Pastoral or spiritual care is offered in our churches or local communities to those who may be facing some life challenges, changes, growth or losses. 

A pastoral carer spends time with the person or family, creating a safe space to compassionately listen, empathise, comfort, reflect together on meaning, and perhaps look to the scriptures and prayer for comfort and encouragement.

This typically involves the use of verbal conversation, and sometimes written material (Bible passages), as the person seeking support shares their story and the pastoral carer responds.

But how does this work for people with intellectual disabilities, who may not have the language skills or understanding that we are used to and comfortable with, and yet will experience the same life challenges, griefs and losses common to all humanity?

Do we in our churches, take time to think about the pastoral and spiritual care of people with cognitive and communication impairments and their families? What situations and needs they may be facing? What connection or comfort may they be longing for? What are their spiritual needs at these times, and how can we facilitate for these to be met? 

What is an intellectual disability?

“Intellectual disability is a lifelong condition that affects a person’s intellectual skills and their behaviour in different situations. It can include difficulties in communication, memory, understanding, problem solving, self-care, social and emotional skills and physical skills.” (Source: Inclusion Australia)

Looking with an additional theological lens, we know that we are not known and valued by God due to our intellect, but because we are His children created in His image (Genesis 1:26–27, Psalm 139), indwelt by His Spirit, and valued members of Christ’s body. (1 Corinthians 1:27–30)

This is all of us who are in Christ, and perhaps even more so, those deemed as weaker members of our church communities. Read 1 Corinthians 12:18–27.

The pastoral care experience

Sometimes in pastoral care, we may be aware of ministering to a person’s spirit, at a deeper level than the mind.

I had the privilege of attending a series of pastoral visits with a young man (let’s call him Mike) in a hospital where I work. Mike has a severe cognitive impairment and complex medical issues. His admission details indicated a Christian denomination, so I gently unpacked with Mike if that was meaningful to him.

Through a mix of single words, basic hand signs, symbol of a cross, and facial expression, Mike was able to affirm he liked going to church. However, his expression of raw emotion was deep, if not confronting for me at times. Simply holding his hand as he sobbed out his fears and loneliness – staying with him, looking deeply into his eyes, so he knew he wasn’t alone, singing familiar choruses with him, praying for him out loud, touching his hand or shoulder – this basic pastoral care felt deep and raw for me. Being with him was not always comfortable, but I determined to prioritise consistent weekly visits.

After a number of weeks, he was finally well enough to be discharged. Mike had touched my soul and I prayed that I had reached his soul with compassion, care, simple presence, and valuing his personhood, and that through this, he may have felt God’s love and presence. 

A year later, I ran into Mike who was out with his support worker. He recognised me straight away, gave a huge smile and took my hand. He spoke some syllables to me which the support worker interpreted as “God bless you”. Mike remembered! This told me that my pastoral presence had meant something to him, and that he knew it was given in God’s name.

And I was honoured to receive a blessing from Mike that day!

The universality of pastoral care objectives

The basic, universal pastoral skills can remain fully relevant when pastorally caring for people with intellectual disabilities, even if approached in different or creative ways by: 

  • showing empathy
  • developing a trusting relationship
  • actively ‘listening’ to enable people to unfold their stories and review their experiences 
  • attending, responding creatively and being a skilful interpreter
  • bringing the ‘gently worded prayer’ or relevant liturgy or ritual.
  • easing anxiety and alleviating isolation
  • promoting a sense of security through words or presence
  • honouring the person, their feelings, experiences, and spirituality. 

(Source: Threlfall-Holmes and Newitt, 2011)

Gaps, barriers and opportunities

While the principals of pastoral care can be adapted and applied to support people with intellectual disabilities, there are several considerations – both gaps and opportunities – to be aware of. These include:

  • The need for recognition of the spiritual lives of people with intellectual disabilities
  • Grief and loss support for people with intellectual disabilities, and their families
  • Social isolation of people with intellectual disabilities and their families 
  • Perceived relational barriers due to communication differences, breeding fear of engaging 
  • Accessible pastoral care and other forms of communicating care such as plain language, visuals etc.
  • Reflexivity on our own biases, assumptions and responses.

Providing pastoral care to an isolated family

A Christian family were raising a son with severe intellectual and communication disabilities, and high daily care needs. They loved the Lord and his people but over the years felt overlooked and excluded by several churches, leading to physical, social and spiritual isolation. 

Finally, they found a church that chose to be determined to love and include – to find a way, whatever it took.

In a period where the family were simply unable to bring their son to a church service, a lady reached out by faithfully delivering the church newsletter to them every week. On another occasion, a plate of food was lovingly sent home to the wife when only the husband could attend a church social gathering on his own. 

These actions, though simple, let the family feel remembered and ‘pastorally cared for’ in seasons when they could not ‘attend’ church services. 

Creating more disability-inclusive Christian communities

It is important to remember that we all have a role to play in creating disability-inclusive Christian communities. Hopefully you now have a deeper understanding of what it could look like to pastorally care for people with disabilities and their families – to consider the range of pastoral and spiritual needs, common to all our experience of being human – and find ways to minister uniquely to each one – body, soul and spirit.

Further reading

There is much opportunity for the provision of accessible pastoral and spiritual care, and I recommend the following books and resources for further exploration: 

Gaventa, William C. Jr., and Coulter, David L., eds. Spirituality and Intellectual Disability: International Perspectives on the Effect of Culture and Religion on Healing Body, Mind and Soul, 2001. 

Gaventa, William C. Jr., Spiritual/Pastoral Care with People with Disabilities and Their Families. (In Roberts, Stephen B., ed. Professional Spiritual and Pastoral Care: A Practical clergy and Chaplain’s Handbook. Woodstock, VT: Skylight Paths Publishing, 2012)

Golding, Linda S and Dixon, Walter. Spiritual Care for Non-Communicative Patients. Jessica Kingsley Publishers, London and Philadelphia. 2019. 

Read, Sue (Ed). Supporting People with Intellectual Disabilities Experiencing Loss and Bereavement: Theory and Compassionate Practice. Jessica Kingsley Publishers, London and Philadelphia. 2014.

Shurley, Anna Katherine, Pastoral Care and Intellectual Disability: a Person -centred approach. Baylor University Press. Waco Texas. 2017.