Altzheimer’s & Communion

by Jimmy Akin

in Canon Law

A reader writes:

My grandmother had altzheimer’s for several years before she died.  During that time, she went through a series of stages; first she started forgetting things, then she became deranged (trying to light a cigarette with a pen, etc), and finally, she became near catatonic.  When my grandfather looked into having Communion brought to her, it was denied because it was speculated that she no longer recognized the Holy Eucharist as the True Presence of Christ. When he told me this, I was horrified!  I can think of very few times when the administration of Holy Communion is more urgent.

In any event, when she died, it had been a period of several years since she had received Communion.

What justification can there possibly be for denying my grandmother Holy Communion, simply because she was very mentally ill?  The explanation given above is insufficient on theological grounds, since in the Byzantine rite, Holy Communion is given to infants, who do not recognize Christ’s presence in the Holy Eucharist.  How can communion, then, be denied in the Roman rite?

Please explain this to me …

What happened to your grandmother is reprehensible. I wish I’d known about it at the time, and I may have been able to point you in the right direction for getting the situation redressed.

Here are the facts:

While it is true that in the Latin Church there is a canonical requirement for people to be able to discern the Real Presence as a requirement for making their first Communion, there is NO REQUIREMENT that a person must retain this faculty in order to continue to be able to receive Communion.

The fact that the ability to discern the Real Presence is not an absolute requirement is illustrated by two things:

1) The Church’s practice (that you point out) of allowing infants to receive Communion in many of the Eastern Catholic Churches, and

2) The historic practice of the Latin Church itself in giving Communion–at least in the form of Viaticum–to people who have lost the use of reason due to illness or age.

The Church feels very strongly that the faithful receive Viaticum no matter what their circumstances, and it is normal to provide Viaticum even to people who are totally unconscious.

I know that if I’m rendered comatose on my deathbed, that’s what I want to happen (after I’m given the anointing of the sick)!

Even apart from Viaticum, though, the Church still make available Communion to those who are mentally handicapped.

This subject was touched on at the recent Synod of Bishops on the Holy Eucharist. The Propositions that the synod fathers wrote for the consideration of Pope Benedict contain the following:

Proposition 44

The Eucharist and the Sick

We consider it of utmost importance to favor Eucharistic celebration for the sick, through an appropriate catechesis on active participation in the Passion, Death and Resurrection of Christ. A special significance of the Eucharist, as summit of Christian life, is enclosed in its reception as Holy Viaticum. Given that it opens paschal fullness to the sick person, it is recommended that its practice be intensified.

It is especially requested that Eucharistic Communion be provided to baptized and confirmed mentally disabled persons: The latter receive Communion in the faith of the family and of the community that support them.

The impossibility of knowing the effective sensitivity proper to certain types of sick people is not sufficient reason not to give them all the sacramental supports of which the Church disposes. It is important that those who suffer from disability may be recognized as members of the Church in all aspects, and have their just place in her.

It is desirable, moreover, that the architectural functionality of churches facilitates their participation in celebrations.

I need to point out that the Propositions released by the synod fathers are not a legally binding document, but they are illustrative of the attitude taken by the Church toward the interpretation of its law on these points, and the law simply does not prevent someone in your grandmother’s condition form receiving Communion.



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Brent Brown March 15, 2006 at 1:11 pm

To the Reader:
I’m so sorry that this happened to your Grandmother and your family. I hope that you can find it in your heart to forgive those who made this terrible, terrible error.

Mike E March 15, 2006 at 3:03 pm

Amen to that, Brent. Amen.

Bob Lozano March 15, 2006 at 3:03 pm

I had breakfast this morning with a friend of mine who’s a hospice nurse, and this exact topic came up. He has one or more patients die most weeks, and has often participated in communion for folks in the end-stages of some disease, including Alzheimers.
Fortunately his experiences have been uniformly better than this, and several of his stories were very moving.

