Too often, a chronic illness, such as fibromyalgia, or a chronic condition like back pain from a car accident, is invisible. Those who live with chronic illnesses do everything they can to look presentable, get to church, and sit through the service. But as someone with rheumatoid arthritis, as I stood during worship and grasped onto the pew in front of me to balance my knees that need joint replacements, I nearly laughed as the worship song said, "I will stand in spite of pain." Surrounded by a church I loved, I still felt lonely and misunderstood.

Churches have an overwhelming amount of needs that must be fulfilled where the need is obvious. So if people aren't saying anything about their pain, doesn't that mean they are coping with it fine? Their faith and the ability to pray for strength should be enough, right?

Let's look at some staggering statistics:

* Despite what we may assume, 60% of those who live with daily illness or pain are between the ages of 18 and 64. * The divorce rate among the chronically ill is over 75 percent. * Depression is 15-20% higher for the chronically ill than for the average person. * Various studies have reported that physical illness or uncontrollable physical pain is major factors in up to 70% of suicides.*

There is cause for concern. Whether you see it or not, your church body has many ailing bodies, and they are often accompanied by broken spirits. So, if people aren't talking about their pain, how do you know how to reach out to them?

(1) Conduct a survey on the needs people may have that they are not speaking out about, especially if you are a large church where people may be more reluctant to talk about their needs. In a recent Barna group study, it was found that larger churches were the leas likely to mention congregational care ministries as a priority (Church Priorities for 2005 Vary Considerably). Ask, "if a van is provided, will you be able to get to church more easily? Would you listen to church on the internet if you were too ill to attend? Do you feel you can call and ask for occasional personal assistance (especially if the illness is chronic and not acute)? Would you like the worship song lyrics in the bulletin and not just on an overhead? Are the seats comfortable or would you prefer a few rows be saved for you with cushions?" Brainstorm with a group of people who have a chronic illness and ask them for a wish list. Then sit down and prioritize.

(2) Provide a small group/Bible study setting for those with illness. For example, Rest Ministries has a small group program called HopeKeepers which provides a wide variety of materials and Bible studies for this purpose. You may find that although people enjoy the small groups they are in, they feel that talking and praying about their illness week after week is a burden. Having a place where they can "speak the same language" and even laugh at the same jokes can be invigorating. And if only a few people come, that's okay. It brings people comfort to know the church has this oasis when they need it.

(3) Have special guest speakers. There are dozens of people who have physical disabilities that go to churches and share their testimony. Allowing them to be at the pulpit and share what God has done in their lives despite physical challenges, sends a message to those that are ill that you recognize their needs, you care, and most of all, that you believe they are still worthy to be used by God. People such as Dave Dravecky, Renee Bondi and Joni Eareckson Tada, and many others, minister to the masses, not just those with disabilities.

(4) Consider adding a parish nurse to your staff, especially if your church body has a lot of seniors. Many retired nurses are finding this area of ministry appealing and most hospitals now offer training. Parish nurses have a variety of duties, depending on your church's needs and goals, for example, they may go to homes to monitor diabetes or high blood pressure of church members, organize health fairs and screenings, help provide walking groups, etc. This position may be more applicable for the size of your church than a specific disabilities coordinator, yet s/he would cover these responsibilities, working closely with the congregational care pastor.

(5) Provide helpful resources that are available for borrowing. Many people with chronic illness are on a fixed-income and yet they need encouragement. Stock your church library with books on living with chronic illness such as "Why Can't I Make People Understand?" by Lisa Copen or "When God Weeps" by Joni Eareckson Tada. Buy a few subscriptions to magazines such as "HopeKeepers", "Guideposts" and even "Arthritis Today." Remember to have books on tape, audio presentations and large-print whenever they are available. Post flyers or have brochures available about chronic illness or disability ministries, such as Joni's "Wheels for the World" program or Rest Ministries' annual outreach, "Invisible Illness Week." A parish nurse may also want to collect lists of local resources and national ministries and put them in binder; lists of organizations, magazines and newsletters on topics for Christian seniors, those with disabilities, caregivers, and assisted living to name a few.

(6) Lastly, and most importantly, remember people with illness want to serve--not just be served. "He who refreshes others will himself be refreshed" (Proverbs 11:25). For example, when someone tells you she is resigning from teaching Sunday school, let her know that she is welcome to serve in other ways when she is ready. She may find she enjoys writing notes to others who have illnesses to encourage them. A man may find he can mentor another man with a chronic illness one-on-one rather than leading a Bible study. Let them know that you value wounded healers and believe that God comforts us "so that we can comfort those in any trouble with the comfort we ourselves have received from God" (2 Corinthians 1:4). About twice a month someone tells me that they went to their pastor with a request to start a chronic illness HopeKeepers ministry and they were told, "you can minister to others until you are healed." I've seen too many broken hearts because people are told they are no longer useful to the church or even to God when they live with illness.

In Luke 14:21 Jesus shares a parable of a great banquet. When the man's friends all turned down his hospitality he commanded, "Go out quickly into the streets and alleys of the town and bring in the poor, the crippled, the blind and the lame." This is still a mandate to us today, but we must remember that to provide a place where we offer hospitality, we must first "go out" into our own pews and provide a place of refuge; then these people who have experienced the comfort in your church will be there to walk alongside the rest of the community with open arms of understanding.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Sources: - Chronic Care in America: A 21st Century Challenge, a study of the Robert Wood Johnson Foundation.), - National Health Interview Survey - Rifkin, A. "Depression in Physically Ill Patients," Postgraduate Medicine (9-92) 147-154. - Mackenzie TB, Popkin MK: "Suicide in the medical patient.". Intl J Psych in Med 17:3-22, 1987

About the Author

Lisa Copen is the founder of Rest Ministries, serving the chronically ill, and editor of HopeKeepers Magazine. http://www.restministries.org . She is the author of various books and church resources that serve the chronically ill community, and founder of National Invisible Chronic Illness Awareness Week.