Religious orientation influences elderly's fear of death

Apr 20 2006

As they approach death, the churchgoing elderly are likely to find little solace in religion if they had little personal commitment to God during the rest of their lives, a new University of Florida study finds.

In fact, talking about religion to comfort people who are not very spiritual can actually increase their fears of dying and what might lie beyond, said Monika Ardelt, a UF sociologist whose research appears in Research on Aging.

The study of 103 relatively healthy older adults and 19 hospice patients in North Central Florida, all of whom were older than 60, found sharp differences between people who are "intrinsically" and "extrinsically" religious.

Those with an "intrinsic religious" orientation dedicated their life to God or a higher power and reported they were less afraid of death and experienced greater feelings of well-being than people who fit into the "extrinsic religious" category of using religion for external ends, such as a way to make friends or increase community social standing, Ardelt said.

"I think the take-home message is that if you cannot commit your life to God or a higher power, it is better to be nonreligious than to be religious for the wrong reasons," she said.

"Extrinsically religious" people are more vulnerable at the end of life than non-churchgoers because they might be reminded in church that their lives have not been morally perfect, Ardelt said.

"Being exposed to the doctrines and teachings of their church, they knew what they were supposed to do, but they may not necessarily have been doing it," she said. "So they may be more afraid of the payback when they die than people who don't believe at all."

Another reason personal commitment may be important is that church fellowship tends to decline in old age, Ardelt said. Elderly people in poor health may end up in nursing homes or assisted living facilities and be unable to travel to their old church, having to substitute it with an unfamiliar congregation that is physically closer or attended by their relatives, she said.

The study underscores the need to distinguish between "intrinsic" and "extrinsic" religious orientations when looking at the effects of religiosity on people's attitudes toward death and feelings of well-being, Ardelt said. Past studies have relied on measures such as what denominations people belong to, how frequently they attend church and how they rate the importance of religion in their lives; with little research done on hospice patients, she said.

Interestingly, the study found that being "intrinsically religious" did not have a direct effect on achieving a sense of purpose in life, although participating in shared spiritual activities did. These might include attending church, participating in Bible studies and watching religious television programming with others, Ardelt said.

"It's not enough to feel that you have dedicated your life to God, you have to actually engage in spiritual activities," she said. "This is kind of a counter argument to people who say, ‘I don't need the church, I can be spiritual by myself.' Apparently it's being part of a community that creates a feeling of communion, of being in connection with a higher power that sustains a sense of meaning and purpose in life."

The findings are important because many people mistakenly believe that bringing up the subject of religion with the elderly is helpful, particularly for hospice patients, when the opposite is actually true for people who are "extrinsically religious," she said.

A minister who participated in the study unexpectedly turned out to fit such a religious bent. "When I asked if he engaged in spiritual activities, he said, ‘Well, not as much anymore, I'm retired,'" Ardelt said. "He ended up not being very spiritual at all."

Ardelt said she believes the man was so busy during his career that he didn't have time to seriously question his religion until later in life, when he had difficulty conceiving of a place like heaven being roomy enough for billions of people. "For these extrinsically religious people, there is some real existential struggle going on at the end of life," she said.

Community-dwelling older residents were recruited from 18 close-knit social groups, including bowling leagues, garden clubs and religious congregations. They were surveyed between 1998 and 1999. Patients from a local hospice group were interviewed and asked to fill out a survey between 1999 and 2001.

The study's effects were most pronounced in hospice patients, who naturally were more affected by thoughts of death, she said. Having "intrinsic religious" beliefs offered tremendous help for these terminal patients at the end of life. "The ‘religious extrinsic' people often ask ‘Why me?'" she said, "'Intrinsically religious' people don't necessarily ask that question because they believe that God must have a reason."