The Anointing of the Sick is the sacrament by which Christ strengthens those who are seriously ill or weakened by age, uniting their suffering to his own Passion, giving them peace and courage, forgiving their sins, and, if it is God's will, restoring their health. It is not a sacrament only for the dying: the Second Vatican Council asked that it no longer be thought of as 'extreme unction', and the Catechism says it should be received as soon as a member of the faithful begins to be in danger of death from sickness or old age. Only a priest can anoint, so the practical task is to ask in time.

What you need

• The phone number of your parish, or of the Catholic chaplain at the hospital or nursing home
• A quiet room with a small table, a cloth, and, if you have them, a crucifix and a candle
• The sick person's wish to receive the sacrament, or, if they cannot express it, the reasonable assumption that they would want it
• A short account for the priest of the person's situation and whether they would also like to go to confession and receive Communion

When to pray it

As soon as an illness or the frailty of old age becomes serious: before a major operation, at a grave diagnosis, on entering hospice care, or whenever an elderly person grows notably weaker. It may be received again if the person recovers and falls ill anew, or if the same illness worsens.

Steps

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   Step 1: Know who may be anointed

   Canon 1004 provides that the Anointing of the Sick can be administered to any member of the faithful who, having reached the use of reason, begins to be in danger because of illness or old age. That includes a person facing serious surgery, someone with a grave or chronic condition that has taken a serious turn, and the elderly who are notably weakened even without a named illness. Children who are old enough to understand the sacrament may receive it. It is not given for minor ailments, and it is not given to the dead. If there is doubt whether the person has reached the use of reason, is dangerously ill, or is still alive, the priest may anoint conditionally.

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   Step 2: Do not wait

   The Catechism (1514) is explicit that the Anointing is not a sacrament only for those at the point of death; as soon as a member of the faithful begins to be in danger of death from sickness or old age, the fitting time to receive it has certainly arrived. Ask early, while the sick person can still take part: confess, answer the prayers, and receive Communion. The Rite of Anointing itself tells us that a careful judgment about the serious nature of the illness is enough, and the USCCB says plainly that there is no need to wait until a person is at the point of death.

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   Step 3: Call the parish or the hospital chaplain

   Telephone the parish office, or after hours the emergency number most parishes list on their voicemail, and say that a member of the family is seriously ill and would like the Anointing of the Sick. Give the person's name, where they are, how urgent the situation is, and whether they would also like confession and Holy Communion. In a hospital or nursing home, tell the nurses that the patient is Catholic and ask them to contact the Catholic chaplain; you may still call your own parish as well. Any Catholic priest may anoint; you do not need your own pastor.

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   Step 4: Prepare the room

   Clear a small table near the bed and cover it with a clean cloth. If you have them, set out a crucifix, a candle, and a glass of water for the sick person to drink after Communion. Turn off the television, invite the family to gather, and, if the sick person wishes to confess, be ready to leave the room for a few minutes when the priest arrives. None of this is required, but it helps everyone present understand that a sacrament is being celebrated, not a visit paid.

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   Step 5: Take part in the rite

   The priest greets the sick person and those present, and may sprinkle them with holy water. If the sick person wishes to confess, this happens now, privately; otherwise there is a penitential act in which everyone may pray the Confiteor▾. A short passage of Scripture is read. Then the priest lays his hands on the sick person's head in silence, gives thanks over the oil of the sick, and anoints the forehead, saying: 'Through this holy anointing may the Lord in his love and mercy help you with the grace of the Holy Spirit.' All answer: 'Amen.' He anoints the hands, saying: 'May the Lord who frees you from sin save you and raise you up.' All answer: 'Amen.' A prayer follows, then the Our Father▾, Holy Communion if it is being given, and a blessing.

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   Step 6: Let the grace do its work

   The Catechism (1520-1523) names the effects of the sacrament: a particular gift of the Holy Spirit that gives strength, peace and courage against discouragement and fear; union with the Passion of Christ, so that suffering becomes a share in his saving work; the forgiveness of sins if the sick person was not able to obtain it through Penance; the restoration of health, if it is conducive to salvation; and preparation for the final journey. Encourage the sick person to offer their suffering with Christ, to pray the Anima Christi▾ after Communion, and to make a simple Act of Contrition▾ each night.

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   Step 7: Receive it again when the situation calls for it

   Canon 1004 §2 provides that the sacrament can be repeated if the sick person, after recovering, again becomes seriously ill, or if the condition becomes more serious during the same illness. So an elderly parent anointed in the spring may be anointed again in the winter; a patient anointed before surgery may be anointed again if complications follow. The Anointing is also often given together with Viaticum when death draws near; see the guide on Viaticum and the last rites.

Tips

• Do not wait for the last hour. A person who can still speak, pray and receive Communion gets far more from the sacrament than one who is unconscious.
• Many parishes celebrate a communal Anointing at a Mass once or twice a year; the chronically ill and the elderly are welcome to come forward at it.
• Hospitals do not automatically call a priest. Ask the nursing staff to page the Catholic chaplain, or call the parish yourself.
• The sacrament is for the living. If the person has already died when the priest arrives, he will not anoint but will pray for them and with the family.