illness have always been among the greatest problems that trouble
the human spirit. Every person of faith feels and experiences pain
as do all other people; yet their faith helps them to grasp more
deeply the mystery of suffering and to bear their pain with greater
courage. From Christ’s words they know that sickness has meaning and
value for their own salvation and for the salvation of the world.
They also know that Christ, who during his life often visited and
healed the sick, loves them in their illness.
Pastoral care ministry is modeled on the Gospels and Jesus’ example
of love and concern for the sick and those separated from their
family, friends and community. Pastoral care ministers give personal
witness to the presence of God in the church through the expression
of their faith, hope and love in their outreach and visitation to
the sick, the elderly, homebound and their caregivers. This ministry
maintains the vital relationship between those being served and
their parish community.
PASTORAL CARE FOR THE SICK AND THE DYING
The theology of the Evangelical Catholic Church with regard to the
pastoral care and anointing of the sick and dying may be taken from
the Pastoral Care of the Sick: Rites of Anointing and Viaticum
In its rite for anointing and care of the sick, the Church notes the
When the Church cares for the sick, it serves Christ himself in the
suffering members of his Mystical Body. When it follows the example
of the Lord Jesus, who ‘went about doing good and healing all’ (Acts
10:38), the Church obeys his command to care for the sick (see Mark
The Church shows this solicitude not only by visiting those who are
in poor health but also by raising them up through the sacrament of
anointing and nourishing them with the Eucharist during their
illness and when they are in danger of death. Finally, the Church
offers prayers for the sick to commend them to God, especially in
the last crisis of life.
In this, several theological and pastoral themes are evident. We see
ecclesiological and Christological elements: that is, the Church
serves the members of Christ’s Mystical Body. The missionary aspect
is evident as the Church follows the Lord’s example and cares for
the sick when and where they need us most. The sacramental aspect is
evident as anointing of the sick is intended for “raising them up”
and the Eucharist for nourishing them “during their illness and when
they are in danger of death. We also see a pastoral reality, that
anointing is situated within the wider context of visiting and
caring for the sick.
While the Anointing of the Sick is a central part of the Church’s
care of the sick, it does not stand on its own. It is complemented
with pastoral visits and with the celebration of Holy Communion. In
fact, the Introduction to Part I of the ritual states, “Because the
sick are prevented from celebrating the Eucharist with the rest of
the community, the most important visits are those during which they
receive Holy Communion” [PCS 51]. In receiving Holy Communion those
who are ill are united to Christ and to the Eucharistic community.
In the pastoral care of the dying, rites are elaborated for the
celebration of Viaticum, for the commendation of the dying, and for
exceptional circumstances (including a continuous rite of Penance,
Anointing and Viaticum and also a rite used for emergencies).
Prayers for the Dead are also included. These rites are different
from the above mentioned rites for the care of the sick. As the
Introduction to Part I of the Pastoral Care mentions, the rites for
the sick “are distinct from those in the second part of this book,
which are provided to comfort and strengthen a Christian in the
passage from this life” [PCS 42]. In the ritual, Pastoral Care of
the Sick, we thus see the entire panorama of the Church’s ritual
response to the sick and dying.
The Pastoral Obligations for Response
There are various levels through which the Church responds to the
needs of the sick and dying. The first level might be considered the
closest circle of persons who surround the sick or dying person,
usually family, neighbors, and friends. Their care, concern, and
prayers strengthen the sick person’s spirit as he or she struggles
with the physical difficulties. The element of emotional and
physical separation from the wider community is lessened by the
presence and care of those closest to the sick person.
The second level might be considered the parish community. When the
sick person is able to participate in communal prayers for the sick,
it serves to strengthen and encourage them. Visits to the sick in
their homes by members of the parish community are important for
reminding the sick person of his or her connection to the parish
community. The reception of Holy Communion is especially important
when a sick person cannot participate in the community’s Eucharistic
celebration: it allows them a sacramental expression of their
communion with the faith community of the Church.
The third level of care of the Church may be considered pastoral or
hospital care. When a sick person is in the hospital, chaplains are
often able to visit them, bring them Holy Communion and anoint them
Pastoral and Sacramental Objectives
Healing is not seen as a single goal, or even a main thrust of the
Church’s rites. Suffering is a mystery. This does not mean a
sleuth-like approach will always net a neat solution. The cause and
purpose of suffering often lies beyond rational understanding. The
believer searches for deeper meaning when encountering a mystery. We
begin with what we know: first, the link between illness and
salvation, and second, that Christ’s gospel witness is verified in
his healings as well as his compassion.
Although closely linked with the human condition, sickness cannot
as a general rule be regarded as a punishment inflicted on each
individual for personal sins (see John 9:3). Christ himself, who is
without sin, in fulfilling the words of Isaiah took on all the
wounds of his passion and shared in all human pain (see Isaiah
53:4-5). Christ is still pained and tormented in his members, made
like him. Still, our afflictions seem but momentary and slight when
compared to the greatness of the eternal glory for which they
prepare us (see 2 Corinthians 4:17).
Assessments of Patient Needs
In order to achieve the best pastoral potential when meeting
patients, hospitals, hospices and nursing home may wish to consider
including the following assessment tool and providing the results to
What is your faith or belief?
Do you consider yourself spiritual or religious?
What things do you believe in that give meaning to your life?
IMPORTANCE or INFLUENCE
Is your faith important in your life?
How do your beliefs affect or influence your behavior or health?
Are you part of a religious or spiritual community?
How is it important?
Who do you love or who is important to you?
How would you like me to address these issues in your care?
