Should Churches stop providing aged care?

Aged care is getting tougher – not only for residents, families and care staff. It’s getting tougher for those who run nursing homes. Take Prescare the Queensland Presbyterian’s aged care arm whose debt has led to receivership for the whole Presbyterian Church of Queensland. Other church groups have sold off their facilities or got out altogether. Smaller organisations face a “get big or get out” decision – Prescare’s struggle to survive included a recognition they were too small.

Despite the latest Federal budget injecting an extra $17.7 billion over five years, Lynelle Briggs (Aged Care Royal Commissioner) says ‘It’s still not enough money to do the job properly in order to fix the system’s problems.’

So, should churches stay involved in aged care? Christians, churches & denominations have allocated significant energy and resources to advocate for the care of the unborn, the refugee and marriage. All critical causes. However, we have failed to advocate for the care of older people. Indeed, some Christian organisations have treated aged care as a cash cow to subsidise ministry to young people and other non-aged ministries. For example, it is alleged that St Basil’s, paid the Greek Orthodox church double the commercial rent (11 million over 8 years). Too often our churches worship youth and are ageist towards the old. By the way, Australia is not alone as a recent WHO report found 50% of the global population is ageist.

Reading Acts 6 we see the appointment of leaders, to care for widows. This is unsurprising as the Gospels record significantly more examples of Jesus engaging with older people than with young people. Indeed, one of the marks of the early church was the care of both infants and older people.

The Bible tells us to care for the aged

Scripture repeatedly and explicitly commands care for older people over 30 times.[1] Not-counting generic commandments to care for people and particularly people who are poor/vulnerable. If this repetition is not enough, consider these four critical verses regarding our treatment of older people:

Honour your father and your mother. (Commandment four, of the Ten Commandments) Exodus 20:12

You shall not mistreat any widow or fatherless child. If you do mistreat them, and they cry out to me, I will surely hear their cry, and my wrath will burn, and I will kill you with the sword, and your wives shall become widows and your children fatherless. (Ouch) Exodus 22:22-24

The second is this: ‘Love your neighbour as yourself. (The second half of Jesus summary of how to live) Mark 12:31

Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress. James 1:27

Australian aged care was largely started by churches. For example, Anglican Archdeacon RBS Hammond started independent Christian charity HammondCare. Hammond did not wait for the government to act; he did not wait for others to provide financial support. Instead, he cashed in his own life assurance policy to buy the land that is today’s Sydney suburb of Hammondville (during the Great Depression). Churches of Christ Care Queensland (then the Social Services department) was also started in the great depression. Thus, historically tough financial times have provided the germination of Christian aged care providers. Today a slim majority of aged care is provided by non-profits, most of which have Christian roots. In fact, if all Australian Christian aged care providers sold up, aged care in Australia would collapse as there are not enough spare ‘beds’ in the system, nor is there an appetite for further investment.

The staffing crisis

Many Christians are surprised by the low number of Christians working in aged care. Given a core tenant of Christianity is love, a lack of Christians working in aged care is sad. Perhaps more surprising is the low percentage is similar across both secular and Christian providers. While employing Christians does not guarantee Christian behaviour – How can a person who does not know Jesus’ love share Jesus’ love?

This brings us to ‘care’ or perhaps more simply ‘how are residents treated’. The Royal Commission has been damning about both abuse and much more commonly neglect. To our shame, however, there has not been a significant difference between secular and Christian providers regarding the level of care.

Unsurprisingly a key difference between a Christian and secular provider’s is ‘name’. Specifically, Christian providers tend to have denominational names (Catholic Care, BaptCare & Uniting) and ‘Jesus’ makes the mission statement. However, having Jesus mentioned, let alone front and centre brings a risk – hypocrisy. For example, when a secular provider closes a financially unviable facility they are not accused of not being ‘Christian’. This challenge is exacerbated by the low percentage of Christians working in aged care as people, not mission statements set culture.

Legally Christian providers still can preferentially hire people who share their beliefs. Practically, however doing so would be provocative to some and pragmatically, the reality is there is a shortage of Christians who want to work in aged care.

Personally, we want to strongly encourage everyone to consider working in aged care. As a growth industry, which needs a diverse range of skills and qualifications. As aged care is ‘care’ focused there is a clear link for Christians to express their love for God and neighbour by working in the industry.

Advocacy, Euthanasia and care

Advocacy is the second key point of difference between Christian and secular providers. Christians and churches get a platform to speak about issues they are involved with.

For example, Anglicare Sydney released a media statement saying: ‘A large majority of these older renters (78%) are in rental stress, spending more than 30% of their income on rent.’ If Sydney Anglicare were not involved in aged care, this advocacy would at best be much weaker.

One of the major implications of Churches exiting aged care would be on the Churches ability to engage with the Euthanasia debate. By providing care, facilitating hope and meaning Churches provide a strong case for life. Equally the churches ability to argue against euthanasia would be weakened if we simply say ‘it’s too hard’ to be involved in aged care.

‘Holistic care’ is a buzzword within both aged care and medicine which basically recognises people are more than a set of symptoms but beings with physical, mental emotional and spiritual parts and needs. There is a deliberate focus on holistic care across aged care, with the employment of allied health professionals (e.g. physio and lifestyle/activity staff). In our opinion, the ‘faith’ providers are well ahead in prioritising spiritual care of residents, families and staff. Typically, through the employment of specialist pastoral care staff.

How do we love?

So, should churches exit the aged care industry? Certainly, aged care is (and looks to remain) a challenging space, resourcing ministry is challenging and the poor (& old) will always be with us. However, churches bring unique and dare I say critical points of difference to other providers. Moreover, Scripture commands and history demonstrates we cannot absolve ourselves from care for older people. We must love older people both physically and spiritually. The real question is how do we love older people?

[1] For example; Exodus 20:12; Exodus 22:22-24; Deuteronomy 10:18; Deuteronomy 14:28-29; Deuteronomy 15:11; Deuteronomy 24:17-19; Deuteronomy 25:5-10; Deuteronomy 27:19; Job 31:16-18; Psalm 68:5; Psalm 146:9; Psalm 94:6; Proverbs 15:25; Proverbs 17:5; Proverbs 28:27; Isaiah 1:17-23; Isaiah 9:17; Isaiah 10:1-2; Jeremiah 7:5-7; Jeremiah 22:3; Ezekiel 22:7; Zechariah 7:10; Malachi 3:5; Mark 12:40-44; Luke 7:11-17; Luke 20:46-47; Acts 6:1-15; Ephesians 6:2-3; James 1:27 & 1 Timothy 5:1-24.