Caregiving Facilitator's Guide

Caregiving Caring for Aging Parents

Facilitator’s Guide

By: Charles Puchta

Adapted for Small Groups by Dan

Strickland

and

Karen Burkett

Communications should be addressed to: Living Free Ministries, Inc.

P. O. Box 22127

Chattanooga, TN 37422-2127

Phone: 1-800-879-4770

Email: info@livingfree.org

Unless otherwise identified, Scripture quotations in this volume are from the Holy Bible, New International Version ® Copyright ©1973, 1978, 1984, International Bible Society. Used by permission of Zondervan Bible Publishers. Other Scripture quotations marked kjv are from the King James Version of the Bible. Those identified tlb are from The Living Bible, and those identified PhilliPs are from the New Testament in Modern English, J. B. Phillips, translator. The Scripture quotations marked the message are taken from The Message, copyright © 1993, 1994, 1995, 1996, 2000, 2001, 2002. Used by permission of NavPress Publishing Group.

©Living Free Ministries, 2007. All rights reserved.

All rights are reserved. No part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system without written permission from the Living Free Ministries.

ISBN 10: 1-58119-084-0

ISBN 13: 978-158119-084-7

Produced by

Layout: Louise Lee

Cover: www.comstock.com

About the Author

Charles Puchta, founder and principal of Aging America Resources, is an awardwinning author and a nationally recognized authority, advocate, speaker, and advisor on the subject of aging and caregiving. Puchta has dedicated his life to helping families and professionals understand and address long-term care issues. He works with churches across the country, helping them formulate and implement programs to support the care needs of their church community.

About the Editors

Dan Strickland has served as President of Living Free since 2010. As well as participating in the day-to-day operation of the ministry, he trains churches in the United States and other countries to implement the Living Free groups. He has more than 30 years experience in pastoral counseling and small group ministry. Prior to his present role he led a successful Living Free ministry in Memphis, Tenn. that involved hundreds of participants. Dan is a graduate of Central Bible College, and earned the M.Div. from Southwestern Baptist Theological Seminary.

Karen Burkett is a published writer with more than twelve years writing experience. She served on the Living Free Ministries staff as Ministry/Development Coordinator from 2005-2010. For more than ten years, she was been deeply involved in caregiving for her parents. She is a graduate of Baptist Christian College in Shreveport, Louisiana.

Caregiving Caring for Aging Parents

Preface

Getting Started

Suggested Group Format

Session 1 You Are Not Alone

Session 2 The Aging Process

Session 3 Through the Eyes of the Care Receiver

Session 4 Through the Eyes of the Caregiver

Session 5 Honoring Our Parents

Session 6 The Role of a Caregiver

Session 7 Developing a Care Plan

Session 8 End-of-Life Planning

Session 9 Forgiveness and Reconciliation

Session 10 Communication

Session 11 A Legacy of Memories

Session 12 The Streets of Gold

Preface

To the Caregiving Group

The purpose of Caregiving: Caring for Aging Parents is to provide hope and direction to loved ones concerned about the health and well-being of aging parents or an ill spouse or relative. This group addresses predominate issues most families face.

Each session is designed to discuss a specific area of concern— for example, your purpose as a caregiver or end-of-life planning. The study will show participants that the Bible provides encouragement and direction to help them through this caregiving journey.

Group members already serving as family caregivers may be dealing with a variety of issues and have different comfort levels. Likewise, other participants may be planning ahead and have little or no practical experience. You will need to gauge the experience levels to determine the pace for each session.

The group should meet each week for one hour and fifteen minutes, but more time may be planned if necessary. The material is designed for 12 sessions. As a leader, be aware of the resource materials found in the Small Group Skills Guide, Core Team Manual, and the Living Free DVD training. These are available from Living Free on the Internet at www.LivingFree. org. Other excellent resources are available on the author’s website: www.CareMinistry.com. Much of the information in the self-awareness portions of this study group have been drawn

from Puchta’s books, Biblical Caregiving Principles and the Caregiver Resource Guide

Leadership

The most important qualifications for leading this group are Christian maturity and a solid, daily walk with God. Personal daily Bible study and a prayer life should be the foundation for each group leader (facilitator). Attendance in a biblically sound church is equally important. Ideally, the group facilitator(s) should have personal experience in caring for an aging or ill loved one. There is no substitute for hands-on experience.

There are two things a small group leader should remember. First, God does not expect the leader to have all the answers or to work miracles in the lives of group members—that is God’s work. Instead, the leader should simply guide the group toward the healing and solutions that the Holy Spirit provides—God will do the rest.

As you meet with group members, be sensitive to their spiritual condition. Be prepared to present the plan of salvation to any who have not yet come to Christ and made Him their Savior and Lord.

The second thing the leader should remember is that Christian small groups are quite different from secular ones. Secular groups attempt to bring about “behavior modification” through peer pressure and group dynamics. Although there is a place for

positive peer pressure and group dynamics in the Christian small group, there must be a change in the heart.

As you meet with group members, be sensitive to their spiritual condition. Be prepared to present the plan of salvation to any who have not yet come to Christ...

Participants

Participants are encouraged to keep a journal and make entries multiple times each week. Entries should be related to their caregiving experiences. Later, as they look back at how the Lord has worked in their lives, they will be encouraged to press on. Encourage the participants to attend church on a regular basis as worship, praise, and fellowship with God and being part of a Christian community offer great encouragement and support.

One Final Note

In addition to this ministry, many people may find outside professional help is needed to address specific issues and concerns. On page 101 is a list of additional resources. Encourage participants to refer to it and check out some of the helps listed.

Getting Started

Group Size

We suggest that each Caregiving: Caring for Aging Parents group have two group leaders (facilitators) and a maximum of 12 participants. Having more than 12 may prevent some from being a part of much needed discussion.

Preparation Time

The facilitator’s material is written in an almost word-for-word dialogue. However, it is hoped that as you come to know and understand the concepts presented, you will be able to “personalize” each session to better fit your own style. Highlight the points you want to emphasize and make notes for yourself.

Your group is unique—so adapt questions to their needs and situations. Be sensitive to each person who is in your group.

Keep in mind that the responses provided in the leader’s guide for the discussion questions are there only as a tool to assist you and may not be the only “right” answers to the questions being asked.

Become thoroughly familiar with the four elements of each session:

• Introduction

• Self-Awareness

• Spiritual Awareness

• Application

You will find more detail about these on the following page.

The facilitators should meet prior to each session to pray and make final plans. They should also meet briefly after each session to discuss what happened during the meeting and go over any follow-up that may be needed.

Caregiving: Caring for Aging Parents Group Member Guides Before Session 1, Caregiving group member guides should be distributed to each group member. Facilitators should be thoroughly familiar with the material before the first meeting.

Encourage group members to complete the appropriate assignments prior to each group meeting. Through the readings and other exercises in the Group Member Guide, group members can come to each session better prepared for meaningful discussion.

Correlation Between Facilitator’s Guide and Group Member’s Guide

Facilitator’s Guide — This guide is designed to lead the group through the four-phase small group format. The facilitator’s responsibility is to start the discussion, give it direction, and thereafter simply keep the discussion personal and on track.

The text is presented in the left column. The right column contains tips and pointers for leading the group along with answers to questions. The facilitator will prayerfully select questions because there are usually more questions than time permits.

Although the text is presented in the Group Member’s Guide, it may not in some cases be word for word as in the Facilitator’s Guide. For example, the Introductions are different in the two guides. The Facilitator’s Guide is directed toward opening prayer

and a go-around question; the Group Member’s Guide focuses on devotions for the week as a part of preparation for the upcoming session. Self-Awareness, Spiritual Awareness, and Application are the same in both guides except for the added notes in the gray area of the Facilitator’s Guide.

Group Member’s Guide — This guide is designed to be done as homework, preparing the participant for meaningful ministry during the small group session. Although the general text is the same as Self-Awareness, Spiritual Awareness, and Application in the Facilitator’s Guide, concentration should be on the group process during the actual group experience.

It is good for the participant to bring the Group Member’s Guide to the group session; however, the participant should be more attentive to the group process rather than trying to find text or written answers in the Group Member’s Guide. Each group member should bring a Bible for meaningful study and application of God’s Word for daily living.

In a Nutshell — The Facilitator’s Guide is designed to lead the group process through Caregiving: Caring for Aging Parents. The Group Member’s Guide will prepare the participant for the group meeting.

Suggested Group Format

The group format for each session consists of four elements: Introduction, Self-Awareness, Spiritual Awareness, and Application. There is a reason for each phase. The facilitators should always plan each session with this format in mind.

Part I Introduction (10

minutes)

Begin with prayer. The facilitator may pray or may ask one of the group members to lead in prayer. After the prayer, a sharing question helps put the group at ease and makes the members more comfortable in being a part of the discussion. The lead facilitator should respond to the sharing question first, followed by the co-facilitator. This helps the group members to feel safer in participating in the exercise. After the facilitators have shared, the group members will share one after another around the circle. Always remind group members they are not expected to share if they do not wish to do so. The rule is that everyone works within his or her comfort level and is welcome to pass.

This is not the time for detailed conversation, so ask the members of the group to keep their comments brief. If a person is obviously in pain during the exercise, the facilitator should interrupt the sharing and pray for the person in pain. After prayer, the exercise may resume.

Part II Self-Awareness (20-25

minutes)

After the sharing question, the facilitator will lead the group into the Self-Awareness phase. Self-Awareness is a time to discuss the practical issues involved in Caregiving. It is important to stay on the subject matter. This is a time to focus on needs and healing, not to have a martyr or pity party.

It is suggested in Self-Awareness that the facilitators ask the group members to share as they wish rather than going around the circle as in the Introduction phase. This is because people are at various comfort levels, and they should not feel pressured to self-disclose if they are uncomfortable. As the group continues to meet, members will feel more and more comfortable in being a part of the discussion.

Remember, prayer is always in order. If a group member is hurting during this phase, stop and pray. One of the facilitators may lead in prayer or ask another group member to pray. This says to the group members that each one is important and that you care about each individual.

Part III Spiritual Awareness (20-25

minutes)

After the Self-Awareness phase, the facilitator will lead the group into the Bible study time. Having briefly explained the topic,

the facilitator should assign Scriptures listed in the Facilitator’s Guide to group members. When each Scripture is called by the facilitator, the group member should read the verse(s). After the verses are read, give time for discussion.

Part IV Application (20

minutes)

This part is actually a continuation of Part III. Ask for volunteers to share their reflections on the question. The facilitators should emphasize the importance of the group members’ applying biblical principles to their lives. Help begins with right thinking. The Bible says, “Be transformed by the renewing of your mind” (Romans 12:2). Obedience to the Word should follow with right behavior. Right feelings will follow right thinking and right behavior.

1Session You Are Not Alone

ntroduction

Opening Prayer

Sharing Question

Welcome to our first Caregiving meeting. I’d like to begin this first session by having each of us introduce ourselves. I’ll start by telling you my name is …

Allow 10 Minutes

Thank God for bringing this group of people together. Invite the presence of the Holy Spirit. Pray that God will help all participants find peace and purpose in their caregiving experiences.

Group Member Devotional Reading prior to this session:

Ecclesiastes 4:9-12

Exodus 18:13-23 Psalm 23

If you are not already providing care or support for a family member or friend, you probably will at some time during your life. The reality is that people are living longer. As a result of this longevity, people often become sick; as people face illness or injury, many will need care.

Ideally, the best time to prepare and become familiar with the roles and responsibilities of caregiving is before there is a need to provide support, but you might find yourself in the middle of the situation before you have taken the time to prepare. Regardless of whether you are currently in a crisis situation, providing occasional support, or are planning ahead, the goal of this study is to help you gain knowledge, skills, confidence, and biblical perspectives to help you provide the care and support your loved ones need and deserve. Although we will be centering most discussion on caring for aging parents, the same principles apply for most long-term caregiving situations (illness, injury, etc.) and when caring for people other than parents (spouse, relative, friend, etc).

The purpose of this exercise is to help group members move toward being more comfortable in sharing with the group. Beginning with yourself and your co-facilitator, ask participants to introduce themselves.

Please share briefly what circumstances in your life have brought you to this group.

While caregiving situations differ, studies indicate that adult children, relatives, and spouses who take on the responsibility of family caregiver usually find themselves unprepared. Most people lack the information, skills, and confidence they need to effectively and efficiently provide care.

What are some ways you feel unprepared for caregiving?

The good news is that you don’t have to be alone in your situation. Try not to internalize everything and let things get bottled up inside. Help is available. Whether you are currently knee-deep in a crisis situation or planning ahead, I encourage you to take steps now to learn about the programs and resources that are available and then to be willing to accept the help you need.

Explain that all participants will have opportunity to share in more detail about their own situation in the coming weeks but for now, ask them to limit their responses to two or three sentences.

Examples:

• My parents are approaching the point of needing more help, and I want to be prepared.

• I’m already caring for my mother and experiencing frustration and confusion. Sometimes I just don’t know how to make the best decisions.

• My husband was in an accident that left him paralyzed. I’m the primary caregiver and just really need a place to vent some of my feelings and get some direction.

Personal responses.

Examples:

• I just can’t seem to communicate with my parents. I want to help them, but they won’t admit they need help.

• I’m concerned about my parents’ ability to cope at home but am not sure what the alternatives are.

• I didn’t realize how much time all this would take. How do I balance things?

Community Assistance

Identify resources in your area. You’ll quickly find that most people are ready and eager to help you. Help from organizations and government agencies ranges from providing information all the way to in-home care. To locate organizations in your area, visit www.ElderCare.gov or call 800-677-1116. You might also ask a local senior services agency or refer to the Health and Wellness section featured weekly in many local newspapers.

As a caregiver, you will benefit greatly from learning about what is available and then pursuing the appropriate kinds of help. We won’t take time during our group meetings to go into detail about this kind of help, but you will find contact information for various agencies in the “Resources” section at the end of this workbook.

Your parents’ team of health care professionals can be a tremendous source of help—especially in assisting you in understanding what is “normal” and giving you an idea of what to anticipate as time goes on. Keep a running list of questions and take the list with you to medical appointments.

Family and Friends

Don’t hesitate to seek emotional support from family and friends. And ask them to pray for you! Find someone with whom you can talk freely about the emotions you are experiencing. Participating in this group is a big step in this direction. You might build supporting relationships with others in the group that will continue even after the group ends.

As a caregiver, you will likely struggle as your loved one’s physical and cognitive limitations become more apparent. As you experience a wide range of emotions, be careful not to deny your feelings. Talking with others may help you accept and cope with loss.

What are some of the troubling emotions you have experienced?

Personal responses.

Examples:

• I grieve as though I’ve already lost my mom—she’s just not the same person.

• Sometimes I get angry with my dad—if he could just try harder, I don’t think he’d go downhill so fast.

• I feel as though I’m on a merrygo-round—up and down and around, never knowing if my mom will be thinking right today or angry at me because I never

come to see her (when I’m there every day) or perhaps she won’t even recognize me.

• Every time the phone rings, I hold my breath in fear—what’s happened now?

• I just don’t understand why they have to suffer like this.

• My sister and I don’t agree on what’s best for mom and dad. Sometimes I get so frustrated!

Your Heavenly Father

God never promised us days without pain, laughter without sorrow, or sun without rain; but He did promise strength to get through each day, comfort for the tears, and light for the way. As you provide care and support for a parent, spouse, relative, or friend, turn to God for strength and hope.

The Bible has a great deal to say about aging and caregiving concerns. I encourage you to meditate on God’s Word. You will find guidance, strength, and hope. Turn to your Bible and spend quiet time with God on a daily basis. No matter how busy you are, determine to set aside that special time with Him. And remember that He is with you every moment of the day.

Spiritual Awareness Lead–In

While you may not understand at times why you and your family are facing challenging times, if you seek God, you will find Him. He promises to hear your prayers and meet your needs. He is your source. He is the one who will make the impossible possible.

How has God helped you in your role as a caregiver?

Personal response.

S piritual-Awareness

The Bible is full of practical advice given from a realistic perspective. The task of caregiving is almost always more than a person can handle alone. In the following verses we will see that God knows that we need the strength of friends and family as well as the help only God can supply.

Ecclesiastes 4:9-12

We are advised to find strength from others.

In your life, have you ever encountered situations that these verses describe? If so, briefly share your experience with the group.

Allow 20–25 Minutes

Personal response.

Exodus 18:13-23

We must learn to delegate tasks that are too large for us to accomplish alone.

When Moses was leading God’s people from Egypt to their homeland, he was overwhelmed with his responsibilities in caring for the needs of the people.

In Exodus 18:13-23, Moses receives some life-changing advice.

In verse 15, what similarity do you notice in the way Moses thinks about his responsibilities and the way many caregivers think about theirs?

In verses 17-18, who does Jethro say will be harmed if Moses doesn’t change his approach in caring for the people?

If I don’t do it, it won’t get done.

Does anything about this surprise you?

In verses 20-21, what kinds of people was Moses advised to choose to help him, and what did he need to do to prepare them for their task?

Both Moses and the people he is caring for will be harmed if Moses does not delegate responsibilities and receive some help.

We often don’t realize that our reluctance to involve others in the caregiving process actually harms our loved one.

Moses was to choose those who were God-fearing, honest, and capable and teach them God’s laws, the way they should live, and how to perform their duties.

What kinds of people might you need to help you in your responsibilities as a caregiver, and what will you need to do to prepare them for their service?

Psalm 146:5-8

We can draw strength and help from God.

Many are surprised to know that God is willing to be our helper. He is pleased when we come to Him in trust and ask for His help.

According to these verses, what is the spiritual condition of those who find help in God?

Of all the word pictures in these verses, which do you find most encouraging?

Psalm 23

God’s role as shepherd provides an example for caregivers.

The function of the shepherd is a wonderful illustration of the task of caregiving. In Psalm 23, King David describes God as his shepherd.

In this psalm, what are the caring acts God provides for David?

Personal response.

What can we learn from this psalm that will help us meet the needs of those to whom we bring care and help?

They are blessed, and they have hope.

Personal response.

Personal response.

People need security, rest, comfort, peace, restoration, guidance, assurance, safety, blessing, love, companionship, and the presence of God.

John 16:13-15

The Holy Spirit can help us as our caregiver.

When someone walks beside us, helps us, and knows the right word to speak at the right time, we become stronger. This is part of an effective caregiving relationship. God’s Holy Spirit is called the Paraclete or the Helper who is called to come and bring God’s presence into the lives of followers of Christ.

According to this Scripture, what are some ways the Holy Spirit helps us?

