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When the care of my parents fell to me six years ago, I knew I would need help if they were to stay in their own home. I beat the bushes for reliable helpers who could provide personal care for my mother, do light housework, and sometimes cook my parents a hot meal at noon. After learning that home health care is not covered by Medicare, I looked at my parents' combined retirement income and saw that it could easily cover four hours of daily care.

Many members of my church, I discovered, were also caring for elderly parents. I asked them for referrals to possible helpers. Those leads proved few and unfruitful. The women already had more clients than they could handle.

Next I checked into home health care agencies. Their services were limited to bathing, feeding, and setting up medications. They didn't do windows-or even clean bathrooms or cook meals. Also, they were shorthanded and could not guarantee what time of day or even what days their workers would be available. A regular routine was essential for my mother who, along with Parkinson's disease, suffered from stroke-related dementia.

At last I found a new agency in town that provided "senior services," including housework and cooking. Their hourly rate was reasonable. But we never knew who would show up. Some days it was Gloria, some days Sharice, and some days a person we'd never see again. The constant change of faces in her house didn't help my mother's growing paranoia.

Then we struck gold. Ella was willing and could cook. She was gentle with my mother, who quickly came to trust her. She listened attentively to my mother's ramblings as she bathed and dressed her. But, like many of the women who do this work, Ella was no spring chicken herself. After Christmas, she was diagnosed with cancer. By Easter Ella was dead.

For some time my mother had been suffering small strokes. Then the big one hit. After three weeks in the hospital, she still needed round-the-clock nursing care. Thus began our introduction to Fair Acres, the best of three local nursing homes. At that point, I thought my mother could not survive a year in her condition. I was wrong. She lived at Fair Acres almost five years.

Christian media and education about family life have focused primarily on child-rearing. Little attention has been given to caring for aging parents. In that arena, Christians, like their unchurched neighbors, generally find themselves at a loss. Many Christians are wrestling with the question of how to incorporate the commandment to honor their fathers and mothers in their already crowded lives.

A quick survey of the history and current status of nursing homes may help us think more seriously and concretely about the continuing, pressing need to honor the elderly in one of the tried and truest ways.

How elderly Americans have been cared for has changed markedly over the centuries. The colonialists duplicated the English Poor Laws system, which obliged church parishes to maintain the infirm and destitute within their precincts. Of course, most parents were cared for by their families. But, if you were old, poor, and childless during the early years of this country, chances are you went to a workhouse or poor farm.

Residents were often kept under lock and key and had to wear uniforms in the hope that public humiliation would keep down their numbers. These establishments were a catchall not only for the elderly, but also for the "deaf, dumb, blind, idiots, aged and sick, poor children, unfortunate women, insane."

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September 2004, Vol. 48, No. 9