Guest Writer: Maria Kraayeveld
4/9/17
Maria is currently a Graduate Student at Calvin College extending on her degree in Speech Pathology. She serves on our son Nolan’s team at our church and has a heart for helping people of all abilities feel welcomed and included within the church.
Recently, she wrote an essay for her coursework on how churches can grow in opportunity to respond and include people who are stroke survivors. The theme of her paper cross-applies to all challenges people face and how the church can respond. It hits at the heart of the Bible passage found in 1 Corinthians 12 (The Body of Christ). I have asked permission to re-post her essay on BeautifullyPuzzled.com:
Inclusion of Stroke Survivors in the Church
By Maria C. Kraayeveld, Calvin College
Due to communication’s vital role in forming relationships, people with communication disorders often lack a sense of belonging. Stroke survivors with aphasia often struggle with both the service and other aspects of church life because of the centrality of communication in churches. Faith communities often respond well to the emotional and
physical needs of these individuals immediately following a stroke. However, when stroke survivors return home and have to readjust to new life, support dwindles. To act as the body of Christ, churches must be a community of love: demonstrating patience, respect, understanding, hope, and support for all of its members.
Churches have a vital but difficult task in incorporating all of its members. They are home to the broken; if they only accepted perfect people, nobody would belong at church. As the body of imperfect believers, churches must incorporate the abilities and gifts of all members. Otherwise, the entire body is weakened. Of all types of groups of people, church members should be the most inclined to create a sense of belonging. As 1 Corinthians 12: 25 states, God desires churches to function in this manner so “that there should be no division in the body, but that its parts should have equal concern for each other.”
As a whole, churches excel in addressing the needs of stroke victims during the “crisis period.” When individuals arrive at the hospital and even as they begin rehabilitation, church members often jump to action – starting prayer chains, sending cards, visiting the hospital, bringing meals, and helping out in any way necessary. Many churches have systems in place for these situations, such as Redeemer Orthodox Presbyterian Church, where I am a member. During times of illness or crisis, an email relaying the news and requesting prayers is sent out to all members and the Congregational Support Committee organizes meals.
Even though most churches respond well during the crisis period, support often slows or stops altogether once people return home and begin “real life.” Because of the sudden nature of a stroke and its effects (e.g. aphasia), those returning home have an entirely new life to which they must adjust and an identity with which they must come to terms. Renegotiating their sense of self requires a lot of time and effort for the stroke survivors, which is made more difficult without the support of others. Some stroke survivors don’t remember much of their time in the hospital, so although they received visitors, they return home and feel as if their churches have ignored them (Goetz, 2011, p. 106). Two major concerns tend to arise as stroke survivors adjust to their new lives: feelings of isolation and struggling to find a sense of purpose.
Due to ignorance concerning aphasia and the stroke survivors’ specific communication need
s, fellow church members often ignore them. If they do engage in conversation, it is in an impatient or condescending manner
(Goetz, 2011, p. 108). Due to the increased time and attention required for conversations with those with aphasia, many stroke survivors’ friend circles dwindle. In an ethnographic study 
following 20
stroke survivors, all participants reported narrowed social circles (Parr, 2007).
Stro
ke survivors returning home also usually question their sense of purpose. During the stroke survivors’ absences, churches must replace whatever positions the individuals held to keep the church and its ministries running smoothly. Although necessary, this replacement only increases the stroke survivor’s feelings of uselessness. Often, churches do not invite the individuals to serve in other capacities regardless of spared abilities.
The reason for the decreased support is not unkindness but often a lack of knowledge. Many people are uncomfortable interacting with those with disabilities because they don’t know what to expect or how to react. Acquaintances and even friends can “feel awkward and even frightened” (Parr, 2007, p. 111). Though understandable, these feelings are of course invalid reasons to ignore anyone. If church attendees are notified of the stroke survivors’ spared abilities and areas of difficulty, they can be more patient and understanding of slow or confusing speech.
Once aware of areas of need, attendees are often quick and willing to rise to the occasion. For example, a family at Redeemer has a boy with autism who struggles to sit in the sanctuary during the worship service. For quite some time, they came to church but would almost always leave the sanctuary, so they felt little benefit from their attendance. They then approached the pastors, who knew nothing about their son but were willing to learn about him and how the church could help. A team was quickly put in place to stay with this boy during the service and the number of volunteers continues to grow. Once church leadership is notified of a situation, they will often attempt to find a solution. At Redeemer and other churches, the majority would like to help, but we might not initially be aware of the need or know how to help.