The Holy Spirit leads us into all truth and comforts us with God’s words.

We introduced three sources of guidance and strength for caregivers earlier in our session: community assistance, friends, and God and His promises to us. Caregivers have unique circumstances that affect the resources available to them. Some may live where community assistance is limited, some may have a small circle of friends and family, and some may not understand how God supplies joy and strength for our service as caregivers.

Which of these sources do you feel is the most important to you?

Allow 20 Minutes

Personal response.

Which of these sources do you think will be the most difficult for you to draw upon?

Personal response.

Too often we exhaust ourselves with our own efforts before we ask God for His help and provision for our needs. We look at what we don’t have and become overwhelmed with the need. Remember that the ministry of caregiving is close to God’s heart; and when we are involved in caregiving, we are reflecting an aspect of His character to the world, bringing Him glory and pleasure. He will help us in this endeavor; and He wants us to pray to Him to give us strength, wisdom, and resources to accomplish His will.

Closing Prayer

Lead the group in a time of prayer, encouraging those who wish to pray personally for one another, especially remembering to ask God to provide those resources that the members said would be difficult for them to access.

2Session The Aging Process

Introduction

Opening Prayer

Allow 10 Minutes

Thank God for the faithfulness of the participants and their desire to help their parents. Ask Him to help each one have a better understanding of their parents and give them a special understanding of and sensitivity to the aging process. Ask for strength and wisdom for each of them.

Group Member Devotional

Reading prior to this session:

Leviticus 19:32

Ecclesiastes 12:1-5

Job 12:12

Luke 2:25-28

2 Corinthians 4:7-18

1 Timothy 5:1

Sharing Question

As you think of yourself growing older, what is your greatest concern?

Recognizing our own concerns about the future can help us better understand what our parents are experiencing and enable us to be more compassionate and helpful.

Personal response.

Examples:

• That I will run out of money.

• That my mind will deteriorate.

• That my health will fail.

• That I will lose my independence.

• That I will not be able to drive.

As you watch your parents age, you may be wondering when you should get involved. Perhaps you are already helping them but wonder if you are doing too little or too much.

The age factor varies drastically as to when a person may face limitations or require assistance. Your parents may age gracefully and live independently into their 80s and 90s, or they could face complications or illness in their 40s or 50s. Your decision about when to get more involved in their lives and when to begin considering aging and long-term care issues and options will depend more on their ability to function than on their age.

Allow 20–25 Minutes

One challenge you will face in making these decisions is distinguishing between characteristics of the normal aging process and those resulting from disease or illness. In the “Resources” section of this workbook, you will find helpful resources regarding the natural characteristics of aging. Physical changes in things like hair color and thickness, wrinkles, eyesight, hearing, physical strength, balance, and coordination are all part of the aging process. Studying that information will help you identify symptoms that might not be part of the normal aging process and may merit attention.

Following are ten considerations to help you assess your parents’ condition and identify potential areas of concern. If you have any apprehensions—even with one issue, it may be time to take a more active role in their life. Some simple things you can do to provide for assistance are suggested. Depending on the severity of your concerns, you may also want to seek professional advice.

Medical Condition. Have your parents been diagnosed with a medical condition that could impact their daily living? How is the medical condition likely to cause limitations to their abilities now or in the future? Suggestions: Go with your parents to their next doctor’s appointment and hear firsthand what the doctor has to say. It is not uncommon for older people to avoid asking questions as they might not want to hear what the doctor has to say or they might not be able to process, understand, or remember what is being said.

Driving. If your parents drive, is there reason to believe they pose an above average risk for being involved in an accident? Suggestion: If you do have concerns, learn about the programs and alternatives offered in your area that might be appropriate. Please visit our “Resources” page for a helpful resource regarding driving.

Food/Nutrition. Are your parents eating balanced meals? Is their weight stable? Are they able to prepare meals and manage grocery shopping? Do they have a reasonable variety of food in the refrigerator (with future expiration dates)? Suggestions: Offer to help with grocery shopping, make an extra casserole each week to share with them, or look into organizations and programs in your area that might deliver meals.

Hygiene. How do your loved ones look and smell? How are their overall appearance, grooming, and ability to match clothing compared to prior years? Are they able to manage the laundry? Suggestion: If towels, linens, or clothes do not appear fresh, offer to do an occasional load of laundry or suggest outside assistance. Do not assume they will request assistance when they need it. Ask how you can help.

As you review these points, encourage participants to briefly share their concerns, questions, and things they have tried or are currently doing. Also encourage them to share their parents’ response to their efforts.

Behavior. Do your parents seem anxious or irritable? Does being away from home make them uncomfortable? Do they seem depressed? Are they inconsistent in the things they say? Do they remember names, places, and current events reasonably well? Suggestion: If either of your parents is showing unusual behavior, try to determine if there are certain times of the day or situations when the behaviors are more extreme. To aid your health care professional in making a diagnosis or determining the best treatment plan, keep a log or journal of unusual behaviors. If particular situations (e.g., crowds and noise) cause anxiety, try to avoid them.

Daily Tasks. Are basic tasks overly challenging, frustrating, or time consuming for them? (e.g., getting ready to go out, preparing a meal, or shopping.) Suggestion: Determine if there might be daily tasks that you or others can perform to help lighten the load and relieve stress.

Medication. Can your parents manage their medications properly? Do they understand why they are taking the medications? Are prescriptions getting refilled in a timely fashion? Suggestion: See if there might be ways to help with medications such as sorting pills into dayof-the week dispensers. Also consider placing reminders around the house or making reminder phone calls. Maintain a list of all medications, the purpose, prescribing medical professional, and expected refill date.

Finance. Does it appear your parents are capable of making sound financial decisions? Are bills being paid in a timely fashion? Do they have a reasonable amount of cash on hand? Suggestion: If managing finances has become difficult for your parents, consider ways a family member can help them.

Mail. Is the mail stacking up? Do you see any past due or delinquency notices? Do your parents appear to be a target for solicitation offers? Suggestion: You might need to warn them about scams. Encourage them to be aware and get a second opinion before buying.

Safety. Are they careful about turning off appliances? Do they ever carelessly leave candles or cigarettes burning? Do they keep the doors and windows locked and are they able to locate the keys? Suggestion: Take steps to ensure that their home is as safe as possible.

Whenever possible, try to observe your parents in a variety of situations. Ideally, this evaluation should be informal so as not to cause alarm or appear disrespectful. If you have a concern—even with one area, chances are that your parents may be struggling unnecessarily. Trust your instincts.

As you identify concerns and begin to address them, try to remember that although your parents’ bodies and minds might be showing signs of aging, they still have much to contribute. Because of growing challenges in caring for your parents, you can easily get discouraged and see only the negative things happening. The Bible has much to say about the wisdom, wise counsel, and fruitfulness of the elderly. It is important for you—and your parents—to recognize all the special contributions they can continue making to your family, to friends, and in service to the Lord during this time of life.

We live in a time and culture that want to deny that we are all aging. Time will eventually have its way with us in spite of all our efforts to delay its effects. Advances in medicine and dentistry along with improved diets and exercise will take us only so far. No matter what we do, age will eventually overtake us.

What measures do people take to minimize and disguise the appearance of advancing age?

In your opinion, are these measures helpful or harmful?

Spiritual Awareness Lead–In

God’s Word makes it clear that a person is never too old to be used of God:

Even when I am old and gray, do not forsake me, O God, till I declare your power to the next generation, your might to all who are to come (Psalm 71:18).

It is important to remember that even though your parents may be facing special and difficult challenges, the Lord loves them and is with them throughout this time.

Describe some special contributions you see your parents making or positive activities you would like to encourage them to pursue.

Cosmetics, surgery, exercise, implants, Botox therapy, dental work, and others.

There is nothing wrong with wanting to look your best, but an obsession with staying young is a vain desire that cannot be fulfilled.

Encourage some extended brainstorming on this. It is important for them to see these positive possibilities.

Personal responses.

Examples:

• Pray for the family.

• Tell us about their life experiences.

• Living example of faith in all circumstances.

• Send cards of encouragement to others.

S

piritual-Awareness

God’s Word teaches us to be realistic about life and death and the impact the aging process has upon us all. Studying these teachings can help us better understand the process taking place in our parents and prepare us for our own aging.

The book of Ecclesiastes was written by King Solomon, who was gifted by God with great wisdom. A recurring theme in this book is that unless we live life with an eternal perspective, we will not find true joy at any stage of life, most especially in the autumn years.

Ecclesiastes 12:1-5

How are the days of old age described in this passage?

How will remembering our creator in the days of our youth benefit us in our older years?

These verses contain figurative language to illustrate the effects of age upon us.

Identify some of these word pictures and give your opinion as to what they describe.

Allow 20-25 Minutes

It is wise to recognize the seasons of life and to gracefully accept their effect upon us.

Human life has a natural cycle that has existed since the time of Adam and Eve. Aging and death were not the design of God’s original creation but have become part of the natural rhythm of life as we know it.

Ecclesiastes 3:1-8

These verses describe the rhythms we find in life. In Ecclesiastes 3:1, the second half of the verse tells us that there is “a season for every activity under heaven.”

What do you think is the significance in choosing the word “season” to describe the time allotted for these activities?

Days of trouble.

A person will have lived a lifetime understanding what is most important in life.

Opinions differ about what these words describe, but many see them as descriptions of the physical decline of old age so these verses may describe trembling hands and head, weakened arms and legs, stooped shoulders, missing teeth, weak eyesight, poor hearing, sleeplessness, increased fear of falling and venturing outside, decreased sex drive, and lost mobility.

A season is not a brief time but a limited time. None of these seasons last forever.

What useful lessons do you see in verses 2-8?

Although there is inevitability to the progress and effects of time, this is no reason for despair.

2 Corinthians 4:7-18

The Apostle Paul described the toll that ministry was taking on his physical body. We may not suffer the same stresses he experienced, but the truth he found in his suffering applies equally to us as we experience the aging process.

How would you expect the hardships Paul describes in verses 8-12 would affect his physical well-being?

We can understand that in life, circumstances are always changing; and when these changes are beyond our control, we must graciously accept what comes our way. Whether the season is pleasant or painful, it is good to remember that none of these seasons are permanent.

What truth in verses 13-15 gave Paul the willingness to continue in these hardships?

Hardship would take its toll on his health and likely leave him with aches, pains, and infirmities that hastened the physical decline that naturally accompanies aging.

He knew God was using him to reach many people with the gospel and that God would give him the ability to continue because Jesus’ life was giving him strength. Beyond this, he knew that his mortal body would die and be replaced by one that will never die.

What truth in verses 16-18 can help us not become discouraged in the face of declining physical abilities?

The true person we are, the inner person, can grow stronger even while our physical person is wasting away. The time we spend in physical discomfort in these bodies is nothing compared to the eternity we will spend in perfect wholeness in God’s presence.

How can you keep this perspective?

To keep this perspective, we have to continue to focus on what we know will happen later and not on what we see happening now.

Age does not diminish the value or spiritual power of a person.

The normal effects of aging may be inevitable but do not lessen our value as persons. In contemporary Western culture, the young are considered more valuable than the elderly. This is not the case in every society, nor has it always been this way in our culture. Following are a few of the Bible verses about valuing elders:

Rise in the presence of the aged, show respect for the elderly and revere your God. I am the lord (Leviticus 19:32).

Is not wisdom found among the aged? Does not long life bring understanding? (Job 12:12)

Do not rebuke an older man harshly, but exhort him as if he were your father. Treat younger men as brothers (1 Timothy 5:1).

There is a spiritual depth and discernment that only comes with a life centered upon God.

Being older brings life into sharper focus, and the distractions of youth no longer dominate our attention. There is time to recognize how God is working and the ability to see things others miss.

Luke 2:25-28

Simeon and Anna are two older people with great spiritual discernment.

What qualities about Simeon are mentioned in verses 25-27?

Being elderly and a widow, Anna was free from many distractions that would occupy the minds of younger women. What are some of these distractions?

What occupied the minds and hands of these two people?

What did their preoccupation with God allow them to see that others were missing?

The most important abilities we have as Christians are not touched by the normal aging process. When we lose the abilities enjoyed by youth, there is no need for despair. Age can bring us into our most profound spiritual period of life.

He was righteous, devout, waiting for God’s promise, and was guided by and walked in the presence of the Lord.

She had no earthly companion or attachments to distract her from total consecration to knowing and serving God.

God’s promises, salvation, worship, prayer, fasting, thanksgiving.

They could recognize that Jesus was their messiah.

A

pplication Allow 20 Minutes

We have seen how aging may bring the loss of mobility, sight, hearing, independence, cognitive ability, friends and loved ones, and other cherished abilities and treasures.

How do you anticipate you will react to these losses? How are your loved ones responding?

It is normal to grieve these losses, but it is also important to concentrate on the relationships, abilities, and opportunities that are still ours. If we dwell on what we no longer have or no longer can do, then we will miss the great opportunities in life. As Paul said in Philippians 4:12-13, “I know what it is to be in need, and I know what it is to have plenty. I have learned the secret of being content in any and every situation, whether well fed or hungry, whether living in plenty or in want. I can do everything through him who gives me strength.”

What are some of these relationships, abilities, and opportunities that you (and your parents) can enjoy and experience?

Personal responses.

What are some spiritual qualities and disciplines you can cultivate now that will carry you through your elderly years?

• We can love those around us as Christ loves us.

• We can encourage others to grow in Christ through our example and words.

• We can memorize and meditate on God’s Word.

• We can deepen our prayer life.

• We can pray for others.

• We can live every moment in the presence of God.

• We can encourage others by phone calls and letters.

• We can do all the things important for spiritual vitality and find great satisfaction in how God will continue to bless and use us.

• We can remember our creator and open our lives to what He has to say to us.

• We can learn how to pray, study, and meditate on God’s Word; walk in the Spirit; give to God and others; and find joy in the basics of life.

• We can understand that we are valuable to God because He values us as a person and not for what we accomplish.

• We can cherish the relationships we have and pour encouragement into those around us.

These qualities have eternal value, they are part of a spiritual legacy handed down for generations, and they enrich our souls as we grow older.

Can you describe a plan you might follow to develop these qualities and disciplines?

We will pursue what we value, so we must first be convinced that these eternal treasures are even more valuable than the earthly ones we acquire. There will be many plans discussed, but the ones that will succeed are those that see this spiritual growth as a lifelong process.

Closing Prayer

Lead the group in a time of prayer. Ask God for the participants to receive wisdom and insight into understanding the changes their parents are experiencing and knowing when and how to get involved.

3Session

Introduction

Opening Prayer

Through the Eyes of the Care Receiver

Allow 10 Minutes

Thank God for the participants and their desire to serve their parents. Ask him to help each one be able to see and hear beyond what their parents do and say and to help them see through the eyes of their parents. Ask for physical and emotional strength for each participant.

Group Member Devotional

Reading prior to this session:

1 Corinthians 4:3-5

1 Corinthians 2:11

Hebrews 2:14-18 Hebrews 4:14-16

Sharing Question

Name something you look forward to in your old age.

S elf-Awareness

As you provide care or assistance for your parents, be sure to consider their perspective—ask God to help you see things through their eyes. Doing so can help you be more sensitive to their needs and better know how to help.

When my dad was diagnosed with leukemia, I spent more time focusing on the diagnosis of the disease than on loving and encouraging him. I wish I had known to consider how the illness was going to impact his daily life and emotions. I wish I had encouraged him to share his feelings, fears, and tears. When he faced new challenges or limitations, I wish I had told him, “It’s okay—I’ll be with you every step of the way.”

When your parents face a challenge, don’t treat them differently— treat the circumstances differently. Assure them that your love and your respect stay the same. Remind them that you are with them no matter what—and even more importantly, that God will never leave them nor forsake them.

Personal response.

Examples:

• Senior discounts

• Retirement

• Slower pace

• Time with grandchildren

Allow 20-25 Minutes

Don’t assume you know how your parents are feeling. Talk to them. Ask questions—and really listen to the answers. Together, face the realities of the situation. Offer guidance and suggestions, as appropriate, and assure them they have the final say as long as they are emotionally and mentally able.

Describe a time you focused on what to do in a situation to the point that you forgot to find out what your parents wanted or were feeling.

Give consideration to what may be going through your aging parents’ minds. They may be afraid of diminishing mental and physical abilities, concerned about being a burden to you and the rest of the family, or fearful of dying. They probably fear losing their independence or losing all control over their lives. Many older adults who lived through the Great Depression may fear spending money and worry about depleting their life savings. They may fear the future and the loneliness it could bring. The list goes on and on.

When your parents do or say something you don’t understand—or perhaps even feel offended by—think about what might be going through their minds. Talk to them and ask questions.

Describe some specific ways your parents have lost control over their lives.

When your parents face a limitation, regardless if the situation is a result of age, illness, or injury, you might find that you have a natural tendency to smother them with help. I call this the Let Me mentality. Someone faces some sort of limitation and people jump in offering to do everything for them… “Let me do that.” Although your gestures may seem like the right thing to do, they are often unnecessary and even demoralizing.

One frequently asked question I receive is, “Why do you think so many older people resist assistance from family members?” Many people think the answer is that older people can be stubborn or set in their ways. I think that more often people are just afraid of losing control of their lives. You mean well when you jump in and try to do things for them, but it’s so much better for them to do everything they can for themselves.

The movie Driving Miss Daisy clearly portrays the Let Me concept. Dan Ackroyd hires Morgan Freeman and tells him that his mother cannot fire him. Then, as Dan Ackroyd explains to Jessica Tandy that he hired Morgan Freeman, she says: “Last I knew I had rights…” People do not want to be treated differently because they are old or infirm. People want to be treated for who they are, not for the illness they have or the abilities they have lost. I believe

Personal response.

Personal response.

that all people, regardless of age, have a basic wish to feel useful. A person losing his or her purpose is sometimes referred to as a “failure to thrive.” In other words, what’s the purpose of living any more? People may simply avoid situations or give up entirely.

What are some things you are doing for your parents that they probably could still do themselves?

Personal response. Examples:

• Jumping up to get them a drink of water when they’ve already started to the faucet.

Retirement can be an especially traumatic transition. Imagine using skills and abilities on a daily basis and then suddenly stopping. Everyone wants to feel that they are needed and that their contributions are valuable.

Encourage your parents to fill their time with purposeful activities. Volunteer work, hobbies, or other activities can give them a reason to wake up in the morning. They still have so much to give to others—years of experience, lessons learned, wisdom developed. Even if their health is failing, they can pray for people and send them encouraging notes and cards.

