Khutbah Friday 2 October 2015:  Elder Care by Dr Rafiq Khan

Khutbah Friday 2 October 2015: Elder Care by Dr Rafiq Khan

Dedication

I dedicate this talk to the beloved memory of my late mother and father. I beseech Allah to grant them and all the marhumin in our congregation, a high place in Jannah.

The Name Of Allah Most Gracious Most Merciful.

Today’s khutbah focuses our attention on the care of the elderly in our community. This is a part of our congregation’s humble response to the call of a United Nations General Assembly Resolution to mark the 1st of October as International Day of the Older Person.(1)

It is an inescapable fact that the biological process of aging affects us all. If we are fortunate enough to live beyond the age of 65 we will reach elder hood (2) with all its attendant challenges and difficulties. As our elders reach their senior years they grow weak, infirm, are beset with many illnesses and often loose their independence.

They are less mobile, experience fewer opportunities for social engagement, often have to endure a crippling sense of loneliness and worse still experience cognitive decline due to several possible causes of dementia in the elderly.

The key question I want to pose is what is our responsibility towards them and how can we help them to navigate their way through the difficulties and challenges they will face as they reach the senior years of their lives?

As always, we frame our responses by drawing inspiration from our foundational sources as well as from the lived cultural expressions of our faith tradition.

The Qur’an conveys many stories involving Allah’s Chosen Prophets and their children. Each of these parent-child forms of dialogue serves to convey a deeper moral instruction of instilling mutual respect for one another, of caring for one another, of conveying wisdom, of improving one’s character, of reaching for higher altruistic goals and at all times cultivating a true Allah Consciousness as the highest objective of our existence on this earth. (3).

One of the most endearing features of our din or way of life is that it is a din ur rahmah. (4) It emphasizes the creation or establishment of a compassionate and humane society. It cares for the weak, the feeble; the frail, the infirm, the indigent, the invalid and those who cannot fend for themselves.

There is no cure for aging. Its effects are not reversable. It is uncomfortable and fearful to talk about aging for it challenges us to deal with our own inevitable loss, decline of function and loss of independence. (5).

This conversation with ourselves is especially more poignant these days for we live in a society that adores cosmetic appearances and promotes the myth of perpetual youth. We are aging everyday no matter how much we want to deny this reality.(6)

There is an urgent need for us to shape a new narrative around aging and care for the elderly. There are two dominant approaches or views around which the question of aging and care for the elderly is framed or problematized these days. (7).

In the first approach, also called the geriatric approach, aging is seen as and treated as a disease. The solution for it is suggested via social, economic or health measures.

Aging is feared because it is a reminder of death; aging is loathed because death is regarded as a failure. Death is regarded as rendering life meaningless and there is almost an instinctive drive to deny it. Only youth and “youthfulness” is endowed with any meaning.

Unsurprisingly, when elders get ill, as they invariably do, there is a tendency to blame them for what they are experiencing. “If only they had to take better care of themselves when they were younger, they would not be looking so sad and pitiable these days”, is perhaps what is implied here. They are stigmatised for their aging and labelled as “problematic” and blamed for needing more services such as pensions, institutionalised care and increased expenditure for health care needs.

The second position, also called a gerontological approach, is a seemingly more positive one. Aging is thought to bring with it more wisdom and the acquisition of a calmer disposition. The individual is less conscious of aging, feels the problem rests with society at large with its discriminatory or ageist attitudes and tries to remain self-reliant for a long time. Aging here is not regarded as a challenge but rather as an opportunity for the creative individual to reach fulfilment.

Longevity has increased worldwide. By 2050, one in 5 persons living in an urban environment in the developed world will be over the age of 60. The corresponding figure for the developing world will be higher. (8)

In developed countries aging of populations have occurred over many decades and it has followed considerable increase in their levels of socio economic development thus having the benefit of time to adjust their policies and do proper planning to allow for resource allocation and policy development.

Whilst the developing world unfortunately will experience a more rapid increase in its elder population, it will not have the resources nor the time to implement plans to adequately meet the rising health care and social needs of its elder population groups. (9)

Whether we live in rich countries or in resource poor communities, the bulk of care for the aged takes place in homes. it is only a small percentage that are resident in old age homes and centres that care for the frail and very invalid aged. (10).

As the theme of my presentation deals with elder care, I want to engage our attention towards one verse of the Qur’an, which I humbly submit to you, is of unparalleled importance for the topic under discussion.

Allah, The Sublime, tells us in Surah Bani Israel, Chapter 17, verses 23-24

Your Lord has commanded that you worship none but Him,
And that you be kind to your parents,
If either or both of them reach old age with you,
Say no word that shows impatience with them,
And do not be harsh with them,
But speak to them respectfully

And, out of mercy,
Lower your wing of humility towards them and say,
“Lord, have mercy on them, just as they cared for me when I was little.”

