“‘Thou Shalt Bear Their Infirmities’: Meeting the Challenges of the Chronically Ill,” Ensign, Jan. 1975, 15
“And remember in all things the poor and the needy, the sick and the afflicted, for he that doeth not these things, the same is not my disciple. … Thou shalt bear their infirmities.” (D&C 52:40;, D&C 42:52.)
The concern of the Savior for the sick has always been central in the gospel, from his day to ours. When a mother has a baby, when someone undergoes surgery, or when serious illness or injury strikes a ward member, the priesthood quorum, Relief Society, home and visiting teachers, and neighbors rally around to assist the sick person and his family. While medical assistance is provided, the family adjusts to the temporary problem, ward members provide food, service, and encouragement, and the patient begins recovery. After a short period of convalescence, he returns to good health and full activity in the Church and in the family.
However, there is another kind of illness. When this kind of illness strikes, the patient becomes ill, doctors are consulted, and the family begins to adjust, but the patient doesn’t recover—perhaps not for many months or years, or perhaps not ever. He may have periods of feeling better or worse, but he never returns to the good health he previously enjoyed. This person is chronically ill.
Many chronically ill people find it difficult to live with their illness. They may fight it, hate it, give in to it, or feel abused and picked on, abandoned, and rejected by everyone, including the Lord. Learning to cope is a major challenge. It is possible to learn from long-term illness, to grow with the burden rather than to be defeated by it. But the process is difficult—not only for the patient, but for family and friends as well.
The chronically ill person must make a tremendous adjustment. Since he has been accustomed to getting well after an illness, he cannot accept this never-ending poor health. Increasingly frantic, he may turn from one doctor, treatment, or proposed cure to another. He may experience periods of apathy when he feels hopeless and wants to give up. At these times, the patient especially needs the support and encouragement of his family, friends, and Church leaders.
The patient may try to handle his illness in two different ways. The “tough” approach is to say, “I’m not going to let this get me down. I’m going to live a normal life.” But, the fact is that he is still sick and may not be physically or emotionally able to assume the normal duties of his home, community, or church. But, if he seems well to others because of his “tough” attitude, others then drop their pattern of support and are glad that he’s “back to normal.” Then, when his responsibilities again become too great for his condition, the patient may be more depressed than ever because his illness has “licked him again,” and no one seemingly notices or cares.
An opposite, but also unsatisfactory, way to handle chronic illness is to become an invalid and thus escape the burden of responsibilities that are too great. If a person stays in bed and appears to suffer, then others accept the person as ill and are ready to help. One chronically ill mother reported that her teenagers helped without complaint if she stayed in bed, but if she got up to do a few things, the children expected her to assume all her former duties. It is as though people think about health in only two categories: one is either sick or well. But chronic illness falls somewhere in between and the patient, as well as family, friends, and Church members, need to learn to live in that intermediate zone.
Even though family members respond sympathetically to short-term illness, they are often unprepared for the illness that can’t quickly be cured. They expect the patient to recover, and when he doesn’t, problems may occur. Sometimes they subtly resent the sick person; in a way, they blame him for not getting well, since he is not allowing his family to return to normal activity. The sick person senses this resentment and struggles to resume his former role. The result is often that his condition may worsen or he may act as if it has.
The chronically ill patient needs special understanding in his struggle to live an appropriate life. He does not want to be a burden to his family and others, but he is distressed when he discovers he is no longer capable of handling his former responsibilities.
He needs to work out his new role, complete with definitions of activities and an understanding of what he can and should do.
In other instances, instead of keeping the patient as a full part of the family, even though his duties and abilities are limited, family members might slip into isolating and ignoring the chronically ill person. Blocking him out of their minds is a way of coping with the unpleasantness of his illness. This may reduce family distress, but it leaves the sick person feeling rejected and alienated from the others.
The family especially needs to understand that chronic illness means permanent change. When any member of the family stops functioning normally, traditional role relations are disturbed and a new balance must be established. For one thing, there is the responsibility of caring for the patient. If the mother or father is sick, someone must assume their duties as well as caring for them. When a child becomes ill, the family loses that person’s contribution to family activity and work, and the parents must assume new patient-care responsibilities. Their former duties then must shift partially to others. Since every family member interrelates closely with the others, all feel the effects when one becomes disabled.
A daughter may have to cook family meals, a son may have to take responsibility for the wash, the father may become family chauffeur and shopper. They must assume these duties in addition to their regular activities with the expectation that the situation will continue indefinitely; hopefully, they will do it in a spirit of willingness and love. This is a great deal to ask of family members, and it takes understanding, discipline, lots of family discussion, and faith to accomplish. Chronic illness can disrupt and divide a family or it can provide members with an opportunity to grow in understanding, patience, sacrifice, and love for each other.
Everyone, sick or well, is accustomed to basing much of his self-esteem on his achievements. A woman deeply devoted to her family naturally finds it depressing to find herself unable to spend as much time with her children as before, unable to keep up with her housekeeping, unable to perform such simple and satisfying functions as canning summer fruit. One woman missed not being able to help her husband with typing. Family and friends should realize that giving up these previous activities is not just a minor inconvenience—it involves giving up part of one’s identity as well.
One woman, age 30, who has suffered from multiple sclerosis since the age of 24, also needed to make adjustments with her family. “It’s been hard to accept that I cannot do as much as I used to do and would like to do.”
