Anointing of the Sick: what it is and when to ask

When someone you love becomes seriously ill, a moment comes when the question gets asked, and almost always in a lowered voice: should we call a priest? Many people don’t dare, for a reason they rarely put into words. They feel that calling would announce something. That the sacrament would tell the sick person what nobody around them has yet had the courage to say.

That fear rests on a misunderstanding. It is an old one, it is understandable, and it costs weeks.

It is not “last rites”

For centuries, practice drifted: the anointing came to be reserved for the final moments, and the name Extreme Unction stayed in people’s minds long after the practice itself had changed. The Second Vatican Council took the question head on in 1963:

“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.

Sacrosanctum Concilium, 73 (1963)

The Catechism repeats that sentence and adds the timing: as soon as one of the faithful begins to be in danger of death from sickness or old age (§1514). The verb carries the whole thing. It does not describe a road ending. It describes a threshold crossed.

Where the gesture comes from

The gesture existed before it had a name. A letter of the New Testament describes it in three lines:

Is any among you sick? Let him call for the elders of the assembly, and let them pray over him, anointing him with oil in the name of the Lord; and the prayer of faith will heal him who is sick, and the Lord will raise him up. If he has committed sins, he will be forgiven.

James 5:14-15 (World English Bible)

Notice who calls. It is not the Church arriving to assess a condition, it is the sick person sending for help. The verb is active, and it sits on their side. That detail settles most of the awkwardness: asking for the anointing is not receiving a verdict, it is making a phone call.

What actually happens

A priest, and only a priest, gives this sacrament (§1516). In the Roman rite he anoints the forehead and the hands with oil blessed for that purpose (§1513). The words he says ask two things: that the Lord in his love and mercy help the sick person with the grace of the Holy Spirit, and that he free them from sin and raise them up.

It takes a few minutes. It happens in a hospital, at home, in a room where other people are standing around not knowing where to put themselves. Nothing about it is dramatic, and that is deliberate: the sacrament is not trying to impress someone who has no energy left to spend.

When to ask, and how often

As often as needed. It can be received again in another grave illness, or a second time within the same illness if the condition worsens; it is also fitting just before a serious operation, and for elderly people whose frailty is increasing (§1515).

This may be the least known part, and the part that defuses the fear best. A sacrament that can come back is not a full stop. It returns as the illness returns, each time a new turn arrives. A prayer the night before surgery and an anointing received that same morning are not competing: they make the same journey, one with words, the other with oil.

What it does not promise

This has to be said plainly, because many people are waiting for it: the sacrament does not guarantee healing. The liturgy has always asked that the sick person recover health, with a condition attached that keeps the request honest rather than magical: if it would be conducive to his salvation (§1512).

What is promised without condition lies elsewhere, and it is already a great deal: strength given, and a forgiveness that does not wait to be correctly worded. James writes it in that order, in fact. The Lord will raise him up, and if he has committed sins, he will be forgiven. The second clause arrives afterwards, almost in passing, like something that goes without saying.

What the person keeping watch can do

In practice: call the local parish, or the hospital chaplaincy, which exists in most hospitals and whose number nobody thinks to ask for. You can do that before mentioning it to the sick person, just to find out what is possible, and raise the question afterwards without making it solemn. “Would you like a priest to come by?” is a sentence that can be said.

And in the meantime, what is always possible remains, including when the words don’t come. If yours are missing, here are some, written for this page.

Lord, I no longer know what to ask, only that You reach that room before we do. Let this oil say what we can no longer say. Give health if health can come, and Your peace either way.

This sacrament does not say it is too late. It says the opposite: that it is time, and that someone is coming. The rest, sitting up, phoning, carrying a name each evening or entrusting a body that is failing, goes on as before, with one weight less.