These are well known, oft-quoted verses. There are I believe two very crucial instructions in it for us which could serve as a template upon which to construct an enhanced level of care for the elderly in our community.

Allah, The Sublime informs us to speak respectfully to our elderly parents

qawlan karima

speak to them respectfully

Speech is the most defining aspect of our humanity. Using kind and beautiful speech we enhance our dignity and affirm our shared humanity and common bond of affection with our parents and elders. It says something about our own moral status, dignity and self respect.

Aging has made many of them hard of hearing, their memory often fades, they have a tendency towards repeating themselves and they cannot grasp as quickly as we can. They require lots of patience and understanding.

I stress this for I believe it is through our speech that we reveal our ageist attitudes. Aging is one thing, ageism is another. Physical frailty, cognitive loss, immobility and evens incontinence must be debilitating. Age has made them invalid and they have no control over that process. (11).

We add to their burden by not treating them with respect and kindness. They might have changed in their outer appearance, yet they have an intact ruh or spirit and a sense of affect or feeling.

Perhaps the best evidence of this for me in recent days was the encounter with an elder who has been diagnosed with Alzheimer’s disease for the past 4 years. Outwardly his personality has deteriorated considerably. He has lost much of his working memory. He is unable to initiate or evens maintain a conversation. He just sits quietly the whole day, staring and drooling.

Yet the moment he sees his great grand daughter, his face just lights up with the broadest smile you can ever imagine!”

Here is an individual entrapped within his own body by his illness, cognitively in steep decline, yet his emotions are alive and miraculously brought to the surface by the loving smile of a spiritually pure and innocent, great grand child!

Ageism takes many insidious forms. Like racism and sexism, we are so engulfed by it that we fail to recognize its existence. We get away with it because elders in many cases might not have the ability to check mate our excesses.

Ageism is a form of social discrimination and prejudice and has a serious effect on the self-esteem and wellbeing of seniors. It stereotypes elders as helpless and not able to contribute in any meaningful sense to society. They are seen as burdensome and are mocked for being slow. (12)

They are the butt of hurtful jokes and typical “over the hill” comments. Their views receive scant regard as they are assumed to belong to the “old school of thought”. Any initiative on their part is met with derision and disbelief. We write them off, we want them to withdraw and gradually diminish in stature.

Kind and respectful speech therefore is the first sign of a qualitatively different and improved attitude towards care of the elderly.

I also found the phrase,

Wah fidh lahuma janahathulli minar rahma

and lower to them the wing of humility out of mercy

quite intriguing.

Most commentators of the Qur’an I have read refer to these words as a metaphor. Sayed Qutb argues that this verse symbolizes an intense characterisation of mercy shown to parents, as if submission personified had wings to be lowered in peace. (13)

I came across a rather interesting understanding of this verse which I culled from non-traditional sources and which I would like to share with you.

Umberto Eco, the well known Italian, linguist, author and polymath in his book Serendipidities: Language and Lunacy refers to the use of the symbol of the stork bird in Egyptian Mythology to symbolise an obedient and caring child. (14)
I wondered whether this could perhaps shed more light on what the Qur’an means by “lowering your wing of humility”?

I was astounded by what I what discovered. When we study the natural history of birds we find that the two adult stork birds in any colony make a loving, loyal and a devoted pair. They raise their young with utmost care.

When they migrate they let the elders fly in front; the adult birds stay in the middle with the young and they leave another group of elder birds at the rear when the colony is in flight. When they return, it is often noted that the older birds who by now are fatigued, are often found resting on the backs of the younger, stronger birds before they are lovingly and tenderly placed down to rest. (15)

My humble understanding is simply that Allah (SWT) is using an instructive example from the natural world to teach us how we should care for our parents and the elderly; the Qur’an does it simply in its own inimitable style and wisdom.

It is thus through our kind, respectful and edifying speech and our compassionate actions that we are able to meaningfully care for the elderly respecting their Allah given dignity without resorting to any paternalistic, condescending behaviour, nor regarding service to them as a burden but rather as an honour to serve those who served us at one stage of their lives.

It is children who need to be reminded of their duty towards the generation that has become old and who is now in need of tender care; after all they lost most of their their vitality in bringing up their young children.

The Qur’an views human beings in a positive light. They have the potential to act altruistically and who in return will thrive as a result of the good that they do. They form part of a virtuous cycle.