What are some positive activities in which your parents are involved or could be involved? Perhaps an activity or service they enjoyed in their younger years or even something new.

Spiritual Awareness Lead–In

Our topic this session, “Through the Eyes of the Care Receiver,” is devoted to understanding the concept of empathy. When we as caregivers empathize with our loved ones, our goal is simply to understand how they are seeing the world and how they are feeling about their circumstances. This requires a certain sensitivity that comes naturally to some, but to others it is a skill that must be developed.

It is also good to remember that Jesus understands our weaknesses.

Do you consider yourself a naturally empathetic person? What do you think others would say about you?

• Making arrangements and decisions for them.

Personal response.

In your opinion, is it easier to be empathetic with someone you love and have known a long time or with a relative stranger? Why?

Personal response.

Personal response.

Only God has the ability to know a person as they really are.

No matter how hard we try, we can never really know the deepest thoughts, feelings, and motivations of another person. In fact, we cannot even trust our judgment of ourselves.

1 Corinthians 4:3-5

Why do you think the Apostle Paul would say that even though his conscience was clear, he was not necessarily innocent?

Allow 20-25 Minutes

What do you think are some of the things mentioned in verse 5 that are hidden to others and ourselves that only God can expose?

Our conscience is an imperfect guide that can mislead us. It is accurate only so far as it is guided by what is true. The influences of a corrupt culture, moral relativism, and self-deception can all cause our conscience to falsely excuse our actions.

The main thing mentioned here is the motives of a person. It is possible to do the right thing with the wrong motive. Our motives may be to manipulate another person, to make ourselves look good, or any number of incentives that are not rooted in love.

If it is difficult for us to truly know ourselves, it is an even greater challenge to understand needs, desires, and motives of the care receiver.

Jesus searches the depths of our hearts and perfectly understands our needs and the needs of those we are helping.

One thing that sets Christian caregiving apart is that as Christians, we depend upon God’s guidance and direction in our helping ministry. Anyone can learn facts and helping methods; but without sensitivity to the Holy Spirit’s guidance, we can miss opportunities to minister to unspoken spiritual needs. God alone knows the deepest needs of people, and He can help us understand how best to help those we care for even when they don’t openly express their need.

1 Corinthians 2:11

What does this verse tell us about one person’s ability to completely understand another person’s thoughts and needs?

It is not possible for us to completely understand another person. In fact, the Bible tells us that it is not even possible for us to completely understand ourselves. See Proverbs 16:2 and 21:2.

Psalm 139:1-4

What do these verses tell us about how well God knows us?

Does this knowledge comfort or disturb you? Why?

Psalm 139:13-16

Do these verses shed any light on whether God knows us better than we can know ourselves?

God searches every person and knows everything about us. He knows our every action and our deepest thoughts. This can make us comfortable or uncomfortable, depending on our relationship to God.

Personal response.

What can we learn from these verses?

God not only knows our present actions and conditions, but He also created our innermost being and was active in our formation as a human being. Not only this, but He also knew that we would be born even before we were conceived; we are no accident. We have been part of His plan from the beginning, and He knows everything about us.

We can learn that we are no accident and that God is concerned enough about us to stay informed about us and involved in our lives. Because He was aware of us even before we existed, then certainly there is no detail about us He does not know. He also knows our loved ones that well and can help us understand them more and know better how to help them.

God gives us a beautiful example of empathy that we can follow.

Care receivers are more willing to trust a person who is making an effort to understand circumstances from their perspective. The following passages from the Bible show what extreme measures God was willing to take in order to care for our needs.

Hebrews 2:14-18

What did Jesus have to do in order to help us?

Hebrews 4:14-16

What do you think it is about Jesus that gives us the assurance we can now approach God with the confidence that He understands us?

He had to become a human and die in our place to pay for our sins. Because He took on a body of flesh and blood, He knows from personal experience what we face as human beings.

What lessons can you draw from this that will help in understanding the needs of the care receiver?

He can understand our weaknesses because He knows what it is to experience a whole range of human conditions such as fatigue, hunger, solitude, anger, rejection, pain, loss, and temptation. Because we know He understands us, we are able to approach Him with confidence.

That those we are wanting to help will find it easier to trust us if they know we are making every effort to enter their world with them and understand what it is like to be them.

A pplication

In Luke 10:38-42, we find the story of two sisters who had differing styles of caring for a special friend.

The story illustrates how easy it is to become task oriented in caring for the needs of people and forget the importance of enjoying a relationship with the ones we are serving. To a caregiver, the most urgent needs may seem to be the outward ones; but to a care receiver, the most important needs may well be internal—those that can only be filled through time spent together, setting aside the chores for the moment.

It takes empathy to see the less obvious needs of our loved ones.

The point of empathy is to understand, not to change or judge another’s emotions and responses. To be a good helper, a person has to first understand the care receiver’s needs and then be able to take appropriate action. Only after we understand can we be helpful.

How does your world differ from that of your loved one?

Allow 20 Minutes

How can you begin to enter their world and experience life through their eyes?

Personal response.

How do you imagine your style of caregiving is perceived by your loved one?

By listening not just to the words they speak but also to the emotions they convey. By attempting to see life through the filters they experience such as loss, limitations and desire for dignity, independence, and self-worth.

Personal response.

Closing Prayer

Lead the group in praying for more sensitivity to their loved one’s needs.

4Session Through the Eyes of the Caregiver

Introduction

Opening Prayer

Sharing Question

Describe an especially happy time you recently experienced with your parents.

S elf-Awareness

Guilt…stress…confusion…anger…frustration…sadness. If you have not already experienced all this and more as a caregiver, you probably will. But there are also positive experiences: celebrating your parents lives with them as you listen to them share their memories of the past…those special moments when honest communication—and love—flow between you and your parents…laughing together over some silly thing…feeling joyful and thankful that you are able to help them through these challenging times.

Guilt is a common emotion experienced by caregivers. Guilt when it’s time to go at the end of a visit. Guilt over the role reversal—you often must take on the parental role. Guilt that you can’t do more.

Allow 10 Minutes

Thank God for the participants and their desire to be better caregivers. Pray that they will always be aware of God’s presence and the strength and comfort only He can give. Pray that God will help them deal with the emotions and stress that come with caring for someone they love.

Group Member Devotional Reading prior to this session:

Romans 8:35-39

Romans 8:1-4

Philippians 4:6

John 16:33

Personal response.

Allow 20-25 Minutes

You may also feel guilty when taking time and attention for yourself or acting against the expressed wishes of a loved one because you believe in your heart that what you are doing is in their best interest. Sometimes you might even blame yourself for your parent’s illness. Try to keep things in perspective.

• Realize that you are just one person and can only do so much.

• In order to avoid or minimize crisis situations, spend time preparing yourself and consider the predominant issues and challenges you are likely to face.

• Do not be afraid to ask for help frequently.

• Recognize all your responsibilities (e.g., spouse, kids, work), not just being a family caregiver, and schedule your time.

• Set reasonable expectations for yourself to minimize your frustration.

• Realize that you are not perfect and give yourself permission to make mistakes.

• Recognize your many accomplishments and take joy in the rewards of caring for a loved one.

Which of these steps do you find most difficult? Why?

Caregivers can expect to experience a variety of emotions along their journey. I vividly remember when my sister and I moved our mom into a dementia care unit at a local nursing home. Once the move was complete, our mom looked at us and said, “Please don’t leave.” Wow, talk about an emotional challenge. Another comment my mom would make was, “You’re coming back tomorrow, right?” When comments like that were made, I often felt guilty if I wasn’t planning on visiting the following day. Another struggle I faced was how to respond. I never wanted to lie; but at the same time, I didn’t want Mom to be sad or depressed or to feel lonely.

It is important to recognize feelings of guilt and frustration and deal with them. Condemning guilt does not come from God. If you love your parents and are doing your best to care for them, don’t feel guilty about things you cannot control. Ask God to help you have a right perspective.

Describe feelings of guilt you have had or are currently experiencing. How are you dealing with these feelings?

Personal response.

Personal response.

You may feel frustrated and even angry if your parents seem to rebel against your help and suggestions. Ask God to help you see each situation through your parents’ eyes and understand their perspective. Then apply the Golden Rule—if you were in their situation, what would you want your children to do?

As long as your parents are of clear mind and deemed competent, they should have the final say on things. However, if it reaches a point where their minds are not clear, you do have the responsibility to look out for their best interests, even if this means going against their desires. Do this with love and respect for them—and don’t fall into the guilt trap.

Describe a time you had to make a decision contrary to your parents’ wishes.

How did they respond?

How did you deal with your own feelings?

Don’t think solely about your parents. Consider yourself and your needs and feelings as well. An unhealthy caregiver is of no value to a care recipient. Caregiving is sure to take a toll on you emotionally and physically. A support group like this one can help. Also find a friend you can confide in on a regular basis. If you are a full-time caregiver for your parents, find an alternate solution every week to give you a chance for a rejuvenating break, to focus on your spouse and children, to do something nice for yourself.

Here are a few more ways to reduce the stress you are experiencing:

• Become educated about the illness or ailment and how it is likely to impact a person.

• Learn about caregiving and helpful techniques.

• Seek assistance from family, friends, and community resources.

• Take care of yourself, eat right, exercise, and get plenty of rest.

• Accept changes as they occur.

• Be realistic about what you can do.

• Keep a journal and express yourself on paper.

• Give yourself credit for what you have accomplished; do not feel guilty if you lose your patience or cannot do everything on your own.

Personal response.

Personal response.

Personal response.

What are some ways you have found to take care of your own needs?

Spiritual Awareness Lead–In

Most of all, remember that God is with you. He will comfort you and encourage you. He will guide you and strengthen you. You are never alone.

Caregivers are called upon to do a job they would rather not have to do. It is not that they do not want to care for their loved one; but given a choice, they would prefer that their parents were well and independent. Everyone knows the day is coming when caregiving will be necessary; but when that time finally arrives, it can bring with it some powerful emotions.

Which emotions have you experienced, or do you anticipate when “the day” finally arrives?

Personal response.

What preparations have you made to manage your feelings?

Responses will vary but will probably include guilt, stress, confusion, anger, frustration, sadness, helplessness, fear, inadequacy, resentment, selfpity, depression, isolation, loneliness, etc.

Preparations include thinking about and preparing for events before they happen, beginning the process of emotional acceptance before the actual event, preparing a personal support system, etc.

Romans 8:35-39

The self-awareness section contains some very practical and helpful suggestions for managing the stress caregivers face. However, some things are beyond our control or influence. No matter what we do, nothing is going to change; and we have to find confidence that God is in control. During these times, we can take refuge in the truth of Romans 8:35-39.

How much control over terrible circumstances could be exercised by those described in these verses?

None whatsoever.

What situations are you now facing that truly are out of your control? What thoughts and feelings do you experience as a result of these situations?

In verses 37-39, we are assured that the powers of death, evil, time, gravity, or any other force that could destroy us cannot reach or break the love God has for us.

Even though there is no promise here that we will not face difficult circumstances, how do you think we can find strength in the promise given in verse 39?

Personal response.

2 Samuel 24:10

This verse gives an account of David’s feeling when he sinned.

What synonym for feeling guilty is used in this passage, and how did this emotion work to his benefit?

Personal response.

Feelings of guilt can force us beyond our limits. Caregivers should never feel guilty for circumstances and events that are beyond their control. However, many struggle with guilt feelings, and it is important to recognize the difference between true and false guilt. Guilt is closely tied to forgiveness and reconciliation, a topic we will address later in this group.

True guilt is a fact, not an emotion. We are guilty of sin when we offend God. We are also guilty when we break the laws of man or wrongfully offend another person. When we are truly guilty, we should feel guilty.

First, God loves our care receivers more than we do; and no matter how difficult their circumstances, He will never forsake them or stop loving them. Even with God’s infinite love and power, everyone will be touched by death, but believers will not be destroyed because we are secure in His love.

Second, in spite of all our efforts, we cannot protect our loved ones more than God can. There are limits to our finite strength, and many situations are beyond our control. Just as we surrender our loved ones to God’s care, we must surrender ourselves as well.

He was conscience-stricken, and the pain of his emotion moved him to confession and repentance.

Do you think David knew what he had done wrong and how he had offended God? Why?

What two phrases did he use to confess his sin, and what did he ask God to do for him?

Romans 5:8-11

There is a solution for true guilt. The pain of a guilty conscience should motivate us to repent, confess, make restitution, and find forgiveness from God and hopefully from man as well. The painful guilt feelings should pass when our true guilt is resolved.

The death of Jesus as a sacrifice for our sins makes it possible for us to experience God’s forgiveness and a release from our true guilt.

The door to experiencing this forgiveness and release from true guilt is admitting our sin and believing that Jesus has died in our place.

1 John 1:9

False guilt is a state of mind, a continuing emotion, a painful condition that does not resolve because it is not based upon true guilt. False guilt does not respond to repentance, confession, or restitution—it persists regardless. In the context of caregiving, it is often associated with a general sense of shame and failure.

When we enter caregiving relationships, memories of past events often come to mind that trigger feelings of guilt. Relatives often use guilt as a weapon to manipulate each other. The result can be that we are motivated by guilt and not by love.

How have you been able to respond to those who want to send you on a “guilt trip”?

He knew exactly what he had done because he mentioned it in his confession.

“I have sinned greatly in what I have done,” and “I have done a very foolish thing.” He asked God to “take away the guilt of your servant.”

Personal response.

Closely associated with false guilt is a sense of personal unworthiness. If we exist under a cloud of false guilt, we will feel defective, unworthy, unloved, and unlovable. In order to earn the love of others, we will exhaust ourselves in serving, trying to earn the approval that only God can supply.

Do you find yourself anxious that you are not a worthy person if

• Your loved one is not always pleased with you?

• You cannot do everything your loved one requests?

• You take time for yourself?

• You make a mistake?

If you think this way, it is likely you are open to being motivated by false guilt.

Romans 8:1-4

These verses are a solid foundation to stand upon when confronting false guilt.

False guilt is a feeling that is usually triggered by a false belief. Therefore, the best way to counter false guilt is to tell yourself the truth.

You can find which truth you need to tell yourself by looking for the source of the feeling.

• Think about what you are feeling.

• Identify the situation that sparked that emotion.

• Determine what thoughts you had just prior to the emotional response to the situation.

• Determine if those thoughts were based on truth or if they were false.

• Apply God’s Word to and accept God’s truth about the situation if they were false.

Describe a recent situation in which you could have used the above steps to confront false guilt you were feeling.

Paraphrase these verses in your own words.

Can you think of some other tactics to help you overcome false guilt and its consequences?

Personal response.

Ask some participants to read their paraphrases.

Personal response.

A pplication

Just as beauty is in the eye of the beholder, so the emotional impact of caregiving can be a matter of mental and spiritual perspective. Even when the task is challenging, there are times when caregivers enjoy some wonderfully positive emotions, if they allow themselves.

Michael Card wrote these lyrics in the song “Joy in the Journey,” a song describing the challenges and joys of the Christian life.

There is a joy in the journey

There’s a light we can love on the way

There is a wonder and wildness to life

And freedom for those who obey

A common positive emotion caregivers feel is joy—joy from being able to provide care and assistance to someone who gave much of their life, time, and treasure to raise you. But there is also joy in the simple pleasures of life, especially the pleasure of the companionship of God who never leaves our sides on this journey into forever. As our lives are centered upon this relationship, we are able to keep everything in proper perspective—our frustrations from lack of being able to control circumstances and outcomes, our feelings of guilt for things that are not our fault, and the other emotions that threaten to overwhelm us.

When we center our lives around this divine relationship in which we live to please God, we are better prepared for the seemingly overwhelming worries common to caregivers.

• Can I handle this responsibility?

• What if the care needed is more than I can provide?

• What if I have to make choices that don’t please the care receiver?

• What if there is not enough money to provide the care needed?

Have you ever been able to enjoy a continuing walk and conversation with God as the center of your daily life?

How have the cares and responsibilities you carry affected your ability to focus on your walk with God?

God desires to be your companion in every situation, and He has promised never to leave you.

“Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God” (Philippians 4:6).

Closing Prayer

Allow 20 Minutes

Pray for the burdens and anxieties of group members.

Personal response.

Personal response.

5Session Honoring Our Parents

Introduction

Opening Prayer

SSharing Questions

Do you know a child who shows respect and honor toward a parent? How does this child show respect and honor?

Allow 10 Minutes

Thank God for our parents and the opportunity to serve them. Thank Him for the group participants. Ask Him to continue with them day by day, helping them understand how to best help their parents. Pray that they will learn to balance their lives in a way that is pleasing to Him. Pray that the entire family will be supportive of one another.

Group Member Devotional Reading prior to this session:

Deuteronomy 5:16

Proverbs 17:6

Proverbs 23:15-25

Matthew 15:3-9

Personal response.

Examples:

• Follows instructions.

• Asks for advice.

• Shows courtesy.

• Helps without grumbling.

• Shows a desire to spend time with the parents.

• Speaks respectfully to the parents.

elf-Awareness Allow 20-25 Minutes

God’s Word leaves no doubt: He wants us to honor our parents. The fifth commandment states it clearly, “Honor your father and your mother” (Deuteronomy 5:16). This instruction is repeated several times in the Old Testament, and Jesus reinforces it in Matthew 19:19.

So you know you are supposed to honor your parents; but how do you do that as they get older, especially when it reaches the point that you become the decision maker for them?

One way to honor your parents is with your time. Are they a priority in your life? Do you prioritize them into your schedule, or do you try to fit them in here and there? You can honor them by making them a priority in your life. Here are some other ways to honor them:

• Ask for their advice on something that concerns you personally.

• Confide in them about things in your life.

• Ask them to pray for you.

• Really listen to them—to their thoughts about their current situation as well as to stories and memories of the past.

• Ask questions.

• Demonstrate a sincere interest.

• If their health permits, include them in some of your activities with friends and other family members.

• Honor their decisions whenever possible.

• Encourage them to use their time and talents to bless others.

• Cherish their wit and wisdom and be thankful you have parents to enjoy.

What are some of the ways you have shown honor to your parents?

Personal response.

As parents become less quick-witted, slower in pace, stubborn or super independent, frustration and impatience are natural responses. During these times, showing honor can become more of a challenge.

When do you find it difficult to honor them?

Personal response.

Examples:

• When they are acting childish.

• When they are demanding.

• When they are confused or ask the same question over and over.

• When they criticize everything I do.