Caring for the Terminally Ill
In terminal illness several stages have been identified. Initially
there is a stage of denial, although usually a temporary response
that is replaced by some degree of acceptance. The denial can be
followed by a stage of anger expressed in “Why me?” and often the
anger can be directed against anyone or anything. Next is the stage
of attempted bargaining, usually with God, to delay the end. This
is followed by a stage of depression due to the patient realizing
what they are going to lose because of their illness, be it a bodily
part, a physical activity or an important function in the daily
activity of life. The final stage is of acceptance, which is not
necessarily a happy or peaceful stage, but the time when the patient
stops fighting their illness and regard death as a relief. These
different stage are coping mechanisms one uses to deal with a
difficult situation and often throughout there is a usually some
hope for a miracle cure. Similar stages also occur with family
members, for they can also engage in denial, expressions of anger,
attempts to bargain, depression and reluctant accepting the
The Chaplain throughout the States of Terminal Illness
In order to be an effective presence, the Chaplain has to assess
which stage the patient is in. If the patient is in the stage of
denial, the Chaplain should not judge them for what they are
saying. The Chaplain should realize and accept that anger could
often be a desire for attention, opening the door for interaction.
When caring for patients who are in the bargaining stage, it is
important not to given them any false assurances. Often the best
response is to listen.
Many of the problems experienced by terminally-ill patients can be
classified as fear. There is the fear of unknown consequences,
perhaps formed by the knowledge they have of others who experienced
terminal illness. It is a natural response for people to fear
suffering and pain; in terminal illness there can be both physical
and emotional suffering. Often there is the fear of physical
disfigurement resulting from the progression of their disease.
Also, many people fear the process of dying rather than death
A patient usually has at least four types of need: physical,
emotional, spiritual and social. The physical needs can be
fulfilled by control of distressing symptoms through nursing care.
Emotional needs can be fulfilled by proper care of the psychological
issues with the possible use of anti-depressant and anti-anxiety
medications. Social needs are usually fulfilled by those prepared
to spend quality time with the patient and assuring them of their
personal value despite their illness.
Each of the aforementioned supports are concerned with helping the
patient have as comfortable as possible journey through their
terminal illness. Yet the pastoral role is uniquely different, for
the Chaplain’s main concern is with the spiritual needs of the
patient and those of the family. In contrast the Chaplain not only
has to cope with the reality of a pending death, they many have to
explain the meaning of death to both patient and their family. And
sometimes they must also do this for the team of health care
The Chaplain’s goals
First, the Chaplain must aim to avoid mere professionalism in such a
situation. In most cases, the Chaplain will have dealt previously
with terminal illness, either in their family or through their
ministry; also they will have studied appropriate literature and
attended relevant courses; these factors can help prepare for
involvement with terminally-ill people, but they also allow for the
danger of rote professionalism. The Chaplain needs to remind
themselves of the uniqueness of each terminally-ill person, and
should respond to them as if they were the only person they are
The Chaplain and the Family
There are a variety of issues that can arise in this relationship.
The Chaplain must aim at enabling the family to face the looming
separation in the context of faith.. This does not mean they have to
experience a negative anticipation for several weeks. The period of
terminal illness can be a time of family bonding, when family
members can express their love and appreciation of one another and
also make any appropriate confessions of wrong attitudes. It can be
appropriate for the Chaplain to ask the patient, if possible, to
initiate and continue to contribute to this as it will help the
family realize they are not adding to their burdens. The dying
person should be encouraged to be a help to their relatives in the
grieving process. They may have a sense of guilt, either for past
failures or even for their inability to help their loved one at this
time of crisis. It is also an effective means of removing possible
causes of guilt after the death of the patient. Such bonding is not
merely based on family relationships but has the added dimension of
experiencing the mercy and grace of God and of looking forward
together to heaven.
Belief and Culture
Spiritual, religious, and cultural beliefs and practices play a
significant role in the lives of patients who are seriously ill and
dying. In addition to providing an ethical foundation for clinical
decision making, spiritual and religious traditions provide a
conceptual framework for understanding the human experience of death
and dying, and the meaning of illness and suffering.
The importance of spiritual and religious beliefs in coping with
illness, suffering, and dying is supported by clinical studies. Most
patients derive comfort from their religious/spiritual beliefs
as they face the end of life, and some find reassurance through a
belief in continued existence after physical death. However,
religious concerns can also be a source of pain and spiritual
distress, for example, if a patient feels punished or abandoned by
God. Furthermore, beyond the role of religious faith in coping and
adjusting to illness, religion also influences patient's medical
decisions, both about active treatment and end of life care.
A common goal for the dying patient, family members, and the health
care professional is for a meaningful dying experience, in which
loss is framed in the context of a life legacy. Such an experience
includes support for the patient's suffering, the avoidance of
undesired artificial prolongation of life, involvement of family and/or close
friends, resolution of remaining life conflicts, and attention to
spiritual issues that surround the meaning of illness and death.
Chaplains must be encouraged to set realistic goals for themselves.
Their primary goal should be the person whom God has called to this
vocation. Their goals should never be given priority over God’s
leading presence. This makes their goals be just what God wishes to
be at that particular moment (1 Thessalonians 4:3).
It is important to be spiritually prepared when making a pastoral
visit. Central in that preparation is praying beforehand. The
Chaplain should strive to clear themselves of any barriers between
themselves and God. They should also pray for the presence of the
Holy Spirit during the visit.
I am here only to be truly helpful.
I am here to represent You who sent me.
I do not have to worry about what to say or what to do,
because You who sent me will direct me.
I am content to be wherever You wish, knowing You go there with me.
I will be healed as I let You teach me to heal.
I am here only to be truly helpful.
Respectfully Yours in Christ,
James Alan Wilkowski
Evangelical Catholic Bishop for the Diocese of the Northwest
The Feast of Our Lady of Lourdes
Patroness of the Sick
February 11, 2012