Nearly 1 in 2 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.

Too often, a chronic illness, such as fibromyalgia, or a chronic condition like back pain from a car accident, is invisible. Surprisingly, according to the U.S. Census Bureau, approximately 96% of the people who have an illness do not use an assistive device, for example, a wheelchair or cane. Pain is invisible and those who live with chronic illnesses do everything they can to look presentable, get to church, and sit through the service.

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.\"

Surrounded by people who care about me, a church I love, I still felt lonely and misunderstood. How must those with illness who also deal with deep depression cope when they feel even their own church doesn\'t understand the magnitude of their illness?

It\'s no secret that churches feel responsible for the many needs that already must be fulfilled in their church body and when someone shares another need it can be seen as an inconvenience. And these needs are visible ones. So the question from pastors is often, \"If people aren\'t saying anything about their pain, then that means they are dealing with it fine? Right? We tell them to send in prayer requests or let us know if they need anything and they don\'t speak up, so evidently they are doing okay with it? Their faith should sustain them during those valleys.\"

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.*

So there is a cause for concern. Whether a pastor or church leadership can see it or not, those church pews are packed with ailing bodies. And the suffering bodies are filled with broken spirits. These are the broken-hearted that Jesus promises blessings for.

So the question remains, if people don\'t talk about their pain, but they still have a need to learn how to cope with it and find hope, how does a church reach out to them most effectively?

1) First, take the time to conduct a survey about the needs people may have that they are not vocalizing, especially if you are a large church where people may be more reluctant to talk about their illnesses (or lack of healing thus far). In a recent Barna group study, it was found that larger churches were the least likely to mention congregational care ministries as a priority (Church Priorities for 2005 Vary Considerably).

In your survey ask questions such as, \"If we provided a van for transportation to church events, would it increase your attendance? If our service was online as a web cast, would you listen or watch it when you were too ill to attend? Do you know who to contact at our church if you have personal needs for personal assistance (especially when your condition is chronic, not acute)? Would having the song lyrics available on paper be easier for you to see than just having the overhead? How could we make the service more comfortable for you, for example, are the seats comfortable?\" Sit down with a group of people who manage daily chronic pain and ask them for a wish list. Then prioritize what your church can do immediately and what should be longer term goals.

(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) Invite guest speakers who have physical disabilities or live with chronic illness. There are amazing people that speak at churches, sharing their testimony and a wonderful message. By letting them be on stage and reveal what God has done in their lives, despite physical challenges, lets people in your church who are ill see that you do in fact recognize their needs. It reminds them that you care, and perhaps most importantly of all, that you believe that people with physical challenges are still worthy to be used by God (a message few hear from their church). Speakers such as Dave Dravecky, Lisa Copen, Joni Eareckson Tada, Nick Vujicic, 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. Marquette University College of Nursing, which has an excellent parish nursing program, reports there are about 6000 parish nurses in United States. Many retired nurses are finding this area of ministry appealing and most parish nurse certification can be given by many hospitals. The parish nurse position description depends 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 walking groups, health fairs and screenings, and even help out with the chronic illness small group. The role of the parish nurse may be a better choice than a disabilities coordinator, depending on your church\'s demographics. This person would help cover the disability ministry needs and work closely with the congregational care pastor.

(5) Have your church library be the source for all materials related to health, illness, caregiving, and Christian ministries. A large percentage of people with chronic illness are on a fixed-income and yet they really want encouragement. So fill up your library with items like 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 Joni Eareckson Tada\'s remarkable book on suffering, \"When God Weeps.\" Subscribe to a few magazine subscriptions like \"HopeKeepers\", \"Guideposts\" or even \"Arthritis Today.\" Don\'t forget books on tape, audio presentations and large-print items when they are available. Be a part of creating awareness in the church by posting flyers or having brochures available about chronic illness or disability ministries, such as Joni and Friends \"Wheels for the World\" program or Rest Ministries\' annual outreach, \"National Invisible Chronic Illness Awareness Week.\" A volunteer could also put together a binder of local and national ministry resources.

(6) Finally, and this is an important point, recognize that people who live with illness want to serve others. Not just be served. Proverbs 11:25 tells us that \"He who refreshes others will himself be refreshed.\" So when a woman tells you that she must resign from the church choir because she can no longer make rehearsals, make sure that she understands that your church body will miss her in that area, but that there are other areas you will welcome her service when she is ready and able. For example, she may find that writing notes of encouragement to members of the church who live with illness and feel alone, may be a way to share her gifts on her own schedule. A man who can no longer commit to leading a weekly small group may find that he enjoys mentor another man one-on-one, perhaps even one who lives with illness and feels there is no one to be authentic with. People in the church need to know that the church body values wounded healers and that the 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).

Roughly twice a month someone shares their broken heart with me because, after much prayerful consideration, they have gone to their pastor to ask him to consider allowing them to start a HopeKeepers small group. The response is \"You can minister to others once you are healed.\" It makes me so saddened to see people who believe they are no longer useful to their church-or God-until they are healed from their illness.

In the parable Jesus shares in Luke 14:21, a man asks his friends to come to a great banquet he has prepared. But his friends turn him down. Upset with their lack of graciousness he orders, \"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 directive to us today. Too few of our churches have recognized the needs of the chronically ill in their own church, much less their community. We must focus on providing a place where we offer unconditional hospitality. We need to \"go out\" into our own pews and ask the chronically ill to help us provide a place of refuge. And then these people will become the comforters, who, with the support of their church, will be able to go out into the community and offer to walk alongside the hurting with understanding.

Sources: http://www.mychronicillness.com/invisibleillness/statistics.htm

Get a free list of 200 Ways to Encourage a Chronically Ill Friend from \"Beyond Casseroles\" by Lisa Copen when you signup\'>http://www.restministries.org/res-ezine_ill.htm\">signup for to HopeNotes invisible illness ezine at Rest Ministries. Lisa founded of Invisible\'>http://www.invisibleillness.com\">Invisible Illness Week