Although you should always honor them as your parents, treating them with love and respect, you may also need to establish healthy boundaries. Honoring them does not mean allowing them to manipulate you. If they have a tendency to take advantage of you, learn to stand your ground. Don’t express anger or say unkind things, but be firm. Ask God to help you gain perspective.

Describe a time when you have had to stand firm with your parents. If you were able to do this and still honor them, tell how you accomplished this.

Personal response.

If you come from a dysfunctional family with strained or damaged relationships, honoring your father and mother may be difficult. However, God’s desire is that we do just that. Even if you cannot honor some of their behavior, you need to honor them as your parents. Ask God for His help and strength in doing this.

Spiritual Awareness Lead–In

The Bible was written in a culture where people were very concerned with achieving honor and avoiding shame. Honor was a measure of public respect that came from a good reputation. Shame came upon a person as a result of personal failure or being humiliated by the actions of family members. In the Middle Eastern countries as well as many others, the motivation to achieve and maintain honor and avoid shame are still very strong.

Nakedness is often symbolic of shame in the Bible. This is illustrated in the story in Genesis 9:18-27 of how the three sons of Noah dealt with their father’s shameful behavior.

What does Ham’s reaction say about his level of respect for Noah?

What do Shem and Japheth’s actions say about their character and their concern for their father?

He did not choose to honor his father by covering him and protecting him from being exposed to others. He instead chose to bring shame to his father.

By covering Noah and refusing to look at his nakedness, they showed respect and honor. They covered his nakedness and had nothing to tell anyone about what they saw.

Why do you think it is difficult for us in our culture to understand Noah’s reaction?

In western culture, we think more in terms of individual responsibility and would likely blame Noah for placing himself in a position where he could be exposed to shame. However, we forget the high priority of giving and defending the honor of our parents.

Spiritual-Awareness

Later in the scriptures, God shows what great importance He places upon honoring our parents as we see in the fifth of the Ten Commandments.

Deuteronomy 5:16

In your own words, how would you describe the concept of honor?

Allow 20 – 25 Minutes

Proverbs 23:15-25

According to Proverbs 23:15-25, what are some ways you see that sons and daughters can honor their parents?

Personal responses.

The biblical word for honor conveys the concept of value and worth. So if we honor someone, we treat them as if they are important; and if we dishonor someone, we treat them as if they are worthless.

• By having a wise heart.

• By speaking what is right.

• By being zealous for the fear of the Lord.

• By keeping your heart on the right path.

• By listening to your father.

• By not despising your mother.

How do these things bring honor to parents?

When our lives reflect the godly heritage of our parents’ example, it brings our parents honor for their faith and example.

It may be that our parents have not set the best example for us or they may not follow Christ.

How can these verses apply in a situation like this?

Most parents will be glad to see their children living a good life that is obtained by following God’s ways. Such a life gives credibility to our words when we testify to them about the difference Christ has made in us. What better way to bring honor to a parent than to love them enough to share with them the good news of the love of Christ?

Proverbs 17:6

Other ways to honor our parents are found in this verse.

Grandchildren are said to bring value to the aged.

In what ways do you see this being true?

When grandparents see their godly spiritual influence extending through their children to their grandchildren, it gives them a sense of meaning and fulfillment that God has used their lives to His glory.

It is very encouraging for children to know their parents are proud of them, but it may not occur to many people that parents want to know that their children are proud of them too.

What are some things you find admirable about your parents?

Have you ever expressed your pride to them? What was the response?

Deuteronomy 27:16; Exodus 21:15,17; Proverbs 28:24; Matthew 15:4

Dishonoring parents is a serious matter in the eyes of God.

What are some of the methods of dishonoring parents described in these passages?

Personal response.

Personal response.

Why do you think the penalties would be so severe? (Hint: How do godly parents help us to understand what God is like?)

• Cursing • Attacking • Robbing

Human society is dependent upon a respect for others, beginning with our respect for God our Father. In normal circumstances, our parents show us what God is like. Parents give us life, protect us, feed us, shelter us, teach and train us, sacrifice for us, and would lay down their lives for us. If we cannot honor our parents whom we can see and touch, we will not be able to honor God who is more difficult to comprehend and appreciate.

Ephesians 6:1-4

“Children obey your parents” (v.1).

Some people believe that even adult children are obligated to obey their parents.

What evidence can you find in these verses to support or reject this interpretation?

The word for children in these verses means a young person still dependent upon parental support because fathers are instructed not to exasperate them but to bring them up (to raise them) in the training and instruction of the Lord. Independent adult children are free to make choices that affect their own lives and are therefore not responsible to obey, but they are responsible to honor.

1 Timothy 5:1-2

Disagreeing respectfully.

Would you harshly rebuke someone you respected and honored?

Why would this be considered appropriate or inappropriate?

If you disagree with your parents, how should you respond? (Hint: Read 1 Timothy 5:1 in other translations.)

Is it always necessary to respond?

Matthew 15:3-9

Honoring is done with a sincere heart. Genuine honor comes from the heart and not just an obligation. When something is an obligation, it becomes a chore instead of a joy, and most people find creative ways to avoid doing tasks they do not enjoy. An example of this is found in the words of Jesus in Matthew 15:3-9.

These people were dedicating money to God at the expense of their obligation to support and honor their needy parents.

What might the people who were doing this have gained by giving money to God while neglecting the care of parents?

Personal response.

Personal response.

You should appeal to your parents with respect, being careful not to treat them with contempt or disrespect even when they are clearly wrong.

We certainly do not have to respond to everything. Save your energy for the important issues.

They could boast about their generosity and avoid their obligation to their parents.

They lost sight of the fact they were breaking one of the basic commandments.

What do you think God expected them to do?

Personal response.

Application

Obviously, God places great value on the relationship of parents and children, and children have an obligation to honor their parents.

In 1 Corinthians 4:15, Paul appeals for respect from the Corinthian Christians based on his role as their spiritual father.

In Malachi 1:6, God appeals to His people to use common sense to recognize the fact that as the Father, He deserves and commands honor and respect. Any other response is considered unnatural.

Not all parents seem worthy of honor. In fact, some adult children have a difficult time finding anything honorable about their parents because they have suffered neglect and abuse from them.

Allow 20 Minutes

If there are people in the group who have parents like this, take time to pray for them that God will give them wisdom in how to respond. Assure them they are not to blame for the neglect or abuse and be sure they know that God understands their situation.

How are you showing your parents honor and respect?

Personal response.

How have you shown them contempt and disrespect?

Personal response.

Based on what you have thought about during this session, what are some very practical steps you can take to be sure your parents experience the honor that is due them?

List some ways you would like to honor your parents in the next month...six months...year.

Personal response.

What obstacles are you likely to face and how might you overcome them?

Personal response.

Personal response.

As you incorporate new ways of honoring your parents in your daily life, jot down the things you are going to do differently. Spend time in prayer and meditation asking God for guidance, direction, healing, and restoration of relationships. Then in a month or two, look back at your list and reflect on how God has answered your prayers and how you feel about the relationship you enjoy with your par-

Closing Prayer

Ask God to show participants if there is any way they are showing dishonor to their parents. Ask for guidance in showing them respect and honor. Ask for special wisdom in showing honor even when disagreeing. Thank God for every parent.

6Session The Role of a Caregiver

Introduction

Opening Prayer

Allow 10 Minutes

Sharing Question

Describe the various “hats” you currently wear (your roles in life).

All of us assume a number of roles. Throughout our lives, some roles come and go; others increase and decrease in the amount of attention we give them. Most of us right now are entering a phase in our lives when being a son or daughter takes more time and focus than ever before.

Group Member Devotional Reading prior to this session:

1 Timothy 5:3-4,8

2 Corinthians 4:8-10

Exodus 34:21

Mark 2:27

Personal response. Possible answers:

• Dad/mom

• Chauffeur

• Cook

• Housekeeper

• Real estate associate

• Husband/wife

• Sunday school teacher

• Son/daughter

If anyone in this group is caring for someone other than a parent, point out that this same principle applies.

Thank God for the participants and their desire to help their parents. Ask for wisdom for each one to be the kind of caregiver God wants them to be. Ask God to help them enjoy their parents and be a comfort to them. S elf-Awareness

What is a caregiver? According to the Family Caregiver Alliance (www.caregiver.org), “A caregiver is anyone who provides assistance to someone else that is in some degree incapacitated and needs help.”

The type of assistance and support people often need from caregivers includes the following:

• Advisor—Someone to offer recommendations to help them identify potential challenges, talk about concerns, and consider alternatives that may help to maximize their independence and quality of life.

• Advocate—Someone to look out for their best interests as an authorized agent (e.g., power of attorney) or as a concerned family member or friend, helping to ensure they get the information, care, support, and treatment they need and deserve.

Allow 20-25 Minutes

• Coordinator. Someone to arrange for services (e.g., professional caregiving, physical therapy, lawn mowing/snow removal, heating/air conditioning repair), schedule appointments, and coordinate deliveries.

• Evaluator. A person to assess their ability to live independently, handle their own personal care, manage medications, operate a motor vehicle, and more. Also, to identify and evaluate programs and services that best match the aging person’s needs and wishes.

• Mediator. Someone to facilitate communication among family members and others involved, resolving issues in a positive and helpful manner.

• Protector. A person who will step in and take charge when necessary to ensure their safety and well-being.

• Provider. Someone to provide assistance when they are not able to care for themselves due to physical or cognitive limitations. Assistance often addresses the following type of needs: Emotional—Listening and responding to concerns, providing encouragement and moral support, maintaining contact, and simply being there. Encouraging social interaction with others and productive activities.

Administrative—Balancing the checkbook, organizing bills, writing checks, and providing money to help cover expenses. Coordinating insurance coverage, Social Security benefits, and Medicare or Medicaid. Handling IRAs, pension plans, savings, etc. Coordinating estate planning (wills, trusts, and other legal documents).

Physical—Assisting with daily living including personal care, household chores, meals, driving, medication, etc.

Spiritual—Helping people find meaning and purpose in life, maintain hope, and find peace through Jesus. Praying with them and reading the Bible to them (and encouraging them to do so on their own if they are able).

Describe an area in which you feel strongly that your parents need help but have been unwilling to accept assistance. How are you dealing with their resistance?

Before someone takes on the role of caregiver, they must acknowledge that a loved one faces functional limitations and requires care—something many people would rather deny.

Since you are in this group, you have probably come to grips with the fact that your parents are at a point of needing assistance with some aspect of daily living.

Describe any struggles you have experienced in recognizing this fact and dealing with it—or with talking to other family members who are not ready to admit your love one’s needs.

Personal response.

Personal response.

It is unlikely your parents are going to ask you to step in and help. They may be having their own problems recognizing or admitting their needs. As we discussed, they are probably fearful of losing their independence and of losing control of their lives so it is vital that you and other family members be honest with yourselves about the need and begin getting involved.

As you do get involved, you may find yourself struggling with juggling the demands of work, personal life, and caregiving responsibilities. Dealing with the uncertainty that comes with each day is another ongoing challenge.

Following are recommendations for you as a caregiver:

Don’t overlook loneliness. Caregivers tend to want to help and feel the need to be doing something. Often your loved one may simply want you to be there—the ministry of presence.

Take care of you. Caregivers often face depression, anxiety, and personal health problems. Be careful not to overlook your own health and well-being by giving too much of yourself.

Seek information and support. Caregivers are often unprepared to deal with the many challenges and decisions they face. Take time to get information, skills training, and support. The “Resources” section at the end of this guide will give you a good start on finding help.

Deal with your emotions. Caregivers often struggle with seeing parents face physical and cognitive limitations. As you experience a wide range of emotions, be careful not to deny your feelings. Talking with others may help you accept and cope with loss.

Be prepared for conflict. Caregivers often experience conflict as they try to balance family, work, and community responsibilities. Also, family members may not agree on the care that is needed and who should be responsible for the individual roles and tasks. Be open, honest, and kind when talking with others.

Remember your source. Don’t get so busy with all you are doing that you neglect your personal time with God in prayer and reading the Bible. God is your source of comfort, strength, and wisdom. Spend more time with Him—not less.

Describe your own personal experience in one of these areas—your struggles and how you are addressing them.

Spiritual Awareness Lead–In

Every person has limits on how much stress they can endure at any given time. We don’t always have the internal resources we need to manage the demands we face. Caregivers often feel like the proverbial camel whose back will break if just one more straw is added to the burden.

Personal response.

Just as we all have varying limits on the amount of stress we can endure, we also have varying responses during times of intense pressure.

What are some of the responses you have had when your life felt out of control and things were just too much for you?

Sometimes it feels as if fulfilling our responsibilities will mean that our own body, soul, and spirit will be permanently harmed. While it is true that there are brief periods when we will be highly stressed, most of the time it is possible to achieve a place where we can enjoy a full life. Remember, Jesus said, “I have come that they may have life, and have it to the full” (John 10:10).

piritual-Awareness

1 Timothy 5:3-4

Caring for our own family is a spiritual privilege and obligation. The Bible speaks to the responsibility to care for one’s own family.

The word repaying is used to describe the child’s responsibility to parents and grandparents and carries with it the meaning of giving to our loved ones what they gave to us. In most cases, parents sacrificed, nurtured, and did for us things we could not do for ourselves. This is a serious commitment and duty that most are honored to fulfill.

1 Timothy 5:8

The believer has specific instructions in this verse.

Who should be top priority?

James 2:15-16

What future needs do you anticipate you will be called upon to fulfill for your loved ones? How well-equipped are you to help?

Responses could include shutting down, depression, anger, hopelessness and despair, ignoring the problem, becoming extremely busy, etc.

In addition to our obligations to parents and grandparents, most caregivers have responsibilities to children, spouses, employers, churches, civic organizations, themselves, and others—all competing for time and attention. Balancing multiple demands can seem impossible thereby creating internal conflicts and extreme stress. Sustained stress is exhausting and affects the ability to think clearly. There seems to be no escape, no relief, and no clear way out.

Allow 20 – 25 Min-

Although the needs mentioned in these passages are primarily physical, it is important to remember that people have social, mental, emotional, and other types of needs as well.

The immediate family.

Although the situation is different, we can begin to identify with the Apostle Paul’s feelings when he wrote, “We are hard pressed on every side, but not crushed; perplexed, but not in despair; persecuted, but not abandoned; struck down, but not destroyed” (2 Corinthians 4:8).

2 Corinthians 4:8-10

What four words are used in verse 8 to describe the stress Paul was feeling at this time? What pictures come to your mind when you think of someone experiencing what these words describe?

The words pressed on every side give a picture of someone fighting for his life in a confined area with no apparent way out.

Perplexed is someone facing sudden confusion and uncertainty, possibly due to broken relationships, danger, health problems, overwhelming circumstances, or other causes.

Persecuted is a word used to describe an animal being hunted, chased, and harassed.

Struck down means thrown to the ground.

Any of these situations described could cause someone to lose hope; but Paul understood that through God’s strength, nothing could ultimately overwhelm him.

Mark 14:33-34

As we can see in this passage, even Jesus felt overwhelmed at times.

What do you think could cause such intense distress and sorrow in the heart of the Son of God?

In order to survive, every person must achieve balance between fulfilling responsibilities and re-energizing the spirit, soul, and body. Caregivers must recognize their limits and honor God by setting limits on their work and taking time for rest.

Sabbath is a Hebrew word meaning to cease or desist. It is a day that is given to rest and remembering God so that our bodies, souls, and spirits can be refreshed. It is a reminder of the eternal rest God has promised to His people.

Jesus was facing the hours when He would become the offering for the sin of all people and suffer the punishment due to all of us. It would be a time when God would turn His back on Him, a situation more horrifying than any we can possibly imagine.

Genesis 2:2-3

Do you see any significance to the fact that the concept of a day of rest in Genesis 2:2-3 appears so early in the Bible?

Exodus 34:21

In this verse, we see just how important it is to the Lord for us to observe a day of rest.

Caregivers are driven by many urgent needs that keep us from taking care of our responsibilities to God and ourselves.

In this part of the Bible, God is establishing order in His creation; and as part of that order, He makes the seventh day holy (set apart especially for Him). A time of rest is incorporated into the natural fabric of creation.

What do you notice in this verse that can help us keep our lives in perspective?

There are no more important tasks than planting and harvesting when your life depends upon farming. Even these tasks were not to take priority over the Sabbath rest unto the Lord.

Mark 2:27

What clarification do these words of Jesus bring to the concept of the Sabbath rest?

During His earthly ministry, Jesus was very much in demand. Caregivers are also very much in demand. Because so many people wanted His time and attention, He certainly needed times of personal reflection, rest, and refreshing.

Application

This topic of the role of the caregiver can be difficult to process. What do we do with the needs that are beyond our abilities to help? And what about children who are caring for parents who were not good to them when they were growing up? What if we are caring for someone who will never be pleased no matter what we do?

There are so many questions, and the list of “what if’s” and what may happen in future days can never be completely compiled. In all of this, caregivers can too easily lose perspective. Guilt, hope, resentment, exhaustion, joy, fulfillment, and other emotions can blur our vision of what is possible and right—to the point where we are just going through motions with no true goal in sight.

The Sabbath was made for man, and keeping it is for his benefit as well as honoring to God.

Allow 20 Minutes

Everyone needs a center for life that is unshakable and a relationship that is always dependable. There has to be a place where we can hide when life is overwhelming and a source of strength when our resources are depleted. There has to be somewhere we can find wisdom for the most difficult of decisions.

According to Psalm 32:6-8, where can we find such a resource?

In addition to protecting our core being, what does God promise to do in verse 8?

In verse 6, how are we told to approach God ?

Based on information in this session, what actions can you begin to take to help you in your role as a caregiver?

God Himself is the source of our protection and deliverance. In Him, we will never be overwhelmed by the fierce forces of life that surround us.

He instructs, teaches, counsels, and watches over us.

Through prayer.

How can we pray for you?

Closing Prayer

Personal responses. Personal responses.

Ask for a group member to conclude the group in prayer.

7Session Developing a Care Plan

Introduction

Opening Prayer

Sharing Question

Describe your favorite activity for rest and relaxation.

As you get more deeply involved as a caregiver, try to continue setting aside time for this activity!

Allow 10 Minutes

Thank God for His presence in the life of each participant. Thank Him for helping them as they seek the best ways to care for their parents. Ask Him to give them the wisdom to take care of themselves spiritually, physically, and emotionally. Thank Him that He cares about everything that concerns us.

Group Member Devotional Reading prior to this session:

Psalm 40:8

Psalm 25:12

Proverbs 1:1-6; 2:1-9

Luke 14:28-30

Philippians 2:3-5

Personal response.

