The sacrament we knew as Extreme Unction is now called the Sacrament or Anointing of the Sick, as it was in the early Church. During the Middle Ages the focus was gradually changed from the sick to the dying.
However, it was never intended just for those at the "point of death" but for the sick "in danger of death," as the Council of Trent pointed out. However, it generally continued to be celebrated only for the dying.
Scripture tells us that Jesus healed people of their physical ills, often combining forgiveness of sin with the healing. Jesus seems to have focused on the disciples healing the sick as much as on preaching.
Anoint with oil
In Luke's Gospel, he sent out the 12 "to proclaim the kingdom of God and to heal" (9:1). Mark says: "They set off to preach repentance; and to cast out devils and anointed many sick with oil and cured them" (6:13).
The disciples continued to heal: Peter heals a man "lame from birth" (Acts 3:1-10) and Paul cures a man "crippled from birth" (Acts 14:8-10). The early Church continued this practice: "If one of you is sick, you should send for Church elders to anoint with oil and pray over the sick person" (James 5:14-15).
In the ninth century, a ritual for anointing the sick gives the sacrament as a communal celebration with members of the community, a choir and various ministers. On their deathbed, people received only absolution and communion called Viaticum (food for the journey).
Later, the Anointing of the Sick was included in a book of rites after the deathbed ritual. A belief developed that this was the official sequence of the Church and so the anointing continued to be combined with absolution and Viaticum. These became known as the Last Rites.
Since this became a preparation for death, prayers for healing were dropped. The senses, the hands and feet were anointed with prayers for forgiveness of sins committed by that part of the body. Since the anointing was done last, it became known as Extreme Unction (anointing).
Heal the sick
Why oil? Oil seems to have been a common remedy, perhaps something like modern-day aspirin. Early in the Church, people took oil blessed by the bishop to their homes and used it to heal the sick.
In the 1950s, a better awareness of the use of oil for these ritual healings created a renewed understanding of this sacrament as being for the sick and not just for the dying. Vatican II supported this renewal and later an official manual was published.
The Anointing of the Sick has truly become what it was meant to be. It is no longer only a private ritual in the corner of a hospital room, but is celebrated in the church, usually during a Mass, as are the other sacraments, with the prayers of the whole Church community, members of the Body of Christ supporting the sick. This is most evident on the World Day of the Sick on Feb. 11.
Of course, it is perfectly acceptable to receive this anointing at home or in a hospital, especially when a person cannot receive it in Church. When this is likely to be the last anointing, then Confession and Viaticum normally accompany it.
It can be administered to an unconscious person conditionally, but it cannot be administered to the dead unless there is still a possibility of life remaining. Therefore, it is important not to wait until the last minute.
Only the hands and forehead are anointed with a prayer for healing. Since the focus is on healing, one may receive this sacrament more than once. The anointing is advisable for the seriously ill and elderly.
Whether the person is physically healed or not, there is inner healing. God's grace strengthens the person: soul, body and mind. Those who have received it testify to its power to enable them to bear their sufferings with more patience and in union with Christ.
Therefore, the Church encourages us not to wait until the deathbed to receive the blessing and consolation of this sacrament of the Church.