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After I led a group of people with cognitive impairments in the celebration of the Lord’s Supper, Sarah approached me to ask a question. I had difficulty understanding her because I don’t know her well and because she has trouble articulating certain sounds.

Finally, I understood that she hadn’t come forward to take communion that evening because she has a swallowing disorder. Sarah feared she would choke in front of everyone as she took the elements. She asked if we could go to a more private place where I could serve her. I was delighted to do so.

If Sarah had not spoken up, and if I had not taken the time to listen, she would have missed out on the sacrament.

Whether we call it communion or Eucharist or the Lord’s Supper, whether a congregation invites all baptized members or only professing members to partake, communion binds the body of Christ together. As many grains are gathered into one loaf, partaking of the elements binds God’s people together into one. Ironically, when church leaders ignore the unique needs of worshipers with disabilities, some are excluded from the sacrament whose very name includes the word union.

Exclusion Happens Unwittingly

Exclusion from the sacrament results not only from the unique needs of the individuals in the congregation, but also from the ways in which the congregation ignores those needs. Here are some examples:

  • When Morningstar Church celebrated communion, they invited worshipers to stand and recite a litany projected on an overhead screen. Joe, who had recently broken his leg, couldn’t stand with other worshipers and therefore couldn’t see the screen. Because the litany was not available on paper, Joe couldn’t participate.
  • First Church’s building committee resisted pew cut-outs because they would change the historic sanctuary. As a result, Sam stopped attending church when his multiple sclerosis required him to use a wheelchair. The ushers will not allow him to sit in an aisle, and he prefers not to be stuck in the foyer or isolated in the front of the sanctuary.
  • Main Street Church always celebrates communion by distributing trays of cut-up white bread and tiny glasses of wine. As a result, several people cannot fully partake. Gert’s Parkinson’s disease prevents her from taking the wine because she shakes, and most of the wine would spill on her blouse. Al’s celiac disease keeps him from eating the bread because the gluten in it would make him sick. Though Jean has been sober for fourteen years, she does not attend worship on communion Sundays because even the odor of wine presents a strong temptation for her.
  • The church to which Perry and his family belong requires a public profession of faith to partake of the sacrament. Because Perry is nonverbal and has severe cognitive impairments, he cannot give clear assent to even the most basic questions about loving Jesus and wanting to live for him. Even though Perry worships with his family every Sunday and participates in the worship service in his own way, he does not take communion.

Many churches proclaim that everyone is welcome to become a part of their fellowship. But when they ignore the unique needs of individual worshipers, only some are actually welcome.

Inclusion Happens One Person at a Time

At a committee meeting of my denomination’s annual synod, I described plans to accommodate the various needs of people in a gathering that would involve more than ten thousand worshipers. Plans had been made to offer wheelchair seating, training for ushers, Braille and large-print programs, and more. I concluded, “Just this morning I found that gluten-free bread will be available for communion so that worshipers who cannot eat regular bread can partake.” At this, one of the committee members exclaimed, “You have to think of everything!”

He was right. In a major gathering such as that one, sensitive planners try to anticipate every possible need of people who might be present.

The good news for leaders of local churches is that they don’t have to plan for a diverse group of strangers. For the sake of outreach, every church should keep the needs of visitors in mind, but local churches do best to learn the needs of their regular attendees so that each person can participate fully.

What is true for inclusion in general is also true for inclusion of people in the celebration of the Lord’s Supper. Churches that are serious about welcoming people to the table consider the unique needs of those whom they expect to come. They work at making their architecture welcoming for people with physical limitations. They work at making their communication accessible for people with sensory impairments. They seek to foster a spirit of welcome so that leadership and congregation will find ways to accommodate all worshipers, in particular in the celebration of the Lord’s Supper.

A brief article cannot possibly cover all the needs of individual worshipers. So the first and most important part of welcoming individuals to the Lord’s table is to ask them what accommodations they might need. This invitation should be given occasionally through the bulletin, and it should be given privately to individuals.

Here is a brief summary of some of the needs you may discover in your congregation with regard to partaking in the Lord’s Supper:


Worshipers with mobility impairments need to be able to enter the building and the sanctuary and then find a comfortable place to sit. Pew cut-outs give worshipers who use wheelchairs seating options, and accessible restrooms are necessary. If worshipers are invited to come forward for communion, worship leaders also need to be ready to serve some people at their seats.


People with visual impairments may need large print or Braille copies of the liturgy. Some people who use Braille have their own embossers and can Braille the liturgy themselves from an electronic file. People with hearing impairments need worship materials written out for them; some may wish to have sign language interpreters available.

Many worshipers benefit from having the litany explained to them in advance, or even “practicing” beforehand. For example, Hillside Church has always distributed the elements in trays passed along pews, but the leadership decided that next time they celebrate the Lord’s Supper they will invite people to come forward to receive the elements. One of Hillside’s members, Jerome, is blind. Jerome may need some explanation in advance. He might even appreciate being invited to come to the sanctuary beforehand to find “landmarks” in the sanctuary that will allow him to come forward, receive the sacrament, and find his way back to his seat comfortably.

Advance Preparation

Also at Hillside, Lori has a cognitive impairment and Alex has autism. They tend to find change difficult. If the usual communion routine is about to change, a worship leader can talk about the change with Alex and Lori and their families in advance, so that they are not unpleasantly surprised or upset by an unfamiliar routine. Lori and Alex may also find it very helpful to do a “pretend” communion celebration.

Profession of Faith

Churches that invite only professing members to partake in the Lord’s Supper should encourage and help people with cognitive impairments to make a public profession of faith. Friendship Ministries publishes an excellent guide for this purpose called Expressing Faith in Jesus: Church Membership for People with Cognitive Impairments (available at; for more information on Friendship Ministries, go to

Allergies and Intolerances

Besides accommodating people with gluten allergies and difficulties with alcohol, many churches have responded to worshipers with sensitivities to fragrances by making their entire building, or at least a section of the sanctuary, fragrance-free.


Many times the people we call “shut-ins” are actually shut-outs because the church has not made the necessary accommodations for them to attend. But some people simply cannot join with God’s people in public worship. For these, home communion is an important option. When a church I served began offering home communion, one longtime resident of a nursing home told me with mixed joy and sorrow, “This is the first time I have received communion in twelve years.”

Because God brings each person into fellowship, healthy churches work to make communion a true union of God’s people. I asked Robyn Saylor, Coordinator of Sunrise Ministries, what advice she would give to church leaders about communion. She said, “Slow it down. I can take the tray and then serve the person next to me if people just give me a little time. But I’m more used to getting out of the way because the people on either side of me just pass the tray to serve each other. People with disabilities are not in the way. As far as we’re concerned, we’re right where we should be.”


Tips for Worship Leaders
  • Be intentional. Hospitality doesn’t happen by chance. Think about which members of your congregation may need special accommodations to celebrate communion.
  • Be proactive. Seek out those who have disabilities and ask them or their families what specific accommodations they need. Include a general announcement in your church bulletin several times a year inviting people to contact a worship leader if they need any accommodations to celebrate the Lord’ Supper. Be sure to keep these individuals’ identity private.
  • Model inclusion. Invite people with disabilities to participate in serving communion by holding the bread when worshipers come forward to receive it, or blessing non-partaking children.
  • Create a welcoming culture. Help all members of your congregation learn how to interact politely with people with disabilities. For example, they shouldn’t pass the communion tray past a person with cerebral palsy if she is able to hold and pass the tray herself.

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