Lifestyle considerations include issues like medical condition, functioning level (physical and mental), living environments, care needs, transportation, socialization, and nutrition. You may be dealing with questions like these:

• I don’t believe my dad is safe to drive, but he won’t admit it. I’m really concerned that my dad, an innocent pedestrian, or another driver might be injured; but what can I do?

• On my last visit to my parents, I could see they were not functioning well on their own.They seem to be getting their medications confused. Mom even left the stove burner on and forgot about it.They won’t move, and I live too far away to help much. What are my options?

Allow 20-25 Minutes

• My mom is still living alone. Her health is declining, and she has been diagnosed with dementia. She really should not be left alone, but I need to continue working full time. What are my options to providing care for her?

Describe one issue like these that you are facing and what you have learned up to this point.

In answering these questions, we will examine two major areas of concern:

Living environment—a place where a person physically resides. Some living environments include care as part of the arrangement (e.g., assisted living or nursing care center).

Care options—programs and services that help people with day-today needs. Care can be provided in a variety of living environments including a private residence, retirement community, hospital, rehabilitation center, or nursing home.

Although we do not have time to explore specific solutions to these and other challenges during this time, links to additional information are provided in the “Resources” section at the end of this workbook. With every question, I encourage you to pray for guidance, to research sources of community and medical help, and to get input from another caregiver or loved one. If your parents are competent, explore alternatives with them and, of course, with your siblings. We will be looking at some helpful communication guidelines in Session 10.

Living Environment

Evaluating and selecting a living or care arrangement, whether short-term or long-term, is a major decision. To help determine what might be best, begin with a clear understanding of current and anticipated needs. Consider questions like these:

• What is it about the current arrangement that is unsatisfactory?

• What are you hoping to accomplish by making a change?

• What specific concerns or limitations are you hoping to address by making a change?

Then carefully review and assess the various living environments and care options to identify the arrangements that best match your particular family situation.

Personal response.

Encourage people to keep this brief; otherwise, it could take up the rest of your group time. But it is good for them to have time to express the question uppermost in their minds and to hear other people express the same quandaries.

Describe options you have considered for your parents’ living environment.

If they have already made a change, how do you feel this change has affected their quality of life?

Care Options

Caregiving is something that usually comes on you gradually—a little help here and there, gradually moving toward more full-time care. Because of the gradual onset, it is easy to just “wing it” as you go; however, just as in every important undertaking, it is vital to develop a plan in order to do the best for your parents.

As a person’s care needs increase, the family may have to expend tremendous effort to evaluate the circumstances, determine the most appropriate and suitable alternatives, divide the responsibilities among themselves, and/or engage professional services. Even when you choose to use outside professional and care services, putting arrangements in place does not mean that everything runs on autopilot. Instead, someone needs to ensure things are done in an acceptable manner on an on-going basis. If there are issues that do not meet your satisfaction, you may need to take action to correct the situation or find a replacement or alternative solution.

One of the first steps in developing a care plan is becoming familiar with your parents’ current limitations and understanding any medical diagnoses that have been made and the prognosis. Then consider questions like these:

• What specific care or assistance is needed and anticipated?

• What is the availability of family members to serve as caregivers?

• What family members have special skills or training that could help?

• Who in the family will share the caregiving responsibility and who will take on the primary role?

• What are the designated tasks and responsibilities for each person?

• What outside services should we use?

Describe one of these issues that you have already addressed and the outcome.

Personal response.

Personal response.

Personal response.

Example:

After a number of discussions, our family decided that my brother would take on the primary role since he is the only one who lives near our parents. Each of us will

My sister and I divided the responsibilities for the care of our parents. I took the lead for our dad, and she took the lead for our mom. This way we were better able to address any male/female concerns. My sister also handled scheduling medical appointments and made most healthcare decisions. I took the lead in handling personal, financial, and legal matters.

Give some thought to the responsibilities for your situation and who can provide the needed assistance. If it ever seems as though you are doing all the work, ask your siblings for assistance. Quite often, siblings less active in the caregiving have no idea how much time and effort someone is spending providing care and support. If this is the case with your family, I encourage you to create a list of all the things you do on a weekly basis and share it with your family. Indicate things that you need help with, point out responsibilities that do not require physical presence, and ask for help. The communication guidelines in Session 10 will be helpful as you have family discussions to develop your care plan.

If there has ever been an imbalance in the distribution of caregiving responsibilities in your family, tell how it has been resolved (or how you are trying to resolve it).

In situations where your family is unable to provide the needed physical care, make sure you understand the care options that might be available in your area and decide which option(s) is best for your situation.

Regardless of whether care is provided by a family member, friend, or care professional, try to keep perspective on the following three “P’s”:

Purpose. A natural tendency of caregivers is to overcare for a loved one. Whenever possible, give encouragement and direction that enable your parents to complete tasks on their own. It is good to help only when help is necessary. Resist completing a task on their behalf even though you might be able to do it more easily or quickly.

visit on a regular schedule to give him some “time off.” Also, we are using my address as their mailing address for bills and such, and I am handling the mail and paying the bills.

Personal response.

Provide. Provide appropriate assistive devices that enable your parents to maintain their mobility (like a cane, walker, or wheelchair) and independence (use of hearing and vision aids, dentures, and other adaptive devices).

Preserve. Always provide care in a manner that preserves your parents’ dignity. The frustration and humiliation people often face as a result of losing ability and independence can be discouraging. Allowing your parents choice and participation in their care will help maintain their dignity.

Which of the three “P’s” has been a special challenge to you and why?

Spiritual Awareness Lead–In

As you certainly know by now, caregivers are called upon to make many decisions. Some of these decisions are very difficult and a few can be extremely unpopular with care receivers. When we make such important decisions, it is vital to know we are making the best possible choices, and it is comforting to know God can give us insight and direction in our choices.

If you have had an experience when you sensed God’s help with a difficult decision, briefly share your story with the group.

Spiritual-Awareness

Good decisions require time and thought, and God is pleased when we use our minds to make good decisions. Sadly, some Christians make decisions based upon impressions and feelings, believing they are hearing and obeying God. This can lead to unwise decisions with disastrous consequences.

Thinking about what you can do and making a sensible plan do not sound especially spiritual, but this aspect of decision making is mentioned throughout the Bible. Simply put, we should seek to make good decisions based upon biblical principles and common sense with our hearts open to God’s guidance.

Philippians 2:25-26; 1 Corinthians 16:3-4; Acts 15:22, 25, 28; Titus 3:12

These scriptures offer a few examples of this type of decision making.

Personal response.

Personal response.

Allow 20-25 Minutes

How would you describe the decision-making process in these verses?

In your opinion, is this type of decision-making process justified only for minor decisions?

The decision process does not seem complicated. They are decisions carefully made after careful thought, discussion, and openness to God’s direction.

Some of these decisions were extremely important and involved sensitive matters like finances and controversial issues such as whether or not nonJewish converts to Christianity would have to first become observant Jews.

Acts 14:27; 1 Corinthians 14:27; 16:9; 2 Corinthians 2:12; Colossians 4:3; Revelation 3:8

Another element of decision making is being aware of your circumstances. Because God sometimes leads us by opening doors of opportunity, we need to be aware of our circumstances. In verses such as those listed above, we find biblical examples of circumstances influencing decisions.

How likely are you to make a decision based upon the presence or absence of a clear opportunity?

What caution do we find in 2 Corinthians 2:12-13 regarding basing decisions only upon open doors of opportunity?

Do not assume that every open door is necessarily God’s will. One way God will confirm His will is with peace (Colossians 3:15).

Luke 14:28-30

Every decision we make carries some cost because to say “yes” to one choice means saying “no” to others. When the disciples were called to follow Jesus, they made a costly decision by saying “no” to their former lives and “yes” to following Christ. They could not have it both ways.

Jesus used this story in Luke to illustrate the cost of deciding to follow Him.

Personal response.

Even though there was an opportunity to preach in Troas, the open door of ministry did not distract Paul because his greater concern was to find Titus. The presence of an opportunity does not always mean it is God’s will for us to pursue it.

How do you see this illustration applying to caregiving decisions?

Proverbs 1:1-6, 2:1-9

The best way to make decisions that are pleasing to God is to immerse your life in a relationship with Christ. The right choices are more clear to us when we are studying God’s Word, listening to the voice of God’s Spirit, and being in close association with God’s people.

The book of Proverbs is a treasure of godly wisdom.

What advice do you see in these verses that can help us have confidence in the decisions we make as caregivers?

Every caregiving decision has an impact both on the caregiver and the care receiver. With each decision, you have to consider if the cost in time, money, wear and tear on your relationship, worry, guilt, and any number of other consequences is worth the benefit of the choice. Oftentimes the right decision carries with it the greatest cost.

Psalms 25:12, 40:8

Another consideration in making decisions is to desire what pleases God, not just what pleases us or our care receiver. These verses are just two of many promises God has given to those who desire to please Him.

In light of these verses from Psalms, would you agree or disagree with the idea that if a person truly wants to do God’s will, then that person will clearly know what God’s will is?

Proverbs 1:1-6 promises us wisdom, insight, discipline, the ability to do what is right and fair, and guidance. Proverbs 2:1-9 promises those who look for wisdom will find wisdom, guidance, and understanding and also will know what is right and just and fair.

1 Corinthians 4:4-5; Philippians 2:3-5

Making decisions that affect others is difficult because we always have to be aware of our motives in choosing one option over another. These verses shed some light on this aspect of decision making.

Does anything surprise you regarding the insight about motives and conscience in 1 Corinthians 4:4-5? What might we learn from Paul’s statements here?

Personal responses. Usually when a person is in tune with God, decisions will be more clear; but this does not mean that decisions will be easier because we are not always willing to do what we know we should.

Personal responses. Most people are surprised that a man who was as close to God as Paul could not even trust his own conscience to judge his

AHow important has the instruction found in Philippians 2:3-5 been in your decision making?

Other scripture verses such as Proverbs 15:22 and Colossians 1:9 emphasize the wisdom of enlisting the counsel and prayers of others.

motives. He was wise enough to understand how important motives are in pleasing God and how difficult they are to discern in ourselves and others. This should make us even more diligent in examining the motives behind our decisions.

Personal responses.

pplication Allow 20 Minutes

Caregiving decisions are not to be made lightly, but decisions will have to be made. God is never annoyed when we come to Him in faith and ask for wisdom. When we ask, He is willing to give it to us. James 1:5-7 makes this clear:

If any of you lacks wisdom, he should ask God, who gives generously to all without finding fault, and it will be given to him. But when he asks, he must believe and not doubt, because he who doubts is like a wave of the sea, blown and tossed by the wind. That man should not think he will receive anything from the Lord.

George Müller was a Christian pastor whose life spanned most of the nineteenth century. He was known for his close walk with Christ and his desire to follow God’s will. He personally lived what he taught, and God used him to provide excellent care for many thousands of orphans in a time when most of these children were terribly neglected. He depended totally on God’s supernatural provision; and even though he never solicited any funds, during his lifetime, the equivalent of $120 million( in today’s dollars) were donated to his work. (The George Müller Foundation website <http://www. müllers.org/cm/general/127> accessed on June 4, 2007.)

It is worthwhile to consider Müller’s instruction on how to listen to God’s leading when making decisions:

1. I seek at the beginning to get my heart into such a state that it has no will of its own in regard to a given matter.

2. Having done this, I do not leave the result to feeling or simple impression. If I do so, I make myself liable to great delusions.

3. I seek the will of the Spirit through, or in connection with, the Word of God.

4. Next, I take into account providential circumstances. These often plainly indicate God’s will in connection with His Word and Spirit.

5. I ask God in prayer to reveal His will to me aright.

6. Thus, through prayer to God, the study of the Word, and reflection, I come to a deliberate judgment according to the best of my ability and knowledge.

Which of the biblical elements of decision making do you normally follow when you have to make choices?

Closing Prayer

Personal response.

Pray for any participants struggling with difficult decisions and ask God to encourage every participant to seek God’s will in the decisions they must make.

8Session End-of-Life Planning

Introduction

Opening Prayer

Allow 10 Minutes

Thank God for our parents. Ask Him to help us communicate with them in love and to really hear their hearts. Ask for His help in addressing some of the more challenging end-of-life issues. Ask for opportunity to engage in faith discussions and to share Jesus if parents do not know Him.

Group Member Devotional Reading prior to this session:

Ecclesiastes 7:2-4

Genesis 47:29-31

Genesis 48 and 49

Sharing Question

Describe a positive character trait you possess that you credit largely to your parents’ influence.

Personal response. Examples:

• Honesty—my mom always told me that no matter what I’d done, I’d be in less trouble with her if I told the truth.

• Persistence—I guess I learned this from my father’s example. He never gave up when facing challenges.

Many parents do not want to talk about aging, long-term care, and death. They might be fearful of the future and what these things mean for them. They might also consider these matters to be personal and private, not to be discussed. But the heart of the matter is this: If they want their wishes to be carried out, someone needs to know what those wishes are.

If you are or anticipate being a caregiver for your parents, do you know their wishes concerning end-of-life care? What roles and responsibilities are they expecting you and other family members to assume? If you do not know, it is probably time for you to start ask-

ing some questions so you will be better able to honor your parents and provide support when the need arises.

While family discussions can often be challenging and uncomfortable, having what I refer to as “The Talk” enables family members to understand a parent’s wishes and gain points of view that may not have been considered.

Having an initial conversation or family meeting is a great start, but do not try to cover too much in a single conversation as you do not want to overwhelm your parents. It might be helpful to think about these talks as peeling back the layers of an onion. Think about the few key questions you might have as you get started. Then as you have the opportunity to go deeper in the future, you can delve into other questions and concerns. The point of these talks is ultimately to understand your parents’ wishes and expectations. Everything else (e.g., inheritance) should be secondary.

What concerns you most in thinking about having “The Talks”?

Personal response.

Examples:

• That the family will end up in a squabble.

• That my parents will misunderstand our intent and feel as though we are “ganging up” on them.

What are some ways you might address those concerns?

Personal response.

Examples:

• Make sure that everyone, including my parents, understand the purpose of the meeting—e.g., to ensure they have completed some sort of estate planning and legal planning and to understand their wishes concerning those things; to understand and be able to carry out their health care wishes should they become incapable of making their own decisions.

• Plan for the adult children to meet ahead of time to discuss when to have the initial talk, who might be most appropriate to initiate the idea of having a talk, and what to cover in an initial discussion.

• Consider everyone’s input.

When you have “The Talks” there are many things to consider:

• Preferences when parents need help with daily living (e.g., expectations of children, move to an assisted living community, arrange for help to be provided in the home, move in with children).

• Ability to pay for care services—what financial resources (e.g., investments, income) are available to cover the expenses. (Some types of care may be too costly to consider.)

• Does the person appointed to make decisions on a parent’s behalf know that they are appointed to do so? Does this person have power of attorney (POA)? If parents reach the point of not being able to handle their own personal affairs and health matters without giving someone that authority, being able to act on their behalf with legal authority to manage their interests and care can be much more complicated.

• Location of legal documents (e.g., POA, living will, insurance policies, prearranged funeral plans, etc.). Preplanned funerals can help ensure that your parents’ wishes are carried out and also reduce pressure and uncertainties for the surviving family members when a death occurs.

• Special requests such as thoughts on medical treatments that may prolong life, organ donation, thoughts on heroics should resuscitation or other treatments become necessary.

In the “Resources” section at the end of this workbook, you will find links to more information about all these important aspects of endof-life planning.

What long-term care and end-of-life-planning issue have you found most difficult to address and why?

What ways, if any, have you found to overcome the obstacles to dealing with this particular issue?

Spiritual Awareness Lead–In

Given that every person has an appointment with death, it is amazing how many people die without wills, adequate life insurance, or clear instructions to their survivors about their final wishes. Perhaps the thought of death is so distressing that people naturally avoid making plans for the end of their lives.

For Christians, death is not the end of life—it is the beginning of an eternal adventure of indescribable wonder and joy. When we live our lives with our hearts in communion with Jesus, we are never quite at home here. Paul the Apostle understood this when he wrote this:

Personal response.

Personal response.

Personal response.

For to me, to live is Christ and to die is gain. If I am to go on living in the body, this will mean fruitful labor for me. Yet what shall I choose? I do not know! I am torn between the two: I desire to depart and be with Christ, which is better by far (Philippians 1:21-23).

Certainly a person who experiences the reality of the love of God through Christ has spiritual resources to face death that the person with no hope in Christ lacks.

Does your care receiver have the spiritual resources in Christ to discuss the end of life?

SIf not, what could be done to encourage them to establish or strengthen a committed relationship to Christ?

piritual-Awareness

Even though people want to avoid the topic, the Bible instructs us not to neglect thinking about death.

Ecclesiastes 7:2-4

Solomon gives some startling advice in this passage.

What are some of the benefits of always remembering that our days are limited in this life?

Personal response.

Personal response.

Death is the ultimate reality check. It focuses our attention like nothing else, and the Bible gives guidance on how to prepare for and face death. With God’s help and faith in His promises, we can face this event that is inevitable.

In the first book of the Bible, we have an example of how a man who loved God and his family engaged in end-of-life planning.

Allow 20-25 Minutes

Some responses may include:

• Remembering that life is precious and time-limited encourages making the best use of our opportunities to let others know we love them and treasure their love.

• To stay focused on eternity.

• To appreciate communion with God.

Genesis 47:29-31

What details in this passage indicate the strength of Israel’s desire that his requests concerning his burial be fulfilled?

What reasons do you think were behind his request?

How do you think Joseph might have felt about being asked to do this?

Israel understood the importance of absolute clarity when he talked to Joseph about his estate.

Genesis 48:3-19

In verses 3-6, what did Israel tell Joseph that might have surprised him?

He appealed to Joseph’s loyalty as a son, he made him swear, and he requested Joseph treat him with kindness and be faithful to him. There was no way Joseph could not understand the seriousness of this request.

He wanted to be buried with his people who had died in the land God had promised them. Perhaps he wanted to set a clear example to his sons and descendants that Egypt was not to be their permanent home, that they should not be absorbed by Egypt, and that they should long for their homeland and not grow comfortable.

Likely he was honored to be called upon to carry out his father’s wishes and perhaps relieved to know for certain what would please his father.

In verses 8-19, what other surprise did Israel reveal?

That Joseph’s two sons who were born before Israel came to live in Egypt would not be treated as Israel’s grandsons but rather as Israel’s own sons in the inheritance. Israel adopted these two children as his own sons. Any other children of Joseph’s remained his and for purposes of inheritance would be treated as descendants of the two sons adopted by Israel.