Hal jaza ul ihsan Illal ihsan “Shall the reward of good be anything but good?” 55;60

A tradition reminds us

“He who honours an old man for his age, Allah will grant him one to honour him during his old age”

This is where there is I believe a huge challenge awaits us as Muslims. How do we move from sentiment to putting structures on the ground which will make a real difference in the lives of the elderly? How geared are our families and congregations to ensure our elders receive optimal care and support when they reach the twilight years of their existence? Is belonging to a mosque congregation akin to belonging to a parish community? Is such an arrangement an identifiable feature of contemporary Muslim societies? Are our future generations of imams and religious scholars sensitized enough to make a real input concerning the elderly? Does a concept of pastoral care feature in their training? (16)

We all need to learn how to care. What are the fears, concerns and hopes of the elderly? How do they articulate these? How do they encode certain messages, convey hints to inform us what is on their hearts and minds? Without this knowledge and sensitivity, we would pretty much at a loss of how to care effectively for them

Our faith is a life affirming tradition yet it is not death shy. It sees death as an extension of our existence as determined by our Creator. It is in all respects the beginning of a new form of existence. Illnesses and infirmity, likewise are from Allah and are seen as a test of our spiritual endurance, patience and perseverance and something we will be richly rewarded for by Allah.

What are the special resources our elders are blessed with?

• How reassuring to note for our elderly that the great affairs of life are not performed by physical strength, or activity, or nimbleness of body, but by deliberation, character, expression of opinion. Old age has an abundance of it.

• They never loose the capacity to love.

• They have lived long enough to have had an opportunity for self purification and reform. They display a greater sense of spiritual and moral refinement.

• The have an enormous amount of perseverance (sabr): they have been tested many a times before.

• They have a longer memory of our past experiences. Little do we realise we can gain a very good view of our own history by engaging our elders in conversation. They are the embodiment of a “lived” experience. You get that textured and very personal understanding of what it must have been like, say for example, to experience forced removals during the Apartheid era in our land. Do we think we can replicate that through a Google search? You may try it. I doubt it very much if you will get anywhere.

• Lastly, their collective experiences cause them to attain wisdom which is a priceless gift from Allah.

It is for these and other reasons that many traditions encourage respecting and honouring the elderly. I want to give you just two examples here.

“He is not one of us who does not show mercy to our young ones and esteem to our elderly.”

“Part of respect for Allah is to show respect to an old person.”

Both these traditions convey a sense of the high spiritual status and honour, Allah, The Most High accords to the elderly or how close is their proximity to Divine Mercy.

It is within the family or usrah that our elders must find their primary source of comfort. It is within our congregational lives or jama’ah that they must find meaning and significance.

The latter is a vast untapped source of support and comfort for the elderly. We need urgent research to see how the positive benefits other faith traditions ascribe to their congregations can be replicated within Muslim societies.

When we think of countries that are very religious the USA seldom ranks very high in our estimation. Yet it has 350 000 registered congregations belonging to various denominations across all the major faith traditions. On average each state has about 7 000 congregations, each serving an identifiable parish community. (17)

What an incredible opportunity they have to make a meaningful impact on the health and social status of the congregants especially the elderly. There is evidence from research that the outreach programmes of these congregations play a very beneficial role.

People who belong to a congregation and attend services at least two times a week have an overall 5-year mortality which is 50% lower than non attendees. Simply put they live longer. This beneficial effect extends to those in the 45 to 65 year-old age group who volunteer their services to care for the elderly, the infirm and those living a solitary existence.

 

Many studies are showing a positive correlation between congregational attendance, membership and support on the one hand and good physical health and evens longevity on the other.

We need to start addressing these issues within our own families and congregations for Allah’s Mercy works its wonders through human hands.

A musjid congregation is not made up of brick and mortar but individuals! it is the quality of our relationships with one another which counts by far for more.

Our elders have been the longest supporters and contributors towards the musjid. They have seen the musjid and congregation grow though its darkest and most challenging days.
We consciously need to engage them in all the affairs of our congregation and honour them for the excellent support they have given to us over all the years.

Within our families

• The best thing we can do for our elders is to provide a safe environment for them to flourish spiritually so they can concentrate all their energies on finding their peace and contentment with the remembrance of Allah. Nothing is more precious to them than their health which they seek, so that they can serve their Creator.
• They have a unique ability to rejoice in our successes; they are thus a great source of motivation, courage and aspiration (himma) for us in whatever we do. They increase our self esteem!
• Our parents and elders are the most sincere people we will ever find in their supplication on our behalf. They are therefore a great source of spiritual blessing and strength!
• I leave you with the words of a revered elder which sums up their spiritual enthusiasm; “Die beste dae van ‘n se mens se ibadaat moet nog kom!”
(The best days of a person’s worship still lie ahead!.) This is a great source of
inspiration (ilham)for us all.

Let us strive, through our families and our congregations, towards establishing an elder-friendly environment. Let us through our better insight and strength Allah has Blessed us with, help them to navigate joyously, with peace and contentment, as they pass through the last days of their lives.

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