The friends, neighbors, and Church organizations associated with the chronically ill person can be either a source of support or a cause of feelings of neglect, rejection, misunderstanding, and frustration. These groups are used to the short-term type of illness, and when the illness goes on and on, they become somewhat confused and slowly shift their attention to other matters. Many chronically ill people who suddenly develop an emergency such as a heart attack or the need for surgery find that others respond with the warmth and concern they would for any short-term illness and then, when the crisis is over, revert to their seeming “I-don’t-care” attitude as they focus on others with less persistent problems.
Sometimes the patient makes it difficult for others to respond to him. He may become preoccupied with his illness, obsessed with his symptoms and treatment. While it is natural for him to be concerned about himself, it is also natural for friends and others to avoid discussing such unpleasant topics with him. As one possible solution, the sick person may try to plan interests to broaden his world and allow for a wider range of interaction with others.
But, even for a cheerful patient, interacting with others may be difficult if they are not tactful. When one sees a person who is ill, it is natural to ask, “How are you feeling?” A chronically ill person often thinks people are asking just to be polite and aren’t really interested. He doesn’t want to complain, so it is often easier to say, “I’m all right,” or “I’m feeling better.” This satisfies the inquirer, since it is what he hoped to hear. A more honest response from the patient might be, “I’m about the same, but I appreciate your concern.”
Even more difficult is the situation of a chronically ill person who goes to church with great effort when people say to him, “It’s so good to see you. You look wonderful.” He may look healthy and perhaps even feel well at that moment, but he has not necessarily recovered.
One quorum president wondered about a man in his quorum who worked five days a week but never came to church or filled an assignment. When he investigated, he discovered a chronically ill man who mustered all of his strength to make a living for his family and used the weekends to recoup his meager energies. When the quorum president understood the situation, he was able to give the man and his family the support they needed.
A woman who suffered from chronic tension depression for 20 years felt that many people avoided getting to know her because they didn’t know how to cope with her obvious neurotic symptoms. “Almost without exception,” she said, “people withdrew from me because they didn’t know what to do or say, and rather than do the wrong thing, they avoided me. Even greeting cards would have helped me feel more accepted.
“Finally, I turned to the Lord for strength and, as my faith grew, he answered my prayers.”
The woman who suffered from multiple sclerosis had more support from those around her, and this made a great difference in her outlook. “When I was the sickest, I was blessed to feel that so many people expressed in one way or another that they cared about me, and that sustained me for a long time. Every expression of concern helped me a lot. No kindness that has been shown me has been unappreciated—food and household service and help with children, visits, cards, or phone calls.
“Something I needed help with most was shopping. I really appreciated one neighbor who would call before she went to the store and ask if there was something she could pick up for me. It’s a real blessing, also, when people do things for your children that you can’t do, like taking them swimming or to a movie, giving them rides to school, etc. I have appreciated people sharing their faith-promoting experiences as they have visited me. When I have been really low, clinging to any bit of hope or faith or inspiration has pulled me through.”
She added, “It’s difficult to be ill and maintain a strong self-image because so much that contributes to a good image of one’s self comes from his ability to do things and to accomplish and succeed. One’s image and security often come from how he feels the Lord views him. And when you know the Lord really understands and that he knows you’re doing all you can, you can still feel you’re a person of worth.
“I must admit that I’m momentarily ‘shot down’ when I feel I’ve been wrongly judged by people who have no idea how difficult things are for me. But these people can’t really understand. And I’m sure I judged others just as wrongly when I was well. Thank goodness there are those who have experienced some of the same things I have and that they understand.”
Many of us don’t know how to respond to persons with chronic illness. If the illness is emotional, the patient may have behavioral symptoms that are upsetting to others or that are difficult to respond to. It can be easier to avoid such a patient rather than break through the barriers to a friendly relationship.
A ward or branch might consider the following suggestions in responding to chronic illness:
1. Survey the ward through the home teachers and visiting teachers to identify all members with chronic illness. This includes any physical, mental, or emotional condition that leaves the person in less than good health for a considerable length of time or permanently.
2. Discuss in detail with the sick person how his illness affects him and his family, and how others could help.
3. Make the visits short in length. Many patients become overtired or overstimulated by long visits. A cheery visit of 20 to 30 minutes is best.
4. Send a card or note to the patient, or make a short telephone call.
5. Look for ways to help with the sick person’s young children. Take them to your home to bake cookies or make candy, and send some home with them. Take the children to church or other functions.
6. Send a cake, a loaf of bread, a bowl of cherries, or some tomatoes to the patient. The feeling of being remembered is more important than the gift.
7. With the bishop’s approval, tape record a sacrament meeting, Sunday School class, or testimony meeting, and play it for the sick person.
8. If the patient is unable to attend church, arrange for him to partake of the sacrament.
9. When the patient does come to church, visit with him pleasantly. Avoid subtle pressure like saying, “We hope you can come all the time now.”
10. Elderly people who are at a rather constant state of low health and energy might like the youth council or other group of young people to visit them and share their fun and spirit.
11. Take the patient an article or book you find uplifting, or stop and share a special experience you have had.
12. Don’t recount to the patient your accomplishments, travels, etc. Chronic illness tends to reduce feelings of self-worth, and the patient isn’t helped by hearing how important or busy you are.
13. It is important that the appropriate Church leaders visit the patient to acknowledge the illness. The condition of the chronically ill cannot be dismissed by saying, “It’s all in his head.” Part of that may be true, but illness “in his head” can result in as much or even more suffering than physical pain.
14. Don’t just ask, “What can I do to help?” People, particularly those who are sick, do not like to ask for help or support. Be sensitive and imaginative, and go ahead and do something.
15. Attitude toward the chronically ill person is important. Others enter his life and share his problems for brief periods, but for him his life and problems go on 24 hours a day. He needs to be treated as a real person and given understanding.