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Throughout his life, Tom DeLoughry has been involved in the health field, in counseling, in teaching, paying attention to the connection between body, mind and spirit. So, he thought he knew a lot about wellness and spirituality.

But then his mother got sick.

Specialists had no answers to an illness that caused her to lose her hair. As DeLoughry watched her sinking, his sister got out her black dress, he said.

Then, instead of just sitting around and being frustrated, he came up with a game that he called a sort of "spiritual exercise": He invited his mother to rate the "lovingness" of each person who came into the room, whether it was a doctor or a housekeeper.

"Sometimes we just sat and held hands," said DeLoughry, "waiting for the next contestant. We'd give each other secret signals on a scale of one to 10."

A day later, she started getting better and she lived another year, said DeLoughry, director of the Center for Renewal at Stella Niagara. The Center is participating in an upcoming conference "Spirituality and Eldercare: A Missing Piece in a Difficult Puzzle."

What surprised DeLoughry, as much as his mother's recovery, was her later admission that she believed her sickness was caused by her failure to pass a GED exam, something she secretly attempted when she was in her 70s.

"It was a grave disappointment to her to miss the passing grade by two points because she couldn't master fractions," he said.

DeLoughry's point is how strong spiritual needs remain, for some, throughout life: "What pulled her back during that illness was love," he said.

Combating isolation

What strikes the Rev. William Wipfler, an Episcopal priest and another conference participant, is the vulnerability of the elderly, he said.

"As frailness enters into it, there's the difficulty of being isolated," said Wipfler, who will speak about the responsibility of faith communities to their aging members.

Wipfler is onto something, according to a 1995 survey (Bradley, "Religious Involvement and Social Resources"). That survey showed that church attendees had an average of three more people to call upon, 13 percent more phone contacts and 9 percent more personal contact. Those surveyed answered questions on whether they could get help and advice if they were depressed or confused, even if they had a place where they could borrow $200 if they needed it.

Because the faith community has such a powerful effect, Wipfler said, there is an onus on congregations, especially the larger ones, to keep track of their elderly members. "It's easy for people not to be noticed," he said. "I think an extra effort has to be made for that not to occur."

Besides that, he said, congregations need to think about accommodating the elderly's special needs. "My wife has Alzheimer's, and I think it's very important that, at certain stages, the community makes them feel at home. They may dress or act strangely - it's hard to say all that may happen - but I think it's the responsibility of the leader of the congregation, whether it's a priest, a rabbi or an imam, to educate on how to embrace those who are different because of dementia."

Also, Wipfler said, he'd like to see churches take mini-worship services into homes so that housebound people could hear hymns, say prayers and read scripture with others. "It's charitable giving," said Wipfler, an associate at St. Matthias Church in East Aurora, "but not just giving money."

End of life issues

For Dr. Patricia Bomba, it's important for those at the end of life to clarify their beliefs and values. "Each of us has our own sense of both religion and spirituality," said Bomba, Univera's vice president for geriatrics and a conference participant.

That plays into how they make decisions about terminal care, she said.

"It's important to explore ahead of time what they want at the end of life and not leave that to chance," said Bomba, whose conference topic is "Who Writes Our Final Chapter?"

Bomba, who integrates such discussions into her practice, said: "In addition to my questions about nutrition, smoking, stress, the last on my list is to ask if they have an advance directive.

"Then I ask if they want to go into a nursing home and no one ever says "yes,' so I ask what supports they have in place and what spiritual supports are available. It's not a terribly long conversation, but it begins to frame things for people. I look at it as finding closure at the end of life and the ability to know that their life has made a difference."

In making these decisions, "spiritual issues are key," said Bomba. "Getting a chance to find closure and make sure that your life had meaning. That's the essence of all of us, one unifying concept that unites us."

Be assertive

DeLoughry said that those who care for the elderly can start discussions about their spiritual needs, being particularly cognizant of not trampling on anyone else's views or beliefs.

"You can begin, in a low-key way, to ask what their sources of support are, whether organized religion is important to them," he said, "if they might need a referral to a chaplain, a prayer group or worship services."

Besides that, he said, he encourages the elderly person to be assertive enough to say what they need, what they think, what they want, how they are feeling.

When the discussion gets to the advance directive, DeLoughry said, the spirituality component certainly remains uppermost.

"It's not just about treatment," he said. "You want to ask the best questions. Is there anyone you want to forgive? Do you want to die in the hospital or at home? Who do you want around you?"

DeLoughry said the other thing he learned during his mother's final days was that spirituality can bolster a person, even when their body is going downhill.

"If someone asked how my mom was, I said I had to answer in different ways," he said. "She was going down the tubes, but overall there was this glow."

Aging and spirituality

"Spirituality and Eldercare: A Missing Piece in a Difficult Puzzle" is designed for health care workers, clergy, students and anyone else with an interest in the elderly.

Sponsored by the Network in Aging of Western New York and the Niagara Caregivers Network, the conference will be held at Banchetti's Banquet Facility, 550 N. French Road, Amherst, from 8 a.m. to 12:30 p.m. on April 19 and May 25.

For information, call Network in Aging at 829-3712.