On the church’s pastoral care of the sick and dying

By Michael R. Heinlein, OSV News

(OSV News) -- When someone is sick, elderly or dying, Catholics tend to automatically think of sacramental anointing. But we don’t tend to think about the sacrament consistently. Some only think it is for those who are actively dying, while others think it ought to be received without serious reason. Sacramental anointing seems to be one of the more underappreciated, misunderstood, under-utilized and least talked about of our seven sacraments.

Some of it is a matter of poor catechesis, some of it is a growing shortage of priests and diminished availability, and some of it is a matter of the culture and our own self-reliance rather than our reliance on God, particularly in times of vulnerability. But whatever the reasons that anointing of the sick doesn’t seem to get its proper due, we can be sure it is an important opportunity to receive Christ’s grace and make his life our own.

The sacrament, in fact, conforms us more clearly to Christ, especially to his passion and death. Through his presence and grace in the sacrament, we are reminded we are not alone, that our struggles, pains and sufferings are not isolated; that we can lean on the crutch of the cross amid our illnesses, infirmities and approaching death to make sense of it all and find strength, purpose and hope.

Anointing of the sick is explicitly mentioned in Scripture, in the New Testament's Letter of St. James (5:14-15), which also identifies it as a ministry of the priest. Through him, Christ is able to encounter, accompany and strengthen those who receive the sacrament. Jesus can bring physical healing to the person, of course, as he brought the same to so many during his public ministry. But as those cures were meant to herald the coming of the Kingdom of God, our prayers for healing now originate mostly from a desire for spiritual healing in the face of illness and death. Christ conquered sin and death, and, through his grace, we share in the victory of his passion, death and resurrection. We experience in this sacrament Christ's peace, assisting us to face the difficulties ahead, as well as his courage and determination to embrace the will of God for our sanctification and for that of the whole world.

We do not need to be at the point of death to receive the sacrament, a fact sometimes confused in the minds of many. The sacrament is for all those seriously ill, so some discernment is needed to determine applicability.

Celebration of anointing of the sick

Anointing of the sick is only administered by a priest or bishop. It may or may not include the sacrament of penance as well, depending on the circumstances. At a minimum, reconciliation is made available for the recipient, if possible. The Liturgy of Anointing itself, during the celebration of the sacrament, involves principally the laying on of hands and the anointing with oil. The laying on of hands recalls Christ's healing of the sick through the same gesture, and offers a sign of the Holy Spirit's presence. The oil of the sick, often itself having been blessed by a bishop at a Chrism Mass in advance of the previous Easter, is applied to the forehead and hands of the person being anointed. The use of oil in Scripture is both remedial, comforting and restorative.

There are times during the year that parishes might offer communal celebrations of the sacrament, either within the context of the Mass or as a separate celebration. The sacrament is available for those whose health is seriously impaired, discerned without scrupulosity, and should not be administered indiscriminately and without prudential judgment. Those to be anointed include the elderly and those preparing for surgery. It can be repeated if the illness returns, if the same illness worsens or has become chronic, or when requested and determined by the minister's pastoral judgment to be warranted.

Timing for anointing

The Sacrament of Anointing of the Sick does not consist exclusively of what is commonly referred to as the "last rites" of the church. It is a sacrament to be celebrated early in illness and may be repeated as a condition worsens or death is thought to be approaching. What constitutes "last rites" would consist of "viaticum" and the Commendation of the Dying ritual prayers.

Part of overcoming this common misunderstanding of the sacrament's timing is to encourage the celebration of the sacrament outside of preparation for death itself. Many priests say privately, but would do well to announce more regularly in the pulpit or elsewhere, that the faithful should not wait until death seems imminent to request sacramental anointing. With fewer priests, and more faithful under their charge in many places, it has become increasingly difficult for priests to be available at a moment's notice. But waiting also keeps God's grace from the person needing it. It is important to see to it that a person in need of the sacrament can receive it as soon as reasonably possible.

Visits to the sick

Anointing of the sick itself is far from the only opportunity for spiritual care of souls, and the church envisions that we are regularly to be offering those who are sick, elderly or dying. There are a variety of rites and prayers available from the church's liturgical treasury that help us to minister to the vulnerable among us. In addition to the rites for celebrating anointing, these are all contained in the rites of Pastoral Care of the Sick, and they should be made more widely known and available.