Normally, fathers would place their right hand upon the firstborn when offering a blessing thereby giving them a higher status. You might remember that Israel had tricked his own nearly blind father into giving him the blessing of the firstborn by impersonating his older brother. Israel made it clear that he intentionally chose Ephraim over Manasseh to receive the greater blessing.

Genesis 48:15-16

What precious gift did Israel convey to Ephraim and Manasseh?

What impact might this formal blessing have had on them?

What damage might have occurred to Israel’s family had he not announced these decisions before his death?

He included them in the covenant God had made with Abraham; and as a result, they received a priceless spiritual legacy.

All their lives they would be able to look back on this event and remember they were part of a chosen family with a rich spiritual heritage of following God and trusting Him to fulfill His promise to them.

Even though Joseph was not the firstborn of Israel, he had always been his father’s favorite. His brothers became so jealous of him they plotted to kill him but decided instead to sell him to the Egyptians as a slave. Even in his dying days, Israel favored Joseph; but the family was more willing to accept Israel’s wishes now because Joseph had rescued his entire family from a famine. However, if Joseph had just assumed his favored position in his father’s will, certainly the old jealousies could have torn the family to pieces.

In Genesis 49, Israel calls for his sons to gather around as he speaks his last words.

Do you think Israel was right to mention the failures of some of the sons in his last words to them?

Do you think parents are obligated to treat all their children equally when making end-of-life considerations?

A pplication

As you can imagine, end-of-life planning can be an emotional process. Raw emotions and attitudes such as fear, grief, anger, jealousy, resentment, and distrust can quickly surface between parents and children, among siblings, and among members of blended families. Even so, planning solves more problems than it creates.

When we lead by example, we have greater influence than when we simply offer advice or our personal opinion. If we believe that end-of-life planning is important for others, then it is important for

Personal response.

Personal response.

Allow 20 Minutes

us too. In preparation for any talk, our input will be taken more seriously if we have already done some planning for ourselves.

What plans have you made for the end of your own life?

Marketers understand that most people are moved to make decisions based on self-interest. If your parents have not made any plans or have not communicated their plans, begin to talk about the benefits that taking these actions will have for them.

What are the benefits to the care receiver of planning and making others aware of their wishes before they become incapacitated?

Personal response.

Do you think there are any ethical problems in using an appeal to a person’s natural self-interest?

• Caregivers will have a clear indication of the parents’ desires.

• Parents can have peace of mind that their wishes are know by those who may have to make decisions for them in the days to come.

• Through wills and personal conversations, parents have an opportunity to speak directly to their descendants.

• Parents can make their own decisions for their care by preplanning.

• Parents can communicate to their descendants the values they hold sacred.

Group members will have more responses.

Prayer prepares our hearts to enter into these talks. Our hearts are changed when we spend time with God. We are more open to hear His direction and follow His guidance when our thoughts are centered upon Him. Also, as we spend time listening to God, we can better understand our motives—whether we are being motivated by love for others or by selfish concerns. Spend much time in prayer for your care receiver, your siblings, and others who would be affected by the decisions that must be made; and whenever possible, spend time in prayer together with them.

As long as our motives in encouraging them to take action are unselfish, helping motivate someone to make such important decisions for themselves is a good thing.

What divisive issues among your siblings or other parties can you foresee? How can you address these potential problems before they occur?

Have you already begun the end-of-life conversations with your parents and with your own children? If so, what did you learn from the experience that might help others? If not, what are your plans to begin your dialog?

Personal response.

Personal response.

What things seem even more precious to you when you consider that we have a limited number of days to live?

Closing Prayer

Personal response.

Ask God to help us number our days, to help us plan for our own end of life, and to give us wisdom how to best communicate with our parents about these important issues.

9Session Forgiveness and Reconciliation

Introduction

Opening Prayer

Sharing Question

Describe a funny or pleasant event from your childhood that involved your parents.

Allow 10 Minutes

Thank God for the participants and their parents. Ask for His guidance and strength during this special period of time. Pray that family members will be sensitive to one another. Thank Him for being our perfect heavenly Father and for being concerned about everything that concerns us.

Group Member Devotional Reading prior to this session:

Proverbs 19:11

Matthew 6:15

Matthew 18:15

1 Corinthians 13:4-7

Forgiveness and reconciliation are at the heart of our relationship with our heavenly Father. God provided for our forgiveness through His Son, Jesus. If God, who is perfect, so desired to forgive us, how can we deny forgiveness to anyone?

Knowing that your parents’ days on earth are numbered, this is a good time to consider forgiveness and reconciliation from several perspectives:

• Forgiving your parents for any past abuses or hurts.

• Seeking your parents’ forgiveness for times you may have failed or disappointed them.

Personal response.

• Seeking God’s forgiveness for these failures.

• Forgiving yourself for past failures.

• Walking in forgiveness day-to-day.

Without going into detail about what your parents did, describe a struggle you have had in the past with forgiving them.

What helped you reach the point of forgiveness?

If you are still struggling with a forgiveness issue, describe what you think might be blocking your ability to forgive.

When God forgives, He wipes the slate clean. It is vital that you do the same with your parents—whether they have apologized or not. We must take two distinct steps: forgive and forget. Forgetting can be difficult; however, it is the Christ-like thing to do. It is important when a similar situation occurs in the future not to react based on memories but to act based on biblical principles. In other words, act—don’t react.

A clean slate is important not only for your parents’ offenses but also yours. You might find it easy to focus on things you wish you had done differently in your relationship with your parents. Don’t fall into the trap of limiting the quality relationship you can have with them now by feeling guilty about the past. Don’t dwell on regrets. Recognize what you could have done differently. If appropriate, ask your parents’ and God’s forgiveness and then move on to making this time with them as special as possible.

If you have tried in a Christ-like manner to mend the relationship and your parents do not respond, just continue demonstrating your love to them. Focus on doing what is right. Just as God’s grace and mercy are not a one-time thing, your actions and words should be consistent over time and not simply a one-time effort. Let your life reflect the loving, kind, and caring character God shows us each and every day.

Describe something you are sorry you did and something you are glad you did in your relationship with your parents in times past.

Personal response.

Personal response.

Participants should not focus on the details of how they were wronged but on the process of forgiveness.

Personal response.

Personal response.

During this phase of your relationship with your parents, you may find it easy to take offense at their words and behavior. Don’t let a simple word, tone, or memory spark conflict. Ask God to help you to focus on the positive, be sensitive to their needs, and respond in love.

Describe your struggles—and victories—in learning not to take offense easily.

Spiritual Awareness Lead–In

The most common Greek word in the New Testament for forgiveness carries the meaning of being pardoned or released from the penalty of our sins. God forgives us of our sin when we repent (regret our sins and turn from them) and believe that Jesus Christ suffered and died in our place to pay the penalty of our sin. When we become a follower of Christ, we are justified (God chooses to see us as perfectly acceptable as though we had never sinned), reconciled to God, and given a new life (Romans 5:8-11).

Which word in Romans 5:1-2 describes the state of the relationship between God and a Christian?

Personal response.

What would this kind of relationship be like?

Do you think this type of relationship is possible between two human beings? Why or why not?

The word peace describes this relationship. Help participants understand that peace is not simply the absence of open conflict. In this instance, it is a place of mutual friendship and love between parties that have no reason to quarrel. Also, peace is more than a feeling. Because of the death of Jesus in our place, there is nothing that is interfering with our relationship with God.

Personal response.

Allow 20-25 Minutes

piritual-Awareness

Jeremiah 31:34

In this verse, the prophet is talking about this new relationship with God through Christ.

According to this passage, how complete is God’s forgiveness?

Does the extent of this forgiveness surprise you?

We often hear that we should “forgive and forget” when we are offended. According to Scripture, it seems God does just that.

Do you think it is possible for us to do the same? Why or why not?

When God relates to us who are followers of Christ, He never thinks about our sins. Even though we remember them, God chooses not to. This certainly is surprising to most people.

Personal response.

God has set an example for us.

Proverbs 19:11

Forgiveness is not a simple subject to study or to practice. There are minor and unintentional offenses we should just overlook.

Matthew 6:15

However, serious offenses should not be overlooked, and biblical principles need to be applied. One principle is found in this verse.

Because God knows all things, most people would say God is certainly aware of our past sins; but because of the sacrifice of Jesus, they have been forgiven. Because our sins are no longer a barrier between God and us, they are never mentioned to us again. It is not really reasonable to tell someone to forget a serious and deliberate offense committed against them. Some things are so painful they can never be forgotten. However, it is possible for us to choose not to use past offenses against those who harmed us.

Matthew 18:23-35

Jesus told this story of a servant who owed his master more money than he could earn in 164,000 years. The master demanded he pay the money, but the servant begged for mercy and the debt was forgiven. That same servant was owed about three months’ wages by another servant; and when the debtor could not repay him, he had him thrown into prison. When the master heard this, he had the servant whom he had forgiven thrown into prison too for being so wicked and ungrateful.

Who do the characters in this story represent?

What is the principle you see taught in this story?

The master represents God and the first servant represents those whom God has forgiven of their sins.

God has forgiven Christians for our many sins; and when we are offended, we should be willing to do the same.

Forgiving may not be easy.

The New Testament urges us to forgive one another: “Bear with each other and forgive whatever grievances you may have against one another. Forgive as the Lord forgave you” (Colossians 3:13). But if we just go around casually saying the words “I forgive you” to every offense, our relationships with each other become phony and superficial. Admitting our fault is not an easy task and neither is forgiving those who harm us.

Matthew 18:15

What does this verse tell us to do when someone offends us?

Tell the offender privately and try to settle the matter privately.

What is the hoped for outcome of this encounter?

Why would you not wait for the offender to come to you first?

That if there is an offense, there would be repentance, forgiveness, and reconciliation.

Many times the person is unaware they have offended us.

Luke 19:1-9

This is a story of a person who had made a good living by cheating people. When he met Jesus, he admitted his sin, gave half his wealth to the poor, and restored those he had stolen from with four times what he had taken from them.

Do you think Zacchaeus was trying to buy his forgiveness?

What did his actions prove to the community?

Forgiveness is a continuing choice.

Forgiving someone is not usually accomplished with a one-time choice, especially when we are related to the person we are forgiving. In day-to-day contact, we will be reminded of past offenses many times by comments, actions, or attitudes of the offender. We will be tempted to be influenced by the past and use it against them.

1 Corinthians 13:4-7

These verses describe how love behaves.

Which aspects of love mentioned in these verses could be applied to the problem of forgiveness?

His response seemed to be a spontaneous act of repentance and restitution and not an attempt to manipulate Jesus.

His sincerity and that his commitment to change was more than words.

How does each one apply?

Each of the aspects can be applied to forgiveness, especially patience, kindness, politeness, selflessness, not easily angered, hope, perseverance, and not keeping a record of wrongs.

Help the group apply each one to the problem of forgiveness.

If you need forgiveness

“Therefore confess your sins to each other and pray for each other so that you may be healed. The prayer of a righteous man is powerful and effective” (James 5:16).

• Commit to making restitution or another method of making amends.

• Arrange the right time and setting when you can be uninterrupted and not distracted.

• Admit you were wrong and apologize without making excuses or shifting blame.

The Lord said to Moses, “Say to the Israelites: ‘When a man or woman wrongs another in any way and so is unfaithful to the lord, that person is guilty and must confess the sin he has committed. He must make full restitution for his wrong, add one fifth to it and give it all to the person he has wronged’ ” (Numbers 5:5-7).

• Do not put the person you offended on the spot by asking them to say they forgive you. It is enough to take full responsibility for what you did and express regret for your offense. If forgiveness is to be sincere and not superficial, it may take time for the offended party to work through their hurt and be willing to let it go. Making sincere amends gives evidence of your sincerity.

• Offer to talk about how to reconcile and restore the relationship with the offended person if and when they are ready but do not demand any response from them. It is only reasonable to think they might want to see if we are sincere in our sorrow by observing if we are true to our words of sorrow over time and not just for the moment.

At which of the above steps do you see the process of seeking forgiveness usually breaking down? Which step would be the most difficult for you?

If you need to forgive

“If your brother sins against you, go and show him his fault, just between the two of you. If he listens to you, you have won your brother over. But if he will not listen, take one or two others along, so that ‘every matter may be established by the testimony of two or three witnesses.’ If he refuses to listen to them, tell it to the church; and if he refuses to listen even to the church, treat him as you would a pagan or a tax collector” (Matthew 18:15-17).

• Understand and own the impact of how you have been offended. Was the offense intentional? Was it minor? Would it be best just to overlook it, or is it serious enough to confront?

Allow 20 Minutes

Personal response.

• Go to the one who offended you and express your grievance without attacking them or demanding a response. Follow the steps found in Matthew 18:15-20.

• Be willing to hear an apology and to forgive as Christ has forgiven you. See Colossians 3:13.

• Reconcile if possible and to an appropriate level. The perfect outcome of forgiveness is reconciliation, but it may not be possible to restore the relationship to where it was before the offense. Good judgment is called for in cases of abuse and other dangerous offenses.

• Let it go—release the debt and do not use the offense as a weapon in the future. See Romans 12:21.

• If there is no apology, do not plot revenge or retaliation—release the offender and place it in God’s hands.

How will you react if there is no response from the person who has offended you?

Personal response.

Are there issues between you and those you are caring for that need to be forgiven and reconciled? How would you like the group to pray for you?

Closing Prayer

Personal response.

Divide into groups of three so that participants can pray for the needs just expressed.

10Session Communication

Introduction

Opening Prayer

Sharing Question

Tell about a time when you embarrassed yourself by speaking before thinking.

Allow 10 Minutes

Thank God for the perfect plan He has for each person. Ask Him to guide all the participants as they try to help their parents, especially when their good intentions are not recognized by the ones they love so much. Ask Him to give participants wisdom and a deep sensitivity to their parents’ needs.

Group Member Devotional Reading prior to this session:

Proverbs 12:25

Proverbs 16:24

Proverbs 17:14

Proverbs 18:21

Proverbs 21:23

Proverbs 25:11

James 3:5-6

Personal response.

We have all blurted out words we wish we could take back. In this session, we will be talking about some of the communication challenges for families of aging parents: communication among other family members as well as communication with parents.

S elf-Awareness Allow 20-25 Minutes

Caring for aging parents can bring about stressful situations—for your parents, for other family members, and for you. Good communication is vital to any relationship; but when faced with stress, people generally do not communicate their thoughts well. Later they often have regrets about things they did not say or something they did say they wish they had not.

As you communicate with your parents, try to keep these things in mind:

• Listen carefully—with your ears and with your heart—to what they have to say.

• Be willing to build trust slowly by demonstrating a sincere interest in your parents’ health and well-being. Your conversations should help you understand their wishes so that you will be in a position to honor and try to meet their expectations.

• Speak kind words accompanied by calm body language.

• Understand the fears underlying your parents’ resistance to your help and respond with compassion and gentleness.

• If conversations and stories seem to be repetitive, try talking about life instead of news, weather, and sports. Reminisce and talk about things from the past. Ask questions. Celebrate their life. If either of your parents is hard of hearing, turn off background noise, speak slowly, and pronounce your words clearly and carefully.

When do you find it most difficult to respond to your parents with love and patience?

Personal response.

Examples:

• When they criticize the things I am doing to help them.

• When they resist help from the family.

• When they persist in complaining about everything.

• When they will not follow the doctor’s instructions.

• When they expect me to be there every day—and often forget that I have been there.

Tell about a time when communication between you and your parents was especially pleasant and/or productive.

What do you think made it a positive experience?

Personal response.

Communication with siblings or other family members presents other challenges. As parents age, families often struggle in determining what needs to be done, how to do those things, and who should do them. Families are frequently faced with making difficult decisions on short notice. The stress from the short time frame can be tremendous. Now, introduce family dynamics and brace yourself.

Tensions and frustrations are likely to emerge; but whenever possible, try to avoid arguments. Sometimes families need to unite for the benefit and well-being of an aging loved one. Not doing so can tear families apart and burden loved ones. Seek God for His wisdom and strength.

Personal response.

Following are some suggestions to help your family communicate effectively and reach agreement.

• Focus more on facts and less on feelings.

• Accurately define the issue before you begin working toward a solution.

• Focus on the needs—the things that are essential to your parents’ health, well-being, and safety. Be sensitive but do not get sidetracked by “wants” (expressed by your parents, your family, or yourself) when they are not in your parents’ best interest.

• Together, assess the options. Align your parents’ prioritized needs with the available options to find the solution that delivers the best match.

• Listen with an open mind.

• If disagreement continues regarding a particular matter, consider whether or not it is worth the conflict. It might be better to drop the issue before a dispute breaks out.

• Avoid misunderstandings. If you disagree with something another family member has said, first clarify that you understood correctly. “If I understood you correctly, you are saying…” Try to understand their perspective.

• Do not expect others to read your mind. Express yourself honestly and clearly.

• Do not avoid difficult issues. Avoidance tends to build up resentment, and people become further entrenched in their position and beliefs. Much of this can be avoided just by talking.

• Remember that the ultimate goal is not whose ideas are used but rather doing what is best and necessary for your parents.

• Pray before discussions—either privately or, if everyone is agreeable, as a group. Ask God to open minds and soften hearts as He impresses upon everyone His wishes and will.

Without assigning blame, describe one of your family’s greatest communication challenges. Personal response.

Describe any ways you have found to facilitate communication.

Personal response.

Spiritual Awareness Lead–In

In their book, Encouragement: The Key to Caring, Drs. Larry Crabb and Dan Allender wrote the following: “The essential fear that is locked deep in the core of fallen people is the fear of insecurity (rejection) and insignificance (loss of value)”(p. 107).

Can you describe an experience you have had with either of these essential fears?

Personal response.

SHow do you imagine that either of these fears might intensify with age?

piritual-Awareness

Listening is vital.

One of the greatest gifts you can give another human being is to listen to them and take them seriously. When we fail to listen to others, we feed those core fears of rejection and loss of value. Listening is a skill that has been lost in a fast-paced and media-saturated society. Excess input from too many sources distracts us and makes us deaf to our loved ones. When we fail to invest the time and effort to listen, they feel rejected and lose their sense of personal significance.

James 1:19

Poor listening can cause misunderstandings among family members, possibly igniting conflicts.

Listening is more than hearing. The Chinese character that represents the word listen symbolizes four aspects of good listening habits: listening thoughtfully with our ears, observing carefully with our eyes, comprehending the emotion, and giving undivided attention to the speaker. When any one of these elements is neglected, we lose our ability to truly understand and the speaker will sense we are not valuing or taking them seriously.

