Saturday, October 29, 2005

'Last Rites': what they are

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?

a) Absolution
b) Anointing
c) Eucharist

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?

a) Absolution
b) Anointing

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


Anonymous said...

Of course, I would just emphasize that ONLY those sick persons who cannot receive the sacred hosts are to receive communion under the form of wine. Secondly, the mens ecclesiae is clearly that Mass would be celebrated in the presence of such a person, when possible. This is not only appropriate theologically speaking but it also eliminates the odd practice of carrying the Precious Blood in a vessel which normally would be unsuitable and undignified.

This from the US Bishops Norms on Receiving Communion under Both Species as approved by Rome:

54. The Precious Blood may not be reserved, except for giving Communion to someone who is sick. Only sick people who are unable to receive Communion under the form of bread may receive it under the form of wine alone at the discretion of the priest. If not consecrated at a Mass in the presence of the sick person, the Blood of the Lord is kept in a properly covered vessel and is placed in the tabernacle after Communion. The Precious Blood should be carried to the sick in a vessel that is closed in such a way as to eliminate all danger of spilling. If some of the Precious Blood remains after the sick person has received Communion, it should be consumed by the minister, who should also see to it that the vessel is properly purified.

Fr Martin Fox said...

Yes, Domfriar, I agree.

Have you ever offered Mass in a hospital room, in an ICU unit, in a dying patient's room at Hospice or a nursing home? I'm curious how that worked out. Its also the mens ecclesiae that a priest offer Mass once a day, twice for special reasons. Would this count?

Also, when you offer Mass in the ICU unit, how do you keep things truly reverent for Mass? Do you find you can locate a suitable table and so forth? I assume you bring everything else with you. Of course, you'd have to do without candles around oxygen.

In all candor, I'd wonder if it wouldn't be rather tiring for the patient to wait through Mass--even a very abbreviated one--to receive Viaticum. And, to be honest, I'd wonder how reverent a Mass -- in most situations where I've ministered to dying people -- would be.

If you know of any properly dignified vessels suitable for carrying the Blood of Christ -- I don't know if you consider the eye-dropper suitable -- I am open to your suggestion.

Paul, just this guy, you know? said...

I dunno Father, I can't think of a nicer way to die than while -- or just after -- hearing mass performed at my bedside.

Anonymous said...

What do you think of the Chaplet of the Divine Mercy in such cases?

Anonymous said...

Rev Ruth says: When I took the Last Rites to one of my little flock and realised that they would not be able to swallow, I asked for a syringe (without needle!) and used that to administer a drop. It worked well and the nurse even came in and joined us for Mass.
And I agree that it is one of the most precious moments a priest can attend.

Fredi said...

Dear Father,

Thank you for this important post.

Please consider informing your readers of this resource:
(Serious Health Care and End of Life Decisions) at:


Fredi D'Alessio

Anonymous said...

I am told a nurse may give last rites if a priest is not available and there is truly no time. Can you elaborate?