Understanding the Sacrament of the Sick
Making Christ’s healing presence known within the faith community
One of the major beliefs we have as Catholics is that the mission of Jesus Christ continues to be carried out sacramentally — that Christ is alive and active in each of the seven sacraments.
What’s more, we believe that the sacraments are meant to be experienced communally, that Christ is present and active not only in the sacrament conferred but, by extension, in the gathered community. As a Church, we have become much better at recognizing this reality in Eucharistic celebrations, as well as in communal penance services and baptisms that are celebrated within the context of Mass. But one area where we still struggle to achieve a truly communal experience of Christ’s sacramental presence is in the anointing of the sick.
Too often, we priests are called at the last minute to anoint a dying person who is already unconscious. Even when family members are present, they are often bystanders waiting for the priest to “perform the last rites” — 50 years after we were supposed to excise that term from our ecclesial vocabulary.
Sometimes it even borders on the superstitious. How often have we been called to anoint a person who was anointed earlier the same day or the day before? There is a need for greater catechesis on what the Sacrament of the Anointing of the Sick is meant to be. What’s more, in a culture that attempts to deny the reality of aging, sickness and death, our faith communities do not always have a proper understanding of the role that our sick brothers and sisters, and sickness itself, play within our communities. We face a huge challenge.
Origins in Scripture
It certainly did not start out that way. When we search the Scriptures, it is clear that those who were sick held a special place in Jesus’ heart. No matter how much the crowd pressed in on him, no matter what matters needed attention, if there were sick present, Jesus made a beeline for them. Everything else came to a halt until the sick and suffering had been attended to.
In response to the question posed by the disciples of John as to whether or not Jesus was the Messiah, he replied: “Go and tell John what you have seen and heard: the blind regain their sight, the lame walk, lepers are cleansed, the deaf hear, the dead are raised, and the poor have the good news proclaimed to them” (Lk 7:22). Jesus’ ministry was very much one in which the sick were restored to spiritual and physical health. And Jesus requested that his disciples continue ministry to the sick, stating that when they did so they were ministering directly to Jesus himself: when I was “ill and you cared for me” (Mt 25:36).
The disciples took Jesus’ words to heart, and we see in the Letter of James how they continued Jesus’ ministry to the sick: “Is anyone among you sick? He should summon the presbyters of the church, and they should pray over him and anoint [him] with oil in the name of the Lord, and the prayer of faith will save the sick person, and the Lord will raise him up. If he has committed any sins, he will be forgiven” (Jas 5:14-15).
Unfortunately, with the passing of centuries, the anointing of the sick became increasingly associated with preparation for death, and therefore somewhat utilitarian. By the 12th century, the use of the term “extreme unction” was widespread, and it was increasingly administered as a final sacrament that was combined with viaticum. Among the laity, “last rites” became the standard name for the sacrament, and people were taught to wait until death was inevitable before calling for a priest.
The Second Vatican Council recognized that this diminished understanding deprived many of the healing effects of the sacrament. Sacrosanctum Concilium stated: “‘Extreme Unction,’ which may also and more fittingly be called ‘anointing of the sick,’ is not a sacrament for those only who are at the point of death. Hence, as soon as any one of the faithful begins to be in danger of death from sickness or old age, the fitting time for him to receive this sacrament has already arrived” (No. 73).
Furthermore, in Lumen Gentium, the role of the sick in the kingdom of God is emphasized: “By the sacred anointing of the sick and the prayer of her priests the whole Church commends the sick to the suffering and glorified Lord, asking that he may lighten their suffering and save them; she exhorts them, moreover, to contribute to the welfare of the whole people of God by associating themselves freely with the passion and death of Christ” (No. 11).
United in Suffering
With this in mind, an important question arises: If a major aspect of the anointing of the sick is to give the sick person a sacramental experience of the healing presence of Christ and to unite him or her to the sufferings of Christ and to the faith community, then why are we so often called in at the last moment to anoint a person who is no longer conscious? What’s more, why are the sick so frequently at the margins of a parish community, rather than at the center of it as Jesus’ words and actions indicate? And how do we change that?
Catechesis and Praxis
As is so often the case in parish life, it comes down to two major areas: catechesis and praxis. If we are to change how the sick are ministered to in our parishes, and if we are to reshape our parishioners’ understanding of the Sacrament of the Anointing of the Sick, then both areas are important. The people (and sometimes priests and deacons) need to deepen their understanding of sickness in the life of the Christian and what the Church has to say about it. And then concrete steps need to be taken to reorient a parish outreach to the sick.
The homily is a good place to catechize. How often in our homilies do we discuss sickness? How often do we talk about what it feels like to be sick, to be confined to our homes? Are we able to share our own experience of infirmity, as well as the experiences of our sick members? It is important to do this.
Within the Sunday assembly are many who are suffering from a serious illness, and their loved ones are also present. We also must be mindful of the fact that at every Mass are people who are on the verge of no longer being able to attend liturgy or participate in parish events due to illness. The homily is an excellent way to help catechize and prepare for this reality.
This past year I was called to anoint a woman who had contacted the parish office with three requests — the anointing of the sick, an application for a cemetery plot and a funeral planning sheet. I drove to her home wondering what I was going to find waiting for me. When I entered the house I met a delightful woman who was in the final stages of pancreatic cancer.
She shared with me some of her life stories and then said: “It has been a wonderful life. I haven’t regretted any of it. I don’t regret this, either … it is time for me to go.” Then, with a twinkle in her eye, she added, “I tell my friends if they feel a rush of warm air when I pass, then they know I went the wrong direction.” With her permission, I shared this in my homily, and from the response, I saw that many people appreciated an honest reflection about terminal illness and hope.
