In the early Church, the three Sacraments of Initiation (Baptism, Confirmation and Communion) were celebrated together regardless of the person’s age – from infancy to old age.  However, by the fifth century, these sacraments were separated in the Latin Rite, where Baptism was normally given to infants, Confirmation was bestowed around the age of 7, and first Holy Communion was reserved for teenagers.  By 1910, Pope Saint Pius X decided that the age of discretion or reason – a requirement needed to receive First Communion – should be lowered to 7 years old as well.

Currently under Church Law, the normal age for First Communion is 7 and Confirmation is between 7 and 16, where each bishop may determine the appropriate age within his own diocese.  In the Latin Rite, it is usually during the Easter Vigil that all three Sacraments are given at the same time to people entering the Catholic Church after a period of preparation.   However, in a life-and-death emergency at the hospital, a priest may administer Baptism, Confirmation, and first Holy Communion (if appropriate) at the same time.  Interestingly, in the Byzantine Catholic rite, all three Sacraments of Initiation are still administered at the same time, regardless of age, as it was done in the early Church.

The Sacrament of Anointing of the Sick has also changed dramatically over the centuries. In the Gospels, we read of Jesus’ many encounters with the sick and of his mercy in healing them from illnesses of the spirit and of the body. Jesus sends his disciples to perform the same work and gives them the power to heal: “They drove out many demons, and they anointed with oil many who were sick and cured them.” (Mark 6:13).

Later, St. James instructed: “Is anyone among you sick? He should summon the presbyters of the church, and they should pray over him and anoint him with oil in the name of the Lord, the prayer of faith will save the sick person, and the Lord will raise him up. If he has committed any sins, he will be forgiven” (James 5:14-16).  It is significant that the first major event following Pentecost was a dramatic healing when in the name of Jesus, Peter healed a crippled man at the gate of the temple (Acts 3:1-8).

In the centuries that followed, references to the power of anointing toward physical healing can be found in the writings of St. Irenaeus in the year 150 AD, St. Ephrem in 350 AD, St. Caesar in 502 AD, and St. Bede in 753 AD. In fact, all known documents from the early Church show that the rite of anointing was meant to prepare the sick for healing and not necessarily for death.  However, by the time of the Middle Ages, this Sacrament began to be viewed more as preparation for death, rather than being primarily a means of healing.

Subsequently, anointing was usually accompanied by the Sacraments of Penance and/or Communion, and only priests were allowed to administer these sacraments. Anointing of the Sick gradually lost its healing dimension and became associated with the “last rites” of the church before death, resulting in it being called “Extreme Unction” or “final anointing.” Because of this, many people avoided it or waited until death was imminent before requesting it.

The Council of Trent (1545-1563) reinforced the fact that this sacrament was instituted by Christ, should be administered to those who are close to death, and can only be done by a priest.  It stated that the significance of the sacrament is “the grace of the Holy Ghost; whose anointing cleanses away sins, if there be any still to be expiated, as also the remains of sins; and raises up and strengthens the soul of the sick person, by exciting in him a great confidence in the divine mercy; whereby the sick being supported, bears more easily the inconveniences and pains of his sickness; and more readily resists the temptations of the devil who lies in wait for his heel; and at times obtains bodily health, when expedient for the welfare of the soul.”

Several centuries later, in 1963, the Second Vatican Council restored the sacrament to its earliest purpose and renamed it “Anointing of the Sick.” Vatican II made changes to the Rite, establishing that Viaticum (final Eucharist) should be regarded as the true sacrament of the dying whereas Anointing of the Sick was to be seen as an expression of God’s presence in the midst of human illness, and Christ’s healing power and concern for all those who are seriously sick.  Hence, the sacrament of Anointing was restored to its original purpose of healing the seriously ill, asking the Lord to lighten their sufferings and to heal them.