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Giving communion to the sick
Question from john on 7/18/2005:

I am pretty clear about who can participate in receiving Holy Communion. I am currently an extra-ordinary minister who provides communion to the sick in a local hospital. I have always followed the rules, for example, only giving communion to Catholics and if I come across a situation where a person has indicated they have not been to church in a while, or have not been to confession (if they feel they should) I indicate I will get a priest to come back and have a little chat with them (i.e. do not give them communion).

There are some in my group who will give communion to non-Catholics and will give communion to Catholics who perhaps should not receive it at that point. I have discussed this with the local head of pastoral care, the reasons they give for these actions is that they indicate that it is not our position to judge (so a person who has not attended church in years and has not been to confession should not be refused, it is up to their conscience), that in a pastoral hospital situation perhaps Anglicans may receive and that finally it is up to the local chaplain to interpret the regulations to fit the pastoral environment.

I have a problem with all of these points. Obviously, the sick, elderly or those on medications are except from the fast, but the other rules pretty much apply with no deviation. The situation that I was aware of was in extra-ordinary circumstance like a ship-wreck where people are stranded or something like that.

Anyhow, am I correct and how do I approach this. It is clear to me that some of my compatriots are not "following the rules" and they are being directed in this way from their supervisors above. I would like to be able to set the record straight so no further errors are committed.

Thanks, john

Answer by Rev. Mark J. Gantley, JCL on 7/20/2005:

It sounds like you understand the norms correctly. I am not sure what you can do about the abuses of which you are aware other than to report them to the diocesan bishop.

I am posting below the guidelines (edited) that I prepared with the held of a parishioner for a prior parish to assist those people bringing Holy Communion to the sick as extraordinary ministers.

Guidelines for Extraordinary Ministers of Holy Communion to the Sick

You have been called to a very special ministry. Jesus calls each of us to visit the sick: “I was sick and you visited me” (Matthew 25:31-46). Bringing Holy Communion to the sick is both a corporal and spiritual work of mercy. In this service, you minister to the whole person – body, mind, and soul. You serve as an ambassador of Christ (2Corinthians 5:20), the Catholic Church, and ----------parish. In bringing the Body and Blood of our Lord to the sick, you are an instrument of evangelization by your actions of love, kindness, and comfort. Getting Started: 1. In your training, you received a blue book or pamphlet with the Rite for Holy Communion to the Sick. Note the options in the Rite that vary depending on whether people are in a hospital, nursing home, or at home. Always bring a copy of the Rite with you to use. You were also given copies of pages from the Code of Canon Law on receiving Holy Communion and information on the Anointing of the Sick. Please read these before going out for the first time, and review them frequently to keep the information fresh.

2. Always use a pyx and burse when carrying the Hosts. These are available at the receptionist’s desk at the church.

3. Blessed rosaries, prayer cards and books, and parish bulletins with the phone number for our church, which can be given to the sick persons, are encouraged. Before Going Out: 4. Before Mass, put your pyx open in front of the tabernacle. If you need more than one Host, put a piece of paper with the number needed written on it. Pick up the pyx after the final blessing at the end of Mass, not during Holy Communion. Check your pyx to make sure that it has been filled before leaving.

5. Go directly to the hospital, nursing home, or to the person’s home after getting Hosts. You may not go to the store, home, to the bank, etc., with consecrated Hosts. Hospital Visits: 6. Check in at the admission desk. Pick up the list of Catholic patients and review it before beginning.

7. Check with a nurse before entering an isolation room and follow the required procedures.

8. Greet the sick person by name. This avoids possible “wrong room” or “wrong bed” situations. It is also more personal.

9. Introduce yourself, say that you are from ------- Catholic Church, and ask if it is OK to come in. This gives people a choice and a sense of control over their limited environment and makes them more open to having you there.

10. Extend your hand, make eye contact, have a soothing tone of voice, and be open to conversation. Speak loudly only if the patient is hard of hearing. Touch is very comforting for many people. Let the patient guide you as to whether he is open to a hand shake or a touch on the shoulder.

11. Show interest in them, listen, notice the positive, be compassionate of the suffering, accept them as they are, but don’t give reassurances of getting better.

12. Do not offer the information that you are a minister of Holy Communion. This will help to avoid any hard feelings when you may make the decision not to offer Holy Communion to a non-practicing Catholic. The people are almost always not aware that you are carrying the Body of Christ unless that information is offered to them.