In order for churches to improve, stroke survivors and their caregivers must initiate contact with church leadership or a committee created to help in such situations. This group can then relay information to church members via verbal or bulletin announcements or pamphlets put in mailboxes or at the front of church. With this method, church members are informed of difficulties that the stroke survivors have as well as how they can best communicate with them.
However, notifying the leadership of communicative needs and requesting help requires stroke survivors to accept their present level of language. The mindset of “getting back to the real me” as soon as possible is part of the medical model. Particularly due to the acquired nature of a stroke, many stroke survivors adhere to their former standard of language and consider their improvement a failure until they reach that previous level. This mentality diminishes stroke survivors by focusing on the return to their pre-stroke selves instead of the potential and abilities of their “new normal.” If stroke survivors do not express their current level of strengths and needs, churches will be less equipped to help. Consequently, stroke survivors sometimes isolate themselves further by stressing the recovery of all past abilities but never notifying the church of needs or asking for accommodations.
Just as stroke survivors must self-advocate, the church must actively look for ways to overcome assumptions and alter expectations. It is more important to focus on what the stroke survivors are currently capable of and how we can build on those strengths than focusing on whether they will return to their premorbid state. This requires churches to meet them where they are at and include their present abilities and strengths.
During the church service, we can incorporate nonverbal and multi-modal forms of communication. For example, Redeemer has times when the congregation listens to someone sing or play an instrument as well as times for silent prayer. These moments allow the stroke survivor to be a part of the service without requiring much auditory comprehension, cognitive processing, or any verbal expression. The church can also incorporate multiple modalities (verbal, auditory, visual) throughout the service. For example, announcements made at Redeemer are written in the bulletin as well. Sermons often begin with a story or example, which are easier for stroke survivors to comprehend (Goetz & Bloem, 2015, p. 61). Although an outline is usually provided during the sermon, stroke survivors would benefit from a written outline or notes provided beforehand. These small changes can be made quite easily and still have an immense impact.
We must also – and maybe even more so – incorporate these individuals outside of the worship service. As mentioned, the greatest concerns for stroke survivors are isolation and finding a sense or purpose, both of which are addressed outside of the worship service. The church must be intentional in producing feelings of belonging, which require more than briefly acknowledging or greeting the individual. The church must partake in deep conversations and discover ways for the stroke survivor to serve within the church.
To create an atmosphere of empowerment and belonging, the church must reconsider how it approaches all of its members. A music minister at a Grand Rapids church said, “We need you. No matter how you sing, we want you in choir” (Goetz, 2011, p. 112). This response must be the mindset of the church towards all its members, regardless of age, ability, or other circumstances: “We need you. No matter how you worship or how you serve, we want you in this church.”
Due to the vastly differing linguistic, physical, cognitive, and emotional factors among stroke survivors, there is no one-size-fits-all area of service for stroke survivors. Just as all able-bodied members of the church bring different gifts and needs, so do stroke survivors. The individual and church must together determine which strengths the individual has and how and where they can and want to serve.
Recognizing and appreciating stroke survivors’ full range of gifts 
allows them to discover meaningful and fulfilling tasks. On the other hand, we cannot dismiss the joy found in “small” tasks. A stroke survivor who was responsible for making coffee noted that “being able to serve and be productive and make a contribution i
s something that I really, really, really had missed (Goetz & Bloem, 2015, p. 253).
Many of the areas that would help these individuals would simultaneously benefit all members and attendees of a church. Providing multiple modes of communication help the elderly, young children, and anyone that struggles with attention or processing. Partaking in deeper conversations as opposed to brief greetings form better relationships for both parties.
The church must address feelings of isolation and uselessness in stroke survivors. Although impairments caused by a stroke negatively impact many aspects of the lives of stroke survivors, they become increasingly disadvantaged once others exclude them because of that impairment. Thus the amount of restriction caused by their lack of communication is somewhat dependent on the subsequent reactions of those around them, including the members of the church. As Christians, it is our duty to consider how we can best function as the body of Christ and create belonging for all members, including stroke survivors.