Visits to the sick may use a ritual centered around Scripture and prayer. An important aspect of these visits is to help the sick person be able to pray, as prayer can at times be difficult when ill. The visits are also meant to accompany, encourage and strengthen the sick. These visits should also be pointing toward and flowing from visits in which Communion is received by the sick person. There are also rituals for the administration of Communion to sick persons in ordinary circumstances or for those in institutional care facilities.

Viaticum

Each illness is different, just as is each death. In the case of the latter, with the help of medical professionals, we try to read the signs of approaching death so that we can be as present and attentive to the person's needs.

Christ said, "Whoever eats my flesh and drinks my blood has eternal life, and I will raise him on the last day" (Jn 6:54). It is, therefore, ideal for a sick, elderly or dying person to be regularly receiving Communion as far as he or she is able. To ensure this, care should be taken to contact the local parish, or the spiritual care staff if at a nursing or medical facility, early in the stages of incapacitating illness or infirmity. Often there are care facilities at which Mass is regularly celebrated or where Communion is distributed, but in some cases it must be specifically requested. If not, one's pastor can be asked to permit the family to bring Communion to their loved one.

The time for an individual's final time Communion before death is called "viaticum" -- meaning food for the journey -- and it unites the dying person with Christ in his passover from death to life. Again, it should be arranged with attentiveness to the person's condition when there is at least a little time to spare. Sometimes as death approaches, it becomes very difficult for the dying person to receive holy Communion. In those cases, it is a consolation to remember that the fruits of the last Communion we’ve received do not have an expiration date and remain living, effective and fruitful still. A spiritual communion might be recited for the person to join in or hear at that time. The most important thing is to not wait until the person is unable to receive the sacrament for whatever reason.

It is fitting that the baptismal profession of faith is also part of the rite for viaticum, tying together the individual's beginning in the life of grace that now draws to a close and prepares for birth into eternal life.

Apostolic pardon

Usually along with viaticum, but not typically when celebrating the Sacrament of the Anointing of the Sick (unless in emergencies or other rare exceptions), the priest will offer the Apostolic Pardon. This is a blessing with a plenary indulgence attached to it, which forgives temporal punishment due to sin.

Commendation of the dying

The prayers offered for use when the time death is near is meant to assist the union with Christ established in viaticum. The church makes clear we have the responsibility to assist the dying person with our prayers for mercy and hope. Priests and deacons are encouraged to lead the prayers of this rite when possible, but any laity are also encouraged to make use of these prayers -- the texts of which should be "readily available," as the rite says -- for the good of the person dying.

The ritual contains a variety of options for use, and any or all can be used, depending on the circumstances. There are a number of short texts from Scripture and other pious invocations. The passages remind us of the salvation won for us through Christ's paschal mystery, our trust and dependence on him, our hope for the future. The passages, often familiar selections from the gospels, New Testament epistles or psalms, can be recited one or several times. The line, "Father, into your hands I commend my spirit" (Lk 23:46), Christ's words of obedience and oblation, can be a great consolation.

There also are longer readings from Scripture provided in the ritual, from both Old and New Testaments. Since the Word of God is always living and effective, hearing familiar passages came alive afresh, with new meaning and significance at such a poignant moment in our lives. It helps to situate a loved one's death within the only context of death that matters for a Christian: to see his or her story absorbed into Christ's story, finally and completely, sealing what began at baptism. It is encouraged, drawing upon the connection of baptism, to also trace the sign of the cross on the dying person's forehead.

To expand this reality, a litany of saints is also provided. Calling upon holy men and women of every time and place is a great consolation. Not only are they in heaven, and praying for our loved ones as they prepare to cross over to the life of the world to come, but these were also men and women who suffered and died, too. There is a special peace that comes in seeking their intercession. The instruction invites invocation of special saints, particular personal patrons of the dying person, the family or of the parish to be included.

When death appears to be imminent, there is the prayer of commendation. There are several options, all of which are among the most beautiful prayers in our liturgical and spiritual patrimony. At that difficult and vulnerable moment, we do not cling to the dying person, but with our prayers bid their soul to "go forth" in the name of the Blessed Trinity. We pray for the dying person's peace, for his or her home to now be in heaven with God, with Mary, Joseph and all the angels and saints.

Finally, the ritual includes prayers to be recited after death. Here the angels and saints are invoked to come to the aid of the recently deceased and usher them into paradise. There is also a psalm and closing prayer. Additionally, at the end, there are a few brief prayers of consolation and hope for family and friends. These can all be useful prayers as the family might spend time with the deceased as funeral home staff comes to retrieve the body.