Personal response.

Allow 20-25 Minutes

The book of Job is the story of a man who is going through a time of extreme stress. Most of the book is about the conversations between Job and the men who are trying to comfort him as he tries to make sense of the string of misfortunes he has experienced.

Job has this to say to those trying to help him.

Job 13:17, 21:2

What consolation does Job seek from his friends?

He wants them to listen to him.

How do you think that having someone to really listen to you can help?

• It helps us to clarify our thinking about our situation.

• It lets us know someone cares enough to take us seriously.

• It calms and comforts us.

• It assures us we are not alone.

Job 16:1-5

Job’s friends try to help him, but their words only make his misery worse.

What does Job find to be most unhelpful from his friends?

Job 32:11-12

Another man, Elihu, joins the conversation with Job. What aspects of good listening skills can you find in the remarks of Elihu?

They are arguing with him, blaming him for his problems, criticizing him.

Words have an incredible power to heal and to harm.

The words we speak are more powerful than we can ever imagine. Measuring what we say to fit the circumstance is one of the most important communication skills anyone can develop. The following Bible passages speak to this and to the fact that our speech can bring terrible harm to ourselves and others.

• He patiently waited without interrupting while Job spoke

• He listened carefully to Job’s words and followed his reasoning.

• He never quit paying full attention to Job even when Job was at a loss for words.

Proverbs 18:21; James 3:5-6

Can you remember a time when your words brought unintended harm to someone?

What lessons can you gain from your experience?

Proverbs 12:25, 15:4, 16:24, 25:11

In contrast to the harm that can be done by our words, these verses speak of the healing power of our words.

So much that happens in life is unintentional, especially in how we speak to others. When we are aware of the powerful healing influence words can have, it is only natural to want to change our speech so that our words help those we meet every day.

What are some small changes you can make in your conversation style that could bring greater encouragement to those around you?

Proverbs 17:14, 21:23

Indiscreet words create quarrels.

Too often, quarrels between family members start with careless or unkind words. Once the initial damage occurs, it is difficult to control the conflict that follows. The stress of caring for a parent can emotionally charge family members to levels where a word can trigger an all-out conflict.

What can we do to prevent unnecessary conflicts among family members?

Personal response. Personal response.

Personal response.

Be aware of the stress levels of others and ourselves, use encouraging words, use empathy with other family members, think before speaking, initiate a conflict only if it is essential.

Application

This session is closely tied to the concepts of empathy and honor which we discussed in earlier sessions. If we are to be able to communicate meaningfully, it is important to get below the level of mere words and techniques. It is important to be able to touch the souls of those with whom we are communicating, but we can never touch people deeply if we do not to pay attention to their needs.

We see in Ephesians 4:29-32 that meaningful communication understands the needs of others.

According to verse 29, how should the needs of other people affect the ways we speak to them?

Allow 20 Minutes

Identify and write down some of the needs of your parents or other loved ones you are helping and share a few of these with the group.

The words that we speak should be tailored to the needs of those who hear them so that they will be strengthened and helped.

Personal response.

How are you helping to build up and benefit your parents with your words? Share a specific example, if possible.

Personal response.

Can you identify a pattern of speech or conversation that does not convey compassion and fails to benefit your parents?

What steps might you take to change this pattern?

Closing Prayer

Personal response.

Personal response.

Ask God to help each person be more wise and sensitive in communicating, especially with parents and other family members.

11Session A Legacy of Memories

Introduction

Opening Prayer

Sharing Question

What do you do with family photos?

S elf-Awareness

Most of us are busy people, wearing multiple hats and forever feeling there are simply not enough hours in the day. With all this busyness and even with the capabilities the new electronic gadgets offer, many of us do not spend adequate time capturing memories. Then something happens and it’s too late. I encourage you to think about things you might do, starting today, to build a legacy of memories.

Allow 10 Minutes

Thank God for our parents. Ask Him to help us make the most of our remaining time with them. Thank Him for the group participants and their desire to care for their parents. Pray that He will fill them with His peace and that He will encourage and strengthen them.

Group Member Devotional Reading prior to this session:

Psalm 78:5-8

Ezekiel 18:14-20

John 15:9-17

Personal response. Examples:

• Throw them in a drawer.

• File them by date or subject to deal with later.

• Put them in albums.

• Make scrapbooking pages.

It is easy to take photos these days. With digital cameras, we see instant results. With cameras in our phones, we are ready to take a picture anytime, anywhere. Photos are fun, but they are also a wonderful way to help build a legacy of memories.

Allow 20-25 Minutes

Consider how you can make the most of the time you spend with your parents. You may find that many of your conversations with them center on news and weather as opposed to life issues.

What are most of your conversations with your parents about?

Personal responses.

Examples:

• How they are feeling.

• Upcoming doctor appointments.

• The most recent ball game or other sports event.

• What my children are doing.

• Politics.

Sadly, many of us simply never take the time to tap into the wisdom and life experiences of loved ones. Spending time with your parents reminiscing about the past can be a most rewarding experience. Let them share what life was like before television, VCRs, Velcro, microwave ovens, computers, and fast food. Ask what it was like living during the Great Depression and the years that followed. Take some trips down memory lane with them. Reminiscing about the past and sharing fond memories can be great therapy—for you and them! Celebrate their life as you talk about it. And don’t trust your memory. After each time of sharing, write down what you learned.

While it is natural to think you know a tremendous amount about your parents’ lives, remember that you were not yet alive during their first twenty or thirty years; and then once you were born, you were too young to recall any details or specifics. The time you have spent with your parents represent only a part of their lives. Taking time to learn more about them will honor them, give you more insight into their lives, and give you an opportunity to glean from their wisdom and experience. It will also be a joyful time of communication—building memories you will cherish.

Following are some sample questions you might want to ask during some of these sharing times:

• What is something that you always wanted to do but never have? Why?

• What is something specific you vividly remember doing as a child?

• What are some of your school memories?

• Who were your best friends at different stages of your life?

• Where are all the places you lived?

• How did you meet each other? Was it love at first sight?

• What do you remember most about dating each other? How long did you date? What kinds of things did you do on dates?

• What is one thing you regret never doing?

• What is most valuable lesson learned in life?

• What is something you would like to be remembered for?

• How did you come to know Jesus?

• What are some of the things you have learned in your walk with God?

• Food.

Describe something you have already learned about your parents during their earlier years—and how this knowledge makes you feel.

It is also important to communicate freely your feelings of love for your parents. Once they have passed, it will be too late to tell them how much you love them and how you appreciate them and all the things they have done for you throughout your life. All too often in this fast-paced world, people take things for granted. Many families fail to speak the love they feel. Make sure you say what is in your heart before it is too late.

If your parents have antiques, collectibles, or other items of sentimental value, be sure to ask about the history, significance, and even value. What is the story behind each item? As you learn these details, write them down. Make sure you will have all the background to pass on to your children.

I was fortunate to receive a few special items from my father, including a watch he received when he graduated from law school and a painting he received from a dear friend. Unfortunately, once he passed away and I attempted to share the significance, I found myself unable to recall the specifics around both items. I am now frustrated to realize I will be unable to share the heritage with my kids. It would have been so easy to write down what he told me.

I encourage you to share your thoughts and feelings while you can. Capture memories on film and on paper and create a legacy that can live on for future generations. Start capturing special memories today and make every interaction count!

Spiritual Awareness Lead–In

Dysfunctional interactions between parents and children are common, especially during the turmoil of adolescence. Sadly, even when children become adults, the relationships between parents and children often fail to mature. In these cases, children cannot see parents as vulnerable human beings, and parents fail to treat their children as friends and equals. These sad circumstances prevent interaction between parents and children that would enrich their lives.

Examples: • I really enjoyed hearing about my parents’ courtship—it helped me see them as “real people.” • Hearing my dad tell me about his early business struggles made me appreciate him more as a provider and respect his boldness and creativity in building the business.

These few lines from the lyrics of “The Living Years,” a song by Mike and the Mechanics, reflect on the tragedy of missed opportunities for emotional intimacy between parent and the adult child.

Every generation

Blames the one before

And all of their frustrations

Come beating on your door

I know that I’m a prisoner

To all my Father held so dear

I know that I’m a hostage

To all his hopes and fears

I just wish I could have told him in the living years

The time we spend providing care for a loved one is an opportunity to deepen our relationship because there are reasons for our conversations to be more personal and intimate. The caregiver can become a close friend to the elder being served. If the care receiver is a parent, there is an opportunity for friendship that moves beyond the parent-child relationship, and these friendships make life more deeply satisfying.

Given the choice between wealth without friends and friends without wealth, which would you prefer?

S piritual-Awareness

John 15:9-17

As Jesus neared the time of His crucifixion, He spoke to His disciples as a friend to friends. These words of Jesus are recorded in this passage.

What two words does Jesus repeat in these verses that describe His feelings for the disciples?

Personal response.

Allow 20-25 Minutes

Describe the impact these words had upon you and what they might have had on the disciples who heard Jesus speak them directly.

Ask a group member to read these verses to the group as they sit with closed eyes imagining they are hearing the voice of Jesus.

Love and friends.

Personal response.

How does Jesus distinguish between a servant and a friend? What does this distinction say about the new relationship?

A servant does not have an intimate knowledge of the master’s life or plans. A friend is trusted with more intimacy.

We use the word friend casually, but obviously Jesus did not. In His mind, friendship requires self-sacrifice.

What implications for relationships between friends can you see in verses 12-13?

Caring for your loved one probably will not involve sacrificing your life but will likely require self-sacrifice. Helping with physical needs can be challenging, but serving to meet emotional needs requires an even higher level of commitment. We may have to move beyond some of the hurts of the past in order to become a friend. For many reasons this may not be possible, but it is worth trying.

Would you consider your caring relationship with your loved one more of a duty to be fulfilled or a labor of love built on a mutual friendship?

If you cannot attain friendship with your loved one, do not beat yourself up but be open to the possibility of its occurring at some point in the caregiving relationship. Sometimes when we treat people as friends, a friendship develops spontaneously.

Friends care about meeting one another’s needs. Physical needs such as food, shelter, water, and safety are essential. But after these immediate needs are satisfied, the deeper needs of the soul take priority; and these are satisfied only through contact and interaction with God and people who care.

One of the greatest needs of the human heart is the need for significance. People want to know they count for something and that their lives have meaning. They want to know they are loved and accepted even when they act and feel unacceptable. There are some practical ways we can help with this need.

How might you help your loved one fulfill these soul needs?

We are called to love each other with the same intensity Christ loved us even if it costs us our lives.

Personal response.

Responses may include listening, spending time together, expressing how the person’s life has influenced you positively, being available with emotional support and remembering that the busyness of life is not as important as spending time together, talking about good times spent together, praying together.

Every life is important, and reflecting with our parents and loved ones about their life stories will help them with their need for significance. When we know that every life matters to God, we can see how He has given us a story that is worth preserving. This story can be handed down to subsequent generations that will long to know the life stories of their ancestors. Capturing these memories can create wonderful opportunities to share your feelings, express joy and sorrow, resolve past conflicts and misunderstandings, find answers to nagging questions, and strengthen relationships.

Which of the following methods of documenting the life stories of your parents would be the most useful to you? What other ideas

• Looking at photos, videos, scrapbooks, etc., and reminiscing together.

• Talking about your parents’ lives before you were born, how they met, their schools, earliest memories, best memories, most difficult experiences, etc.

• Telling them what you remember most, the best times, what you learned from them, what you appreciate about them, etc.

• Asking them questions about how they viewed you at various stages of life.

AEvery parent will leave an inheritance to their children—some valuable and others not. And money is not the most important thing a parent can leave to offspring. The most valuable inheritance is the godly legacy left by a parent who loved God.

Unfortunately, not every parent leaves such a wonderful legacy, but this does not necessarily mean the child is left spiritually poor. For instance, the son in Ezekiel 18:14-20 did not inherit a rich spiritual legacy.

It is often said that God has no grandchildren.

In your opinion, do these verses in Ezekiel support this sentiment?

Allow 20 Minutes

How might the son have reacted to his father’s example and why?

Personal response. God is holding each generation accountable for its own choices.

He could have followed his father’s example and lived an unrighteous life. He could have used his father’s example as an excuse for his own sin.

In spite of all the negative influences, this man chose to do what was right and began to build a spiritually rich legacy for the next generation; and a legacy of godly example and fond memories provides powerful motivation for future generations to serve God.

Personal response.

pplication

Psalm 78:5-8 tells the importance of passing on a rich spiritual legacy.

How would you describe the spiritual legacy you received? If you have children, what type of spiritual legacy do you hope to leave for them?

If you are not happy with the spiritual legacy you will be leaving, you can begin investing in a new legacy by following Christ. If your parent or loved one has no godly spiritual legacy, they can also begin to set a godly example and leave valuable memories. It is never too late to begin.

The Bible is clear about the bad news that everyone has offended God and stands in need of God’s grace and forgiveness; but the good news is that God loves everyone, even people who have not honored him, and He wants to be friends with those who will admit their shortcomings, ask His forgiveness, desire to serve Him, and accept His gift of a new life that is made possible by the sacrifice of His son, Jesus Christ. A lifetime of offending God can be forgiven in an instant if a person will make a sincere commitment to Christ.

The Bible has a lot to say about living a life that pleases Him, but following are a few verses that will help you begin your new life or guide you in a discussion with your parents at the appropriate time.

Personal response.

Eternal life is found in having the Son of God, Jesus.

1 John 5:11-12

“And this is the testimony: God has given us eternal life, and this life is in his Son. He who has the Son has life; he who does not have the Son of God does not have life.”

Everyone has disobeyed God and needs God’s grace and forgiveness.

Romans 3:23

“For all have sinned and fall short of the glory of God.”

Ephesians 2:1-2

“As for you, you were dead in your transgressions and sins, in which you used to live when you followed the ways of this world and of the ruler of the kingdom of the air, the spirit who is now at work in those who are disobedient.”

We cannot become reconciled to God by our own good works.

Ephesians 2:8-9

“For it is by grace you have been saved, through faith—and this not from yourselves, it is the gift of God—not by works, so that no one can boast.”

Titus 3:5-7

“He saved us, not because of righteous things we had done, but because of his mercy. He saved us through the washing of rebirth and renewal by the Holy Spirit, whom he poured out on us generously through Jesus Christ our Savior, so that, having been justified by his grace, we might become heirs having the hope of eternal life.”

We are reconciled to God and have eternal life through Jesus Christ.

John 17:3

“Now this is eternal life: that they may know you, the only true God, and Jesus Christ, whom you have sent.”

Romans 5:1

“Therefore, since we have been justified through faith, we have peace with God through our Lord Jesus Christ.”

God offered His Son, Jesus, for us so that we could be forgiven.

Romans 5:8

“But God demonstrates his own love for us in this: While we were still sinners, Christ died for us.”

2 Corinthians 5:21

“God made him who had no sin to be sin for us, so that in him we might become the righteousness of God.”

When we believe in Christ and accept His sacrifice for us, our relationship to God is restored and we receive eternal life.

John 1:12

“Yet to all who received him, to those who believed in his name, he gave the right to become children of God.”

John 3:16-18

“For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life. For God did not send his Son into the world to condemn the world, but to save the world through him. Whoever believes in him is

not condemned, but whoever does not believe stands condemned already because he has not believed in the name of God’s one and only Son.”

What about these verses means the most to you?

Personal response.

Have you ever made a personal commitment to be a follower and believer in Jesus?

Closing

Prayer

Personal response.

Pray for the needs that have been expressed throughout this session.

12Session The Streets of Gold

ntroduction

Opening Prayer

Sharing Question

Tell about one way you have been helped during these group sessions.

Allow 10 Minutes

Thank God for each participant’s faithfulness to the group sessions. Thank Him for the encouragement, comfort, and hope He has given. Thank Him for His guidance in caring for your parents. Ask for His presence as you discuss the final chapter in everyone’s life.

Group Member Devotional Reading prior to this session:

Psalm 16:15

John 4:1-4

1 Corinthians 13:9-12

Hebrews 2:14-15

Revelation 21:1-6, 22-27

When a person faces the reality of death, family members often start to reprioritize the things they do and the ways they spend their time. For most people, dying is a process. Deterioration can be slow or rapid. People are said to handle death in the same way they approach life. Some people want to isolate and approach death in a private manner while others want to be surrounded by loved ones. Some may be more reserved, others more expressive. There is no right or wrong way. It is up to the person who is dying. When your parents reach this point, it is important to let them die with dignity.

Personal response.

During this final group session, it seems fitting that we spend some time talking about the final chapter in every person’s life.

I lost both of my parents in the last ten years. As I look back on my caregiving experience, there are many things I would have done differently had I known better. I also would have avoided one major regret: My dad had been fighting lymphoma leukemia for a couple of years. On his 79th birthday, he became rather delirious after catching what I thought was a common cold. The cold turned out to be pneumonia. Over the next two weeks, he became quite agitated and began doing and saying things I had never observed before. While I visited him each day, it was very difficult to see him restrained for his own safety. It got to the point where I just could not face him in that condition. It was too sad. While I never gave up hope that he would pull through, days later the doctor called to tell us he would not make it through the night. I chose not to be by his side because I was afraid of death, did not know what to expect, and just could not cope. That night he passed away. As I look back, I wish I had been by his side…holding his hand and telling him how much I love him and what a great dad he was.

As for our mother, she had been challenged by dementia for years. She lived in a marvelous nursing home that specialized in Alzheimer’s care and everyone there loved her. On Thanksgiving weekend of 2001, I got the call. She was deteriorating rapidly. When I arrived, it was apparent that many of her bodily functions were shutting down. She was on oxygen and was taking huge, gaspy breaths. It was then that I asked my family to leave the room for a minute so I could have some time alone with her. It was during that three or four minutes that I thanked Mom for a wonderful life. I reflected on a few fond memories; told her I loved her and always would; and then I told her it was okay, almost as if I gave her permission, to die. Finally, I told her she was going to a most wonderful place. She immediately began to breathe easier and within minutes, she died at the age of 70. Words cannot describe what a beautiful experience it was to see her released from her suffering. I only wish I had been by my dad’s bedside when he died.

I have learned that death is really not a frightening experience for believers. It is a passage from this life to a much better one. If your parents refer to approaching death, I encourage you to discuss it with them freely. Let them share their feelings. Read scriptures together about the joys and wonders of heaven. Speculate together what it might be like and talk about loved ones who are already there.

Describe some of the emotions and thoughts you experience when you think about your parents’ death.

