participation in organized religion, however, are not necessary to be considered spiritual

(Burkhardt, 1989; Principe, 1983). Different authors have defined 'spirituality' in

various ways. For the purpose of this discussion, I will use the "spirituality" to describe

the way of life an individual chooses that involves a belief in God or a higher power, a

belief in an after life, and a belief that a higher power influences life's events. I did not

limit this study to 'spirituality' associated with any specific religion or sect.

 There has been an increasing interest in the interrelationship of spiritual

involvement, spiritual activity, and health outcomes among the elderly. Koenig,

McCullough, and Larson (2001) give three reasons for this current interest. First,

spirituality and religious affiliation continues to be a central part of people's lives despite

advances in technology, education, and medicine. Second, the United States and other

worldwide populations are aging due to a declining birth rate and greater longevity. In

the future, social programs will have severe financial hardships in providing services for

this population and religious groups may assist in providing some of these services.

There is the possibility that spiritual coping may aid in the prevention of health problems

and thereby assist in health care cost containment. Finally, there is a depersonalization in

the health care delivery system. Individuals seeking medical care and treatment expect

compassion with attention to their social, psychological, and spiritual needs. McFadden

and Levin (1996) summarize recent gerontologic spiritual research as focusing on four

areas of interest: "(a) multidimensional measures, (b) patterns, (c) predictors, and (d)

psychosocial and health related outcomes of religious involvement in older adults and

across the life course" (p. 350).