John March 15, 2006 at 9:36 pm

Thank you, Bob Lozano, for spelling “Alzheimer’s” correctly.

bill912 March 16, 2006 at 4:37 am

I just googled “altzheimer’s” and got over 18,000 hits. Thanks for the correct alternative spelling, Jimmy.

discomike2000 March 16, 2006 at 3:46 pm

Thanks for all your kind words. This is something that has been bothering me ever since my grandfather told me about it several years ago.
Around the same time that she was sick, I read a book entitled “Purgatory” by F. X. Schouppe. In it, I read a story about a priest who had a vision of someone suffering in purgatory. The priest was able to speak to the suffering soul, who identified himself as an Irish king, who had been condemned to suffer in purgatory until the end of time. The priest was so moved by this poor soul’s suffering, that he said Mass for him every day for a month. At the end of 30 days, the priest had another vision, this time he saw the same soul ascending into Heaven.
Inspired by this story, after my grandmother died, my family donated some money and asked a priest to have 30 consecutive days of Masses said for her. I figure that if a man condemned to purgatory until the end of time could ascend to Heaven after 30 days of Mass said for him, how much sooner could a saintly woman like my grandmother ascend?
Not entirely related, but kind of a neat story … when her father died (he had a stroke and was left paralyzed and unable to speak), to the astonishment of all present, he sat straight up in his bed, said, “Look at the beautiful lady”, fell back, closed his eyes, and died.

aplman March 16, 2006 at 5:43 pm

“The impossibility of knowing the effective sensitivity proper to certain types of sick people is not sufficient reason not to give them all the sacramental supports of which the Church disposes.”
I’m not sure this answers every pastoral situation. I minister to several nursing homes whose residents include those suffering from dementia or Altzheimer’s. Some of these residents come to Mass in the Recreation Room in wheel chairs. When I approach them with the Eucharist at Communion time, I hold the host before them and say, “The Body of Christ.” If there is no usual facial or verbal response or gesture, I’ll ask, “Would you like to receive Communion?” Still no response? I make the Sign of the Cross out loud. Still no response? I bless the individual, tracing a cross on the forehead. My prior experience tells me that many residents who make no show of recognizing the Eucharist being presented to them subsequently remove the Host from their mouth and all manner of unintended disrespect for the Sacrament follows. In catechesis in the parish and in nursing homes I encourage families and staffs to call for Anointing and Viaticum while the person to receive these sacraments is able to participate in them. Am I wrong in this practice?

discomike2000 March 16, 2006 at 6:08 pm

Wouldn’t a drop of the precious blood suffice? The alzheimer patient couldn’t remove it from their mouths, and their recognition of it wouldn’t matter.

DiscoMike March 16, 2006 at 7:27 pm

And what, exactly, is viaticum?

aplman March 17, 2006 at 7:03 am

DiscoMike wrote: “And what, exactly, is viaticum?”
“The celebration of the eucharist as viaticum, food for the passage through death to life, is the sacrament proper to the dying Christian… The sacrament of the anointing of the sick should be celebrated at the beginning of a serious illness. Viaticum, celebrated when death is close, will then be better understood as the last sacrament of Christian life.” (PASTORAL CARE OF THE SICK, Chapter Five, no. 175)

Michael J.Houser August 3, 2007 at 11:39 am

Adveniat Regnum Tuum!
I found this thread searching, since I just made a Communion call this morning in which an Alzheimer’s patient was involved, and I wanted to know what the Church has to say on the subject.
It is interesting to note that in the old (pre-Vatican II) version of the Roman ritual it says: “Amentibus et phreneticis communicare non licet; licebit tamen, si quando habeant lucida intervalla, et devotionem ostendant, dum in eo statu manent, si nullum indignitatis periculum adsit.”
I would translate this something like: “It is not permitted to give communion to the insane and the phrenetic; however, it is permitted if they sometimes have lucid intervals, and they show devotion while they are in that state, if there is no danger of indignity.” I’m not quite sure what they’re referring to by “insane” and “phrenetic”; obviously our understanding of mental illness has become more nuanced since these older rubrics were written.
A prime concern is clearly the protection of the Blessed Sacrament from disrespectful actions that might result from giving it to someone who is not aware of what’s going on, and I think that concern still holds. For the rest, it does seem that at least in the past there were restrictions on giving Holy Communion to the mentally ill, although I’ve not found a specific treatment of the subject in more recent books. I suppose one would also have to look in the old manuals and see how this rubric was interpreted back then.

Alph August 3, 2008 at 11:13 pm

What about the Intinction? You could give a crumb of the Host to the patient like they did Terri Schiavo.

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