Personal response.

As you and your parents talk about these things, be sure to share with them your appreciation for the legacy they are leaving you— not so much any physical things you may be inheriting but character traits that have developed in your life as a result of their influence. Reminisce about times when a word, a touch, an act from them touched you in a special way.

What are some things you would like to share with your parents about how their lives have influenced yours?

Spiritual Awareness Lead–In

Many circumstances work together to remind us that human life is temporary. In spite of our best efforts, the aging process is relentless and merciless, and everyone who lives will die. Not even the young are exempt from the reality described in James 4:14:

Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes.

Everything about this life is temporary, even the memory that we ever lived is erased in a brief time. How many of the billions of people who have lived are remembered? Even the most historic figures fade from public memory, a fact that is starkly worded in Ecclesiastes 1:11.

There is no remembrance of men of old, and even those who are yet to come will not be remembered by those who follow.

What is the impact of these thoughts on you? How have you or others you have known tried to cope with the temporary nature of life?

Personal response.

Some people become depressed, bitter, or angry when they feel the impact of this truth. Others are able to accept it more graciously. Some people pretend there is no end—they live only for today, they deny reality, they try to stay young.

piritual-Awareness

John 14:1-4

Aging and death are unsettling for those who live only for this life. But even those who believe in Christ can feel anxious when they think of moving from the known to the unknown. Jesus understood this human anxiety so He prepared His disciples for His own death with the words recorded in this passage.

How do you think most people imagine heaven to be?

Based upon these verses, what do you think is the most important thing about heaven?

Allow 20-25 Minutes

Those who follow Jesus and long to be with Him are never completely comfortable in this present existence. They yearn to be with Him and will not feel at home until they arrive in the place He spoke about in John 14:2.

When Jesus spoke these words to them, the disciples did not know that by dying, Jesus was about to destroy the power of death and bring freedom to those who are hostages to the fear of death.

Since the children have flesh and blood, he too shared in their humanity so that by his death he might destroy him who holds the power of death—that is, the devil— and free those who all their lives were held in slavery by their fear of death (Hebrews 2:14-15).

2 Corinthians 5:6-9

Have you ever known someone who lives the sentiment of this scripture? What do you think makes this possible?

It seems that few people today would say with Paul that they would rather be away from the body and at home with the Lord. Home is such a comfort word that it seems to be out of place when talking about dying.

When you think about the word “home,” what images come to mind and what feelings stir in your heart?

Usually people focus on physical aspects such as mansions, streets of gold, etc.

That we will be with Jesus, where He is.

Personal response.

Personal response.

For the Christian, Christ is our home. Since home is more about a relationship with Jesus than being in a particular place, the most important aspect of heaven is that we will be with Him. God loves us more than we can imagine; and when we are finally and fully in His presence, we will truly be home.

We spend time on earth pursuing many things, but the only things we can take into eternity are the relationships we build and the fruit of those relationships. Heaven will provide an eternity to experience the worship, presence, and fellowship of God and to enjoy friends old and new

Matthew 8:11; Hebrews 12:22-24

How would you describe the images that come to your mind when reading these verses?

Even though the most important aspect of heaven is enjoying our relationship with God and those we love, there will be other wonders there too.

Think about this.

God’s visible creation is so immense that it is impossible for humans to comprehend. For instance, our sun is only one of 200 billion stars in our galaxy which we call the Milky Way. In order to reach the nearest star to our sun, a space ship would take 70,000 years to complete the journey. If you were to travel from one side of our galaxy to the other at 186,000 miles per second (the speed of light), your journey would take 100,000 years. Now multiply this by the fact that there are believed to be at least 100 billion other galaxies in the universe and you get some idea of the vastness of God’s creation. These numbers and distances are more than we can imagine. And this is just the physical aspect of the universe.

1 Corinthians 2:9

It is no wonder then that the Bible speaks in this verse that “However, as it is written, ‘No eye has seen, no ear heard, no mind has conceived what God has prepared for those who love him.’ ” If the universe is indescribable, then it is no surprise that heaven also is inconceivable to the finite human mind.

Heaven will be a gathering of family that will be like no other reunion. We will see Jesus our Savior and fully appreciate His love for us that moved Him to die for us. It will be a place of greeting believers we have never known from other times and places, and we will renew relationships with those we already know. It is a festival gathering where God is honored and adored.

2 Corinthians 12:2-4

The Apostle Paul experienced a glimpse of heaven and attempts to describe what he saw in these verses.

Why might he have found it impossible to describe what he experienced there?

Have you ever had an experience that you find nearly impossible to describe in words?

Perhaps the experience just could not be described by using words, or maybe he was told not to reveal what he heard.

Personal response.

1 Corinthians 13:9-12

How does this passage of scripture describe our present ability to understand? How will the experience of heaven change this?

The experience of being in the physical and spiritual presence of Jesus will open our eyes to things we cannot even imagine. We will not see through dim eyes or be limited in our understanding...we shall fully know reality even as God fully knows everything about us.

Revelation 21:1-6, 22-27

The best description we have of heaven is in Revelation. Consider the scenes described in these verses.

Which image of heaven in these verses means the most to you and causes you to look forward to the day when you are there?

Personal response.

A pplication

Charlie Peacock wrote a song some years ago that spoke of his desire to live as if heaven is a real place (“Heaven Is a Real Place,” 1990). The teachings of Jesus and the writings of Paul emphasize that since heaven is our ultimate destination and our true home, we need to make choices in life based on the fact that our present life is a temporary delay in the journey to our eternal home.

According to Matthew 6:19-21, Colossians 3:1-4, and 2 Corinthians 5:1-4, how should heaven influence the way we live?

Allow 20 Minutes

How would your life change if you made every decision considering that heaven is our eternal home?

Heaven calls us to lay up treasures there, to set our hearts on it, to evaluate our priorities and how we spend our days, to see our lives in the present as temporary and in no way as wonderful as what we have coming when we are with Jesus.

There is a time for everything, including departing from this life. In 2 Timothy 4:6-8, Paul the apostle recognized this when he said, “the time has come for my departure” (v. 6). The word he used for departure means to lift anchor or to free someone from chains and let them leave.

When you read these verses, what is Paul’s attitude toward his impending death? Does he seem to look forward or backward?

Personal response.

Psalm 116:15 states that “Precious in the sight of the Lord is the death of his saints.” No follower of Christ dies without God’s taking special notice. No dying believer is leaving behind anything that can compare to what God has reserved for His children. The saying “Where there is life, there is hope” may be true for everyone; but for the Christian, this hope extends beyond life into death.

Paul is realistic, and he seems to know that his life is ending. He does not seem to be filled with self-pity or regret. He is looking forward to heaven.

How do the verses in Hebrews 11:13-16 and 1 Peter 1:3-4 challenge you to change the way you think and live?

How would your life be different if you were to live like heaven is a real place?

Closing

Prayer

Personal response. Personal response.

Pray for God’s comfort, strength, encouragement, and wisdom in the days ahead for each participant and their family.

The Plan of Salvation

Is there any good reason why you cannot receive Jesus Christ right now?

How to receive Christ:

1. Admit your need (that you are a sinner).

2. Be willing to turn from your sins (repent).

3. Believe that Jesus Christ died for you on the cross and rose from the grave.

4. Through prayer, invite Jesus Christ to come in and control your life through the Holy Spirit (receive Him as Savior and Lord).

What to Pray

Dear God,

I know that I am a sinner and need Your forgiveness. I believe that Jesus Christ died for my sins. I am willing to turn from my sins. I now invite Jesus Christ to come into my heart and life as my personal Savior.

I am willing, by God’s strength, to follow and obey Jesus Christ as the Lord of my life.

Date Signature

The Bible says: “Everyone who calls on the name of the Lord will be saved.” Romans 10:13

“Yet to all who received him, to those who believed in his name, he gave the right to become children of God.” John 1:12

“Therefore, since we have been justified through faith, we have peace with God through our Lord Jesus Christ.” Romans 5:1

When we receive Christ, we are born into the family of God through the supernatural work of the Holy Spirit who lives within every believer. This process is called regeneration or the new birth.

Share your decision to receive Christ with another person.

Connect to a local church.

References

Barg, Gary. The Fearless Caregiver. Hollywood, Florida: Caregiver Media Group, 2003.

Card, Michael (Vocalist). “Joy in the Journey.” Sparrow, 1994.

Crabb, Larry and Allender, Dan. Encouragement: The Key to Caring. Grand Rapids: Zondervan Publishing House, 1990.

George Müeller Foundation. www.Müllers.org

Gilbert, Bruce (Producer), and Rydell, Mark (Director). On Golden Pond [Movie]. Universal Pictures, 1981.

Mike and the Mechanics (Artists). “The Living Years.” The Farm Surrey. Atlantic (U.S.)/ WEA (rest of world), 1988.

Puchta, Charles. Biblical Caregiving Principles. Cincinnati: Aging America Resources, 2005.

_______. The Caregiver Resource Guide. Cincinnati: Aging America Resources, 2005.

_______. “Your Care Advocate Caregiving Series.” Available for download at http:// nursing.uc.edu/CareAdvocate/Publications.htm. University of Cincinnati, 2007.

________. “Your Care Advocate Getting Started.” Available for download at http:// nursing.uc.edu/CareAdvocate/Publications.htm. University of Cincinnati, 2007.

Wendell, Richard. The Second Half. Cincinnati: W.E.B Properties, Inc., 2005.

Zanuck, Lili Fini and Richard D. (Producers), and Beresford, Bruce (Director). Driving Miss Daisy [Movie]. Warner Bros, 1989.

Resources

Aging and Caregiving

Administration on Aging: www.aoa.dhhs.gov. Click on Elders and Families. 202-619-0724.

Aging America Resources Care Ministry: www.CareMinistry.com. Site of Charles Puchta (author of this group study). Alzheimer’s Activities: www.AlzheimersMinistry.org, boldendeavors@comcast.net. 423-870-3864. Aids to nourish the mind and heart of persons who have Alzheimer’s disease or other forms of dementia or cognitive limitation.

Area Agency on Aging: www.aoa.dhhs.gov.eldfam/How_To_Find/Agencies/Agencies.asp. Lists state and local agencies dedicated to helping older adults and their families.

Benefits Check-Up: www.BenefitsCheckup.org. 202-479-1200. Guide to financial assistance.

Caregiver Media Group: www.Caregiver.com. 800-829-2734. Helpful caregiving site, magazine, and conference. Caregiving.com: www.Caregiving.com. On-line support groups, discussion boards, and other resources.

Center for Aging with Dignity: www.CareAdvocate.org. 513-558-2428.

Centers for Medicare and Medicaid: www.cms.gov. 800-633-4227

ElderCare Locator: www.ElderCare.gov. 800-677-1116. A public service of the U.S. Administration on Aging. Visitors can search for information and organizations by zip code, city, or county.

ElderCarelink: www.eldercarelink.com. Help finding residences, home serves, and products.

Family Caregiver Alliance: www.Caregiver.org. 800-445-8106. Information and online consulting.

MedlinePlus-Caregivers: http://www.nlm.nih.gov/medlineplus/caregivers.html.

National Alliance for Caregiving: www.Caregiving.org. Publications and guides to help family caregivers.

National Association of Professional Geriatric Care Managers: www.CareManager.org. 520-881-8008. Locate a professional care manager to help you address specific care needs and concerns.

National Center on Elder Abuse: www.ElderAbuseCenter.org. 202-898-2586. Resources and support for people suspecting elder abuse, neglect, and exploitation.

National Family Caregivers Association: www.nfcacares.org. 800-896-3650.

National Hospice and Palliative Care Organization: www.nhpco.org. 800-658-8898. End-of-life planning, advance directives, hospice, grief, and more.

National Institute on Aging: www.nia.nih.gov. 301-496-1752. Health and research information.

National Respite Network: www.archrespite.org. 919-490-5577. Help finding temporary caregiving relief.

Social Security: www.socialsecurity.gov. 800-772-1213.

Strength for Caring: www.StrengthForCaring.com. A service of Johnson and Johnson.

U.S. Consumer Product Safety Commission: www.cpsc.gov/cpscpub/pubs/older.html. Home Safety Checklist and other safety tips for older consumers.

Well Spouse Foundation: www.WellSpouse.org. 800-838-0879. For spouses who are serving as caregiver.

Driving

American Automobile Association: www.SeniorDrivers.org or contact your local AAA office.

American Association of Motor Vehicle Administrators: www.GrandDriver.info.

American Medical Association: www.ama-assn.org/ama/pub/category/10791.html. Physician’s Guide to Assessing and Counseling Older Drivers Center for Aging with Dignity: www.CareAdvocate.org. 513-558-2428.

Insurance Institute for Highway Safety: http://www.iihs.org/laws/state_laws/older_drivers.html. State information on the driver licensing procedures for older drivers.

Living Facilities

American Association of Homes and Services for the Aging : www.aahsa.org. Click on Consumer Information for tools and information to help select a suitable living environment. 202-783-2242.

A Place for Mom: www.aplaceformom.com. 877-666-3239. A free referral service helping families find nursing homes, assisted living, Alzheimer’s care, retirement communities, and home care.

LongTermCareLiving.com: www.longtermcareliving.com. Guide to planning, preparing, and paying for long term care.

Medicare-Nursing homes: www.medicare.gov/Nursing/Overview.asp. Checklists and comparison data to help evaluate options.

MedlinePlus

Assisted Living: www.nlm.nih.gov/medlineplus/assistedliving.html

Home Health Care: www.nlm.nih.gov/medlineplus/homecareservices.html

Nursing Homes: www.nlm.nih.gov/medlineplus/nursinghomes.html

NursingHomes.com: www.nursinghomes.com. Free consultation available. Senior Outlook: www.senioroutlook.com. 888-539-1150. A guide to senior housing.

Medical Conditions

Alzheimer’s Association: www.alz.org. 800-272-3900. Alzheimer’s Disease Education & Referral Center: www.alzheimers.org. 800-438-4380. American Academy of Family Physicians: www.FamilyDoctor.org/seniors.xml. American Cancer Society: www.cancer.org. 800-227-2345. American Diabetes Association: www.diabetes.org. 800-342-2383. American Heart Association: www.americanheart.org. 800-242-8721. American Parkinson Disease Association: www.apdaparkinson.org. 800-223-2732. American Stroke Association: www.strokeassociation.org. 888-478-7653. Arthritis Foundation: www.arthritis.org. 800-568-4045. HealthSquare: www.healthsquare.com.drugmain.htm. Medications commonly prescribed for specific conditions. Leukemia & Lymphoma Society: www.leukemia.org. 800-955-4572.

Medical Network Inc: www.HealthAtoZ.com. Click on Senior Health below the Healthy Lifestyles heading. Medline Plus

Health topics: www.nlm.nih.gov/medlineplus/healthtopics.html.

Drugs and supplements: www.nlm.nih.gov/medlineplus/druginformation.html.

National Cancer Institute: www.cancer.gov. 800-422-6237.

National Institutes of Health: www.nlm.gov/medlineplus/druginformation.html.

National Mental Health Association: www.nmha.org. 800-969-6642.

National Osteoporosis Foundation: www.nof.org. 202-223-2226.

National Stroke Association: www.stroke.org. 800-787-6537.

NetWellness: www.NetWellness.com/healthtopics/aging

NIH Senior Health: www.nihSeniorHealth.gov

Parkinson Disease Foundation: www.pdf.org. 800-457-6676.

The Health Scout Network: www.HealthScout.com/channel/1/1001/main.html

Online Searches

One of the most comprehensive and best resources for information on programs, services, and organizations in your community is found online. The following list includes some of the search criteria you may reference:

Government listings

Drug Hotline

Health Department

Human Services

Medicare Mental Health

Nursing Home Licensure & Complaints

Senior Citizen Services

Social Security

Veterans Affairs Information

Welfare

Business and Organization listings

Alcoholism Information & Treatment Centers

Alzheimer’s Resources

Ambulance Service

Apartments

Assisted Living Associations

Cancer Resources

Cemeteries

Clinics

Concierge Service

Condominiums

Cremation Services

Disabilities & Special Needs Equipment & Supplies

Funeral Directors

Funeral Pre-Arrangement Plans

Geriatric Services

Hearing Aids

Home Health Services

Hospices

Hospital Equipment & Supplies

Mental Health Services

Monuments

Nurses

Nursing Home Consultants

Nursing Homes

Physical Therapists

Rehabilitation Services

Retirement & Life Care Communities & Homes

Senior Citizen Centers

Senior Citizens’ Service Organizations

Social Service Organizations

Wheel Chair Lifts & Ramps

Wheelchairs & Scooters – Sales & Service

While the headings may be different in your local yellow page directory, hopefully the categories listed above will give

We’d love to hear from you!

I hope your life has been changed in some way during these past weeks. If you would like to share how God has touched your life through this group, please send us your thoughts. A personal testimony of God’s love will honor Him and could encourage others to reach out for help. Also, we would love to celebrate your victories with you!

May we shout for joy when we hear of your victory and raise a banner in the name of our God (Psalm 20:5 NLT).

We would also appreciate your suggestions for how we might improve the curriculum.

Three ways to send us your comments:

E-mail: info@livingfree.org

Postal mail: Living Free P. O. Box 22127 Chattanooga, TN 37422-2127

Fax: 423-899-4547

May God richly bless you as you continue your journey with Him.

The Living Free Team

To learn more about Living Free, please visit us at www.LivingFree.org.

• Shop in our bookstore

• Guidelines for small groups

• Read about new curriculum

• Help for facilitators

• Discussion forums

• Help for life’s problems

Has Living Free made a difference in your life? Would you like to help others receive similar blessings?

Prayer

More than anything, we desire your prayers for the ministry of Living Free. We can work hard, write excellent curriculum, and offer great training experiences; but none of this can be effective without the power of the Holy Spirit. God is the one who changes people’s lives. Our prayer partners receive periodic prayer requests for the ministry by e-mail.

Mission

Living Free team members make several international trips each year—training, making ministry contacts, and in general assisting ministries desiring to develop Living Free groups in their country. Some of these trips will be open to individuals or groups. We will be looking for trained and experienced Living Free facilitators as well as people wanting to join a work team for a mission service project or medical mission.

Support

God is opening doors for Living Free ministry around world, and we are moving through those doors by faith. We are excited and thankful for the growth, but growth brings new financial challenges. Our Giving Partners help us continue and expand the ministry.

If you are interested in getting involved, please contact us

E-mail: info@livingfree.org

Postal mail: Living Free P. O. Box 22127 Chattanooga, TN 37422-2127