On the edge of ministry – reaching those with dementia, intellectual disabilities or brain damage

Peter Barnes Rev Dr Peter Barnes is a Presbyterian pastor who lives in Sydney, Australia. He has served on the mission field in Vanuatu, ministered on the Nambucca River in northern NSW, and is currently pastor at
01 October, 2010 5 min read

On the edge of ministry – reaching those with dementia, intellectual disabilities or brain damage

The Westminster Confession declares that ‘elect infants, dying in infancy, are regenerated, and saved by Christ, through the Spirit, who worketh when, and where, and how he pleaseth: so also are all other elect persons who are uncapable of being outwardly called by the ministry of the Word’ (chapter X on ‘Effectual calling’).

This is dealing with people – notably infants and intellectually impaired persons – who cannot reasonably be expected to come to an understanding of what it means to come to faith in Christ for salvation.

Robert Shaw comments: ‘The Holy Spirit usually works by means; and the Word, read or preached, is the ordinary means which he renders effectual to the salvation of sinners. But he has immediate access to the hearts of men, and can produce a saving change in them without the use of ordinary means.

‘As infants are not fit subjects of instruction, their regeneration must be effected without means, by the immediate agency of the Holy Spirit on their souls. There are adult persons, too, to whom the use of reason has been denied. It would be harsh and unwarrantable to suppose that they are, on this account, excluded from salvation; and to such of them as God has chosen, it may be applied in the same manner as to infants’.

God is love

In other words, if we are justified by faith in Christ alone, what does that mean for an infant who dies at six months, who cannot exercise faith in Christ? And what does that mean for someone who has dementia, or whose intellectual faculties are so damaged that he cannot understand the simple gospel, or to someone who has suffered brain damage, perhaps in a car accident?

Can God reach such persons? In the ruthless quest for perfection – albeit often clothed in the language of benevolence – modern society discards those who do not measure up, and so practises the elimination of the unfit. Thankfully, the God of the Bible is the God who reaches down to the lowliest of people to lift them up into the heavenly places.

There are plenty who have ministered more effectively in this area than I have, but it might be worth telling something of what I have learned over the years. Three things can be said with the utmost certainty.

God’s Word

First, God’s Word can reach where we cannot. In the region of the Gerasenes, Jesus cast demons out of a man who was completely demented. He lived in the tombs, ran about naked, and would shriek day and night.

He cut himself with stones, and was unfit for any place in human society, but after our Lord dealt with him, he is described as ‘clothed and in his right mind’ (Mark 5:15).

Dealing with such a person is beyond my experience, but over the Christmas break of 1976, I worked as a student pastor in a country town in New South Wales. I was asked by one woman to visit her mother who was living in a nursing home in a town about an hour’s drive away.

Off I went, thinking that I would read the Scriptures to a little old lady, and then return to base. What the woman had not told me was that her mother had dementia of some kind, and spent the whole day in a room, jabbering away to herself.

When I arrived, the rest of the people in the room were watching television, and the old woman was jabbering away, making no sense at all, and not making any eye contact with anyone.

I introduced myself, to no avail, and then looked around the room for some help or guidance – or perhaps just a little sympathy. The woman continued to stare ahead and talk nonsense at a rapid rate.

Finally, I decided to read the Scriptures. Immediately, she stopped jabbering, and started to nod her head in agreement. When I tried to explain the Word, she jabbered again, so I went back to reading the Scriptures without comment. All the rest of the residents in the room stopped watching the television (a minor miracle in itself!) and watched and listened to us with deep intensity.

This went on for some time. I read chapters and chapters from John’s Gospel, and she would nod agreement and say ‘Yes’. If I tried to do anything else – like explain the Scriptures or pray – she returned to her incoherent jabbering.

Finally, of course, I had to leave, and the woman returned to her full-time jabbering. But I had witnessed a vivid demonstration of the truth that God can minister his Word in circumstances where we can do nothing. The Word of God is living and active, sharper than any two-edged sword (Hebrews 4:12); it has power from another world.

Means of grace

Second, the Lord’s Supper can minister where we cannot.God has left us his Word as one means of grace, but he has also given us the sacrament or ordinance of the Lord’s Supper. Horatius Bonar writes of the Christian’s experience of the supper:

Here, O my Lord, I see Thee face to face;

Here would I touch and handle things unseen.

Here grasp with firmer hand the eternal grace,

And all my weariness upon Thee lean.

Further on, he says:

Feast after feast thus comes and passes by,

Yet, passing, points to the glad feast above,

Giving sweet foretaste of the festal joy,

The Lamb’s great bridal feast of bliss and love.

In the supper, Christ uses physical emblems to point us to spiritual truths – including the truth of the resurrection of the body.

Sometimes the supper can speak in a surprising way. I once celebrated home communion with a wonderful Christian man struggling with Alzheimer’s disease. He seemed to follow the Word okay, but after the sacrament he suddenly put his arms around the other elder and myself, and prayed that within his limitations he would be able to love and serve God; and thanked him for all the precious memories of past friends and fellow believers.

The supper played some part in ministering to this Christian man and bringing something of heaven to him. Christ left us with this permanent memorial of his death for good reason. We proclaim the Lord’s death till he comes again – and do so in the ministry of the Word to the ear, and of the sacrament to the eye and taste.


Third, Christian songs can minister in a way we cannot. In 2004 John Wessells published a book entitled Conversations with the voiceless: Finding God’s love in life’s hardest questions. John Wessells has a ministry to those who are comatose and brain-damaged in hospital wards. He carries this out by reading, speaking, praying, and singing and playing Christian songs.

Wessells tells a number of heart-warming and touching stories from his ministry. For example, a comatose man once tapped his foot in perfect time to Wessells’ guitar-playing, and another young man later told Wessells how he had become a Christian while in a coma, and had heard every word that Wessells had said and sung to him. Music, says Wessells, is ‘one of the languages of the voiceless’.

Every Monday during school term, I teach Scripture to a class of very disabled children. Most cannot speak at all, and none can wield a pencil or a crayon. A Scripture lesson along normal lines is simply out of the question. I play the guitar and sing Scripture songs to them, taking a minute or two to explain each song.

We – or to be more accurate, I – sing Wide, wide as the ocean;The wise man built his house upon the rock;I am the way, the truth and the life; and other such songs. I am never sure what sinks in and what doesn’t, but one day news came that one of the children had died.

Heaven’s touch

I talked about death, and how Jesus rose from the dead. Then we sang Jesus loves me, this I know, for the Bible tells me so. The children were not at all articulate but they knew something, and I do not expect to experience such a song again until I hear the ten thousand times ten thousand angels sing in heaven ‘Worthy is the Lamb, who was slain, to receive power and wealth and wisdom and strength and honour and glory and praise!'(Revelation 5:11).

There will be situations in life where we may be tempted to think that God cannot renew the mind of a fellow human being. We ought to remind ourselves that God is far greater than our conception of him. His Spirit can minister to the spirits of his elect, by his Word, by his sacrament, and by song.

Peter Barnes

By permission of Australian Presbyterian

Rev Dr Peter Barnes is a Presbyterian pastor who lives in Sydney, Australia. He has served on the mission field in Vanuatu, ministered on the Nambucca River in northern NSW, and is currently pastor at
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