In addition, people are grateful when a priest shares his own experience of suffering. A good priest friend of mine was dealing with terminal cancer. While preaching at the Triumph of the Cross liturgy, he revealed in his homily that he was a very private person and that one cross that he had been forced to accept was that priests are not permitted to deal privately with serious illness. We are not allowed to die privately. He also shared that this cross had allowed him to deepen his relationship with others, to receive the love they had to offer. He admitted that this was something that he had not always been able to do when he was healthy.
This simple, beautiful moment of honesty reshaped for some the understanding of illness, not only as a cross but as an entry point for grace. Preaching on illness and the centrality of sick people in the life of the Church is crucial if we are to help people move into a deepened understanding of this reality. What we preach can be reinforced in bulletin articles and adult faith formation classes.
Celebrating the Sacrament
If we want to deepen our parishioners’ understanding of sickness and grace, we could also pay greater attention to how the sacrament is celebrated. The Catechism of the Catholic Church challenges us on this: “Like all the sacraments the Anointing of the Sick is a liturgical and communal celebration, whether it takes place in the family home, a hospital or a church, for a single sick person or a whole group of sick persons” (No. 1517).
In other words, it is liturgy. How many of us would be satisfied with a rushed Eucharistic liturgy where optional parts were left out and only the crucial elements were included? How many of us would want to celebrate the Mass solo, with no one else taking part? Certainly, in some settings, we need to keep the ritual simple and concise, especially if someone is gravely ill; but to do whatever we can to make it prayerful, inclusive and loving will result in a deeper experience of the sacrament for all. What’s more, the liturgy itself catechizes; it is not something we want to rush through. This is especially true when the sacrament is celebrated within the context of Sunday Mass, where all present can participate in praying for the sick.
Suffering for Others
Another area of the rite that is often overlooked is that the role of the sick person is not strictly passive. He or she receives sacramental grace, certainly, but the sick person also unites himself or herself to the passion and death of Christ for the good of the People of God.
This concept is thoroughly biblical: “Now I rejoice in my sufferings for your sake, and in my flesh I am filling up what is lacking in the afflictions of Christ on behalf of his body, which is the Church” (Col 1:24).
In other words, suffering can be offered for others. The Catechism reinforces this concept: “He [the sick person], for his part, through the grace of this sacrament, contributes to the sanctification of the Church and to the good of all men for whom the Church suffers and offers herself through Christ to God the Father” (No. 1522).
This message is so important for our sick members to hear. They often struggle with feelings of uselessness. They, who once did so much for others, find themselves wondering what they have left to offer. The Church assures them that they indeed have much to offer — their very selves, for the good of others.
We can also entrust our sick members with prayer intentions. Asking them to pray for an unemployed person or a woman with a high-risk pregnancy shows how much we regard them as brothers and sisters in Christ who still have much to contribute.
Placing the sick at the center of the community involves more than a good celebration of the Sacrament of the Anointing of the Sick. In today’s world, the sick can frequently fall through the cracks, even in a close-knit parish community. This problem is exacerbated by the growing size of parishes and the diminishing number of priests.
Every parish should have a person who coordinates outreach to the sick, and that person needs to be properly catechized and trained. This coordinator would maintain a parish sick list, keep track of who is may need anointing, and assist parishioners who are ministers to the homebound.
Ideally, this coordinator would oversee a committee that looks for opportunities to bring the sick into closer contact with the larger parish community and vice versa. An outreach-to-the-sick committee could also create programs to catechize the larger parish on issues related to sickness and the Christian life.
In a culture that undervalues the sick to the point where they are marginalized and, increasingly, offered the option of terminating their lives, the Church is in a privileged position to demonstrate what a gift the sick are to the rest of us. Our parishes can become places where people who are sick know that they are respected and cherished as sources of “ecclesial grace,” as the Catechism refers to them.
By celebrating the Sacrament of the Anointing of the Sick with them as a community, by praying with them and for them, and allowing them to pray for us, our outreach to the sick can be a true continuation of the ministry of Jesus. Through deepened catechesis and praxis, our parishes can become places where all can find healing through word, sacrament and community.
FATHER SCOTT JONES is a priest of the Archdiocese of St. Louis, pastor of Immaculate Conception Church in Arnold, Missouri, and a former assistant professor of Church history at Sacred Heart Seminary and School of Theology in Hales Corners, Wisconsin.
Better Experience for the Sick and the Community
I know that for myself, my conversion to a sacramental experience of the anointing of the sick came early, during my transitional diaconate year in Milwaukee. I attended a chrism Mass celebrated by Cardinal (then Archbishop) Timothy Dolan. The words of his homily challenged me to think about the Sacrament of the Anointing of the Sick in a new way.
Reflecting on the polarized culture in which we live, Archbishop Dolan asked a powerful question: “Why are we so angry? Why is anger such a defining element of our culture? We wear our anger like a fashion accessory. It is as if the only way to show we are serious about something is to be angry.”
He then went on to talk about the calming, soothing effect of oil, that it is often used to bring comfort and peace to those who are suffering. He talked about how the oil blessed for use in the anointing of the sick was intended to comfort and strengthen those who are weakened with illness.
I had always had a functional view of the sacrament — that it bestowed grace, forgave sin and prepared the person for either a happy death or a speedy recovery. Despite what the Catechism of the Catholic Church said about helping the person to find courage, peace and comfort in his or her infirmity, that had never been my focus. Archbishop Dolan challenged me to reflect on how the reception of the sacrament could be a better experience both for the sick person and for the community.
— Father Scott Jones