Our end-of-life rhetoric is typically limited, as Atul Gawande complains in The New York Times, to gaining more control over death. For some, this means passing legislation to allow doctors to prescribe lethal doses of drugs that would prematurely kill a terminally ill patient. For many Christian groups, it means opposing physician-assisted-suicide or the withdrawl of life support from people who can't speak for themselves. For some people it means signing statements that ask doctors to do everything possible to keep them alive.

But, as Gawande points out, there is a lot of life to live between our active years and our dying days. "We don't like thinking about it, but after retirement age, about half of us eventually move into a nursing home, usually around age 80. ... But we don't much talk about getting more control over our lives in such places. "

The priority of a nursing home is to keep residents safe, Gawande says. Describing one woman who recently entered a nursing home, he writes, "Basic matters, like when she goes to bed, wakes up, dresses, and eats were put under the rigid schedule of institutional life. Her main activities have become bingo, movies, and other forms of group entertainment."

This kind of living, he argues, takes the meaning out of life. "Surveys of nursing home residents reveal chronic boredom, loneliness, and lack of meaning - results not fundamentally different from prisoners, actually."

It doesn't have to be this way. Some nursing homes are rethinking institutional life for the disabled elderly, and they are doing it within the confines of what the government will help pay for--an achievement indeed. Life can have meaning an purpose even when many of the things that provided fulfilment are no longer possible for us to do.

Certainly, being in a nursing home does not prohibit a meaningful life. One geriatrician told me he always tells his patients upon retirement, "Wake up knowing what you will do that day, and go to bed knowing someone was helped by what you did." Such a thing is possible, he points out, in a nursing home.

Yet, there is also a place here for the church. How can we better care for our widows, our widowers, our frail elderly. How can we give their lives meaning and keep them integrated into a church community?

This is a question baby boomers, who have already changed so much of the American church, are just begining to face.