My friend, Mark Horne, has raised some important pastoral concerns regarding the participation of physically and cognitively impaired persons in the sacraments. I contributed the following as feedback, not to chide Mark, but to share from my own struggle to overcome the practical and credal limitations imposed by American Presbyterian/Reformed practice.
Presbyterian Bedside Rites (If there is such a thing)
PCA folk generally won't be able to properly imagine the communion of persons outside of public worship (whether because of cognitive or physical difficulties) without a minor liturgical reformation regarding bedside rites and the reservation of the Sacrament.
First, The Westminster standards preclude private masses, and the usual practice of inviting the elders and deacons to an off-site service would seem to violate the spirit of that precept. If anything, the Puritans who composed the confession would have been working from the principle that the grace of the sacrament is non-peculiar and spiritually available elsewhere, so why go to extremes to provide something nonessential?
Secondly, when the Sacrament is re-consecrated in these services (where it is properly consecrated at all), a real disservice is done to the notion of the common table. The Book of Common Worship prescribes this solution to the dilemma. I used it for a while, but stopped when my conscience got the better of me.
Having a number of older folks in my Chicago congregation, I adopted beside liturgies of the Book of Common Prayer and bought a portable communion kit with a pyx to reserve a portion of our Sunday sacrament. I added to the kit some anointing oil and a small stole.
By the time I left Chicago, my home bound folks came to expect that I would bring Holy Communion each time I visited. Fortunately, the RCA isn't quite so hung-up on these things, and I was able to get away with my "Puseyan" innovations.
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