13. Ask the patient, “Which parish are you from?” or “Which church do you attend?” in a friendly, non-confrontational way. This allows you to find out if the person is a fallen away, goes to church rarely, or now attends Episcopalian or Protestant services. Usually a practicing Catholic will offer, on his or her own, whether he or she can receive Holy Communion. Be careful of false Catholic churches (not in communion with Rome and not under the authority of the pope). Many Eastern Churches are also in union with Rome and their members may receive. Eastern Orthodox Christians are allowed to receive, if they request it. It should not be offered to them out of respect for the discipline of their own Church.

14. Take into consideration whether the patient has not attended Mass in a long time because he or she is elderly and can no longer drive, has difficulty getting around (infirmity of some kind), or has been ill for extended periods of time, or just moved to the area and has not registered at a parish yet. These are not reasons to withhold Holy Communion.

15. Spouses who are practicing Catholics are also allowed to receive, but not hospital workers.

16. Do not be judgmental. If a person has fallen away, etc., do not chastise him or her. Avoid debates on controversial subjects. Respect a person’s right to privacy by avoiding personal questions on marriage, divorce, baptism of children, etc. Offer what information you have (handouts) and defer questions you cannot answer to a priest.

17. When giving Holy Communion, follow the Rite in the blue book or pamphlet. Read the Scripture reading, especially the gospel of the day or of the past Sunday. No fast is required for either patient or caregiver. Right after giving Communion, allow for silent prayer by saying “Let us pray” and pausing before the concluding prayer.

18. If necessary, offer to break the Host into a small piece that the person can easily swallow. The person may need to drink water before and after receiving Holy Communion.

19. Be careful to read signs regarding any restrictions on water or food. If NPO is posted on the door, this means that the person can receive nothing by mouth and would not be able to receive Holy Communion.

20. Offer to pray with those who cannot receive Holy Communion. Give the choice of prayer with them or for them later. Some are not comfortable praying with a stranger or have not prayed in a long time. The Lord’s Prayer, Hail Mary, Glory Be, and a prayer for healing are all good prayers to use. You can even pray with those who are heavily medicated, unconscious, or “out of it.”

21. Don’t forget to offer a rosary, prayer card or book, or bulletin.

22. Before leaving, you may ask if the person would like to be blessed. To bless, you may trace the sign of the cross on the person’s forehead with your thumb. (Do not make the sign of the cross to bless like a priest or deacon.)

23. Let the patient know when the next minister will visit. This is comforting for many.

24. If a person is returning home and will be homebound (either temporarily or permanently), encourage them to call their parish and ask for Holy Communion to be brought to them on a regular basis.

25. Wash or sanitize your hands between patients to minimize the spread of germs.

26. Consume the left-over Hosts (broken ones too) in a discrete place with no one present. Often the chapel or meditation room is ideal, but your car is also appropriate when you cannot be alone in another location. Do not think of this as a second communion for yourself but as an extension of the Holy Communion already shared in at Mass, from which you brought the Lord Jesus.

27. If the list from the hospital does not need to be returned, it should be shredded or ripped up before discarding, but you may keep it for a couple of weeks for reference before discarding if helpful. Nursing Home Visits: 28. Follow the procedures outlined above for hospitals, and review the instructions in the blue book for giving Holy Communion to those in individual rooms.

29. For Communion services, follow the special instructions in the ritual book and be trained by the ministry coordinator or another minister in this specific Rite.

30. Be aware that the patients are often heavily medicated and may not be able to respond to questions even if they appear alert. Homebound Visits: 31. Refer to the ritual book for procedures for giving Holy Communion to the homebound. It is different from those of the hospital and nursing homes.

32. Follow the above instructions for hospital visits as they apply, except as stated below.

33. The person receiving or someone caring for him or her may have the room ready for you with a linen cloth, candle, and crucifix if available. These things emphasize the sacredness of the event. They can be omitted if circumstances suggest. You may bring these items yourself if appropriate in the circumstances, especially for a first visit.

34. Spouses and other relatives who are practicing Catholics are also allowed to receive if they request it, unless they have already received at Mass that day.

35. Safety comes first. Two ministers must always go together for a first visit to a private home or apartment.

36. If a situation seems unsafe (e.g., a single male living alone), two ministers should always go instead of one. If anything unsafe arises, leave immediately. Err on the side of caution. If you are uncomfortable, for any reason, it is better to leave and determine if the person can be visited in the future.

Calling a priest:

37. Ask the patient or the relatives present if they want a priest if the illness seems serious. Strongly suggest that they not wait until the hour of death, if they seem to not understand the sacrament of Anointing of the Sick. Explain that the sacrament of Anointing of the Sick is for healing, strength, and forgiveness if the outdated term “last rites” is used by them. You may notify the priest yourself, if one is requested.

38. The anointing of the sick does not need to be repeated during the same illness, unless there is a serious set back. You can explain this to the people if they request a priest but a priest has already visited recently.


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