, “Thanatophobia (Death Anxiety) in the Elderly: The Problem of the Child’s Inability to Assess Their Own Parent’s Death Anxiety State,” Frontiers in Medicine, 2017, https://pmc.ncbi.nlm.nih.gov/articles/PMC5326787/. ↩︎
2. Deniz Pamuk, et al, “Quo Vadis Gerotranscendence? A Systematic Literature Network Analysis of Existing Themes and Emerging Trends in Gerotranscendence Theory with a Focus on International Applications,” Journal of Religion and Health, 2025, https://link.springer.com/article/10.1007/s10943-025-02349-9. ↩︎