This afternoon, I got called down to a nursing home to administer "Last Rites." Sometimes you'll hear contemporary-theology-minded folks tut-tut and say, "we don't speak of the Last Rites anymore"; but telling people you don't administer "Last Rites" isn't very helpful.
So just what are the Last Rites?
Broadly speaking, "Last Rites" refers to whatever the Church can provide someone, near death, to prepare him or her for death and what lies beyond, and to strengthen him or her in this situation. In reality, it's also about the family and friends who gather around the person--the comfort is for them, too.
Strictly speaking, the only part of the "Last Rites" that's exclusively "last"--that is, for death, are the "Apostolic Blessing," which only a priest or bishop can impart, and the prayers of commendation, which anyone can pray for the dying person.
The Apostolic Blessing is given by permission of the Holy See, and is a remission of sins, but it presupposes receiving absolution--so it's intended to apply to temporal punishments due to sin and hence, relieve the dying of any "debt" to pay in purgatory. Like absolution, it's not magic: it presupposes a response of faith to God.
The other parts of "Last Rites" should hardly be held to last: the sacrament of reconciliation, the sacrament of anointing, and the Holy Eucharist. If necessary, of course, "Last Rites" can include baptism and confirmation, if the one dying requests them, or--in the case of a child, the parent requests them.
Quiz time: If time doesn't permit a priest to do everything for a baptized Catholic, then what one sacrament is the most important to give?
The answer is "c," the Eucharist. (And that's if time truly is short: because the brief administration of penance and anointing is pretty brief!)
Which do you think is next in importance to give?
The answer is "a": Absolution. Hence, the anointing, while important to give, comes third.
The sad reality is that I often can't give Viaticum to the dying: either they're non-responsive, or, more often, they have tubes, or they simply can't swallow.
Here's the truly sad part of that: most of the time, I could bring Viaticum, if only people gave me some notice. What do I mean?
It is perfectly appropriate to bring the Precious Blood as Viaticum!
But we can't reserve the Precious Blood in the same fashion as we can hosts. The Precious Blood may, quite licitly, be reserved in the tabernacle; but only for a brief time, in anticipation of such a need. So, this takes extra planning and coordination.
At my previous parish, I began to spread the word about this option; and a lay member of the staff, who coordinated communion calls to the sick, went and found some eye-dropper bottles; we blessed them, and used them for this purpose. Occasionally, folks at daily Mass would see one of these small bottles on the altar, alongside the paten and the chalice.
So often, I'll be told (as I was earlier this afternoon, when I visited the nursing home), "oh, she can't receive anything by mouth." I've even been told that a drop of the Precious Blood would be a problem. Well, I really wonder how can a tiny drop of liquid, from an eye-dropper, be any problem? (If you have expertise in this field, please comment on this specific point.)
Unfortunately, not enough think of this; not enough priests, lay pastoral associates, health care workers, patients, or their families. My advice? If you, or someone in your family, is getting to this point, plan ahead, contact your priest, and make the request ahead of time. If your priest doesn't think he can do it, feel free to describe how I've done it, and refer him to me, if necessary.
Another bit of advice, which would, at least, be helpful for me: tell the priest the dying person is dying!
After all, just because the nurse, or the lay chaplain, says the patient is dying, doesn't mean the family, or the patient, is in that frame of mind; and it's hardly comforting to launch into "prayers for the dying" for someone who isn't ready!
Also, don't worry so much about "keeping the priest too long." For my part, I worry about staying too long, and wearying the patient, and intruding on the family's time.
The two most beautiful prayers, other than the sacraments themselves, are the Litany of the Saints, and the commendation of the dying: "Go forth, Christian soul..." goes one of the prayers. I want a priest to pray that prayer for me, when my time comes, and I trust it is comforting for those who realize they're dying and want a priest to be a priest for them.
I have to confess, this remains the most mysterious part of my ministry; nowhere do I feel least adequate, do I most fear to tread. I really don't feel very competent at this ministry, but--I know the sacraments speak for themselves, and their power communicates directly with the faithful. "Unless you know for sure what to say, don't say anything" remains good advice for such situations.
By the way--please pray for Eleanor, who I visited, her family, and all in such situations. Vaya con Dios