1 in 3 people in the U.S. have a chronic
condition. If it's not you, it's someone sitting
next to you or a friend who has yet to reveal
her greatest personal struggle.

Chronic illnesses are often invisible. In fact,
according to the U.S. Census Bureau, approximately 96% of the people who have an
illness do not use an assistive device, like a wheelchair or cane, and may not show any
effects of the illness. Pain from a car accident, or the pain and fatigue from an illness such
as lupus or fibromyalgia, is nearly always undetectable. But many of these people who
suffer still get up and get to church, despite the chronic pain because they desire to stay a
part of the church body.

I remember one specific day that I tried to make it through a church service. My
rheumatoid arthritis was flaring badly, but since I had gotten there, I was determined to
stay. "Please stand" they announced during worship and I took a deep breath and
carefully pulled myself up, using the pew in front of me for leverage and balance. At the
age of 24, fifteen years of living with this disease has left my feet deformed and painful,
and my knees need joint replacements as soon as possible. I rolled my eyes as they sang a
worship song and the lyrics declared, "I will stand in spite of pain."

Churches already feel pushed to the brink, trying to fulfill all the needs that are obvious.
Even large churches lack the amount of volunteers they need to rock babies in the
nurseries or visit the elderly who are unable to attend the weekly service. So, if the people
who have a chronic illness aren't even speaking up about their needs, then that must
evidently mean that they are having all of them met, right? Pastors often ask, "If they
don't ask for what they need, how can we even know what it is? It sounds to me as
though they must be coping perfectly fine if they aren't calling us or asking for more
prayer. They have their faith and that should be enough during the dark moments to carry
them through."

- We usually assume the chronically ill are the elderly, but 60% of people who live with illness or daily chronic pain are between the ages of 18 and64. - 75% of marriages where one of the spouses have a chronic illness end in divorce - When you are chronically ill, depression is 15-20% higher than it is for the average person - Many studies have found

Whether the need is obvious or not, we should be concerned because our churches are
filled with many people who are living with chronic pain. And when chronic pain exists,
broken spirits are also there. People are hurting silently and need help and
encouragement. These are the broken-hearted that Jesus says he will give comfort.

(1) Perform a survey about what people may desire that they are not mentioning to the
church leadership. This is especially vital if you belong to a large church. People are less
likely to ask for help when they don't know the church staff intimately and reluctant to
mention their illness. They are afraid they will be bombarded with all the scriptures about
healing. A recent Barna group study discovered that larger churches were the least likely
to have congregational care ministries listed as a priority (Church Priorities for 2005 Vary
Considerably).

Ask questions on a survey such as, "If we provided transportation, such as a van ride,
would it increase your ability to attend church? If you were too ill to attend church,
would you listen to the service on the internet? Do you know who to call at the church if
you occasionally need personal assistance (especially when the illness is chronic and not
acute)? Are you able to see the worship song lyrics on the overhead, or would having
them available on paper also be helpful? Please rate the comfort level of our seats." Sit
down with a group of people who live with chronic pain and brainstorm ideas with them
about what would increase their church attendance or connection with the church and
then prioritize what they say.

(2) Provide a small group/Bible study setting for those with illness. For example, Rest
Ministries, the largest Christian organization for the chronically ill, has a small group
program called HopeKeepers which provides a wide variety of resources, Bible studies,
and leader support for this purpose. You may find that although people enjoy the small
groups they are in, they can start to feel that talking and praying about their illness week
after week is a burden to others in the group. They often enjoy having a specific place
where everyone "speaks the same language" and even giggles at the same jokes. It 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 encourage your church body. There are dozens of people
who have physical disabilities that go to churches and share their testimony about what
God has done in their life. Allowing them to be at the pulpit and share what God has done
in their lives, despite physical challenges and set backs, 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, Joni Eareckson
Tada, and many others, minister to the masses, not just those with disabilities.

(4) Discuss the possibility of adding a parish nurse to your church staff. The number of
parish nurses in United States is estimated to be about 6000, according to the Marquette
University College of Nursing. If you church has a lot of seniors this may be an obvious
need and she will help organize the ministries to this group of people. There are a lot of
retired nurses who are discovering this kind of ministry engaging and parish nurse
certification can be found at most hospitals. The parish nurse position description
includes a variety of duties, depending on your church's needs and goals. For example,
the role of the parish nurse may include going to homes of church members to monitor
high blood pressure or diabetes, organizing health screenings and fairs, starting walking
groups, and even assisting with chronic illness and disability ministries. The parish nurse
would network closely with the congregational care pastor.

(5) Be a clearinghouse of helpful resources for the ill that are available for borrowing.
Many people with chronic illness are on a fixed-income and yet they are trying to find
encouragement. Stock your church library with books on living with chronic illness such
as "Why Can't I Make People Understand?" or "Beyond Casseroles: 505 Ways to
Encourage a Chronically Ill Friend," by Lisa Copen or the exceptional book on suffering,
"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 materials 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, "National
Invisible Chronic Illness Awareness Week." A volunteer could collect materials of local
and national ministry resources for a binder; items could include 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) Finally, and perhaps most importantly, keep in mind that people with illness want to
help serve. Not just be served. Proverbs 11:25 says, "He who refreshes others will
himself be refreshed." For example, if a woman with a chronic illness explains that she
must resign from teaching Sunday school, make sure she knows that she is welcome to
serve in other ways when she is ready. Though she no longer is physically able to teach
four-year-olds, she may discover that she loves writing notes to people who have just
been diagnosed with a chronic illness. A man may discover that he prefers mentoring
another man with a chronic illness one-on-one, instead of leading a weekly Bible study.
Let people know that you value wounded healers and that your church believes 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).

Nearly twice per month someone tells me that after much prayer and consideration they
went to their pastor with a request to start a chronic illness HopeKeepers ministry. And
his response was "When you are healed, then you can minister to others. Until then you
need to focus on yourself." I've seen so many broken spirits because people are told, in so