A celebration of Holy Communion in the home, at the bedside of an ill or homebound person, or in a clinical setting such as a nursing home, hospital or hospice, is one way for congregations to provide for communion of the ill, homebound, imprisoned and others. Such celebrations require an ordained pastor to preside at this liturgy. The text of the liturgy, "Celebration of Holy Communion with Those in Special Circumstances," is on pages 83-88 of Occasional Services
The strength of this form for communing the ill, homebound, and imprisoned is that it ties together the proclamation of the Word through the Words of Institution, the pastoral office, and the ministry to the ill. Its weakness is that unless special care is taken to involve family members or members of the congregation in the bedside or home celebration of the sacrament, it can appear to be happening apart from the life and ministry of the congregation (almost like a private mass) to which Luther reacted so strongly in the 16th century and which Lutherans have carefully avoided ever since.
also provided a second way to carry out this important pastoral and sacramental ministry. "Distribution of Communion to Those in Special Circumstances" is found on pages 76-81. This service can and ought to be conducted not by an ordained pastor, but by laity who have been trained and appointed to carry out this ministry. This service is based on an understanding of Holy Communion that sees the sacrament reaching out to embrace even those who are forced to be absent because they are poor, ill, being homebound, imprisoned, and so forth.
What does this expansion of the congregation’s celebration look like? The service involves specially appointed lay ministers receiving the elements of bread and wine from the congregation’s celebration and carrying them in appropriate containers to the home or other setting of the absent members of the congregation. To make clear the connection with the congregation’s celebration, the elements should be taken directly from the church to those who are unable to be present. (The notes on the service and the service in detail make these details more apparent.)
What is the strength of this service? This form of distribution as a ministry to the ill, homebound, or imprisoned makes a very clear connection between members of the congregation in the sacrament, whether assembled in the liturgy or separated from the congregations.
The current ELCA statement on sacramental practices, The Use of the Means of Grace: A Statement on the Practice of Word and Sacrament, establishes this principle:
Principle 48 Congregations provide for communion of the sick, homebound, and imprisoned.
Application 48A Occasional Services provides an order for the Distribution of Communion to Those in Special Circumstances. As an extension of the Sunday worship, the servers of Communion take the elements to those unable to attend.
Application 48B When pastors celebrate a service of Word and Sacrament in a home, hospital, or other institution, the corporate nature of the gift is strengthened by including others from the congregation. Occasional Services provides an order for the Celebration of Holy Communion with those in Special Circumstances.
The pastor and other leaders will want both to engage in careful teaching and explanation to those who receive these ministries, and to train those who will carry it out. Preparation should also include prior contact with the absent member to arrange for either a celebration with the pastor or distribution by lay ministers.