Program on Medicine and Religion

The Emmaus Project: Stories of Suffering and Healing in Aging Seniors

Background: Many senior men and women endure the physical and cognitive repercussions of aging as well as the personal challenges of watching friends and family pass before them. Up to 21% of residents in a nursing home have reported experiences of nursing home neglect within the last year (1). Aging-related issues can lead to despair, abuse, depression, and existential loneliness (2). Moreover, discussions regarding prognosis and death are often evaded, and few opportunities in healthcare are provided for psychological and spiritual processing and healing (3).

Goals: Our study aimed to address the challenges of aging by drawing upon the patient’s spiritual resources in a group setting. We sought to better understand in their own words, what senior men and women are going through and how spiritual processing shapes their narratives of suffering and healing.

Brief Description: The Emmaus Project was a multi-method qualitative research study that consisted of a faith-based focus group of 10 senior men and women at Montgomery Place Retirement Community in Chicago, IL, conducted from October 2018-December 2018. The format for the focus group was derived from the Scripture story in Luke’s Gospel [Luke 24:13-25] and modeled after the Emmaus Walk developed by the McGrath Institute for Church Life at the University of Notre Dame for high school ministry. It was then piloted among faculty and students at the University of Chicago before being introduced to our senior population. The focus group was comprised of one introductory session followed by seven sessions that each addressed a different theme of the Christian journey of suffering and healing as witnessed in the Emmaus story: (1) accompaniment, (2) lamentation, (3) doubt and mercy, (4) grace and beauty, (5) hospitality, (6) communion, and (7) discipleship. Sessions were 1 hour long and co-led by the in-house chaplain at Montgomery Place and a medical trainee from the University of Chicago. Sessions consisted of group prayer, Scripture catechesis, art activities, and conversation reflecting on the intersection of physical illness, aging, and the journey of faith. Open-ended, qualitative questionnaires were distributed at the beginning and end of each session, and participants submitted handwritten responses. Each questionnaire focused on the theme of that week in relation to the experience of aging.

Methods of Analysis:  Qualitative analysis was conducted to describe the unique experiences of aging in Christian seniors. An inductive approach was utilized to analyze the data for new themes or frameworks (beyond the themes set for the week) that arose within the questionnaire responses, and data was sorted into these frameworks. Themes were separately coded for by both the focus group leader and a blinded reviewer. They were then mutually reviewed, separately coded for a second time, and conjoined. QSR Nvivo software was used to transcribe, edit, store, code, and display data. Words in the questionnaire responses were coded for as defined by Merriam-Webster Dictionary and John Hardon’s Modern Catholic Dictionary. 

An Overview of the Results: Themes from the questionnaires were coded for according to three overarching categories: 1) clinical themes, 2) spiritual themes, and 3) themes that were equally clinical and spiritual:

A Sample of the ResultsEach coded theme had multiple quotable examples from the questionnaires. A sample of a few such themes and corresponding quotes is presented below.

THEME 1: God’s Presence
# of coded responses = 12

THEME 2: Reconciliation and Spiritual Healing
# of coded responses = 8


THEME 3: Processing Death and Existential Anxiety
# of coded responses = 7

ConclusionWe hope to provide the medical community with a richer understanding of the spiritual experiences of aging Christians, as offered by our participants’ accounts. We aimed to identify central themes in the lives of Christian seniors. We believe that by engaging the tools and language of the Christian faith — by discussing aging, illness, and death through the lens of Scripture — senior men and women might find the increased capacity for spiritual processing and consolation in discussing their journeys of suffering and healing.

Publications and Presentations: 

1. Dong, X. Q. Elder Abuse: Systematic Review and Implications for Practice. J. Am. Geriatr. Soc. 63, 1214–1238 (2015).
2. Zhang, Z. et al. Neglect of older adults in Michigan nursing homes. J. Elder Abuse Negl. 23, 58–74 (2011).
3. Curtis, J. R., Engelberg, R. A., Nielsen, E. L., Au, D. H. & Patrick, D. L. Patient- physician communication about end-of-life care for patients with severe COPD. Eur. Respir. J. 24, 200–205 (2004).