Sacramental Preparation

Parish catechetical and sacramental preparation programs may need to be adapted for some parishioners with disabilities, though, as much as possible, persons with disabilities should be integrated into the ordinary programs.

 Catholics with disabilities have a right to participate in the sacraments as fully as other members of the local ecclesial community. “Sacred ministers cannot deny the sacraments to those who seek them at appropriate times, are properly disposed, and are not prohibited by law from receiving them.”
-Guidelines for the Celebration of the Sacraments with Persons with Disabilities, Revised Edition

The Revised Guidelines for the Celebration of the Sacraments with Persons with Disabilities (2017) provide a wonderful framework to provide access to the sacraments for persons with disabilities.  Included below are exerpts as regards each sacrament and what is necessary for the reception of the sacrament.

Baptism
9. Through the Sacrament of Baptism the faithful are incorporated into Christ and into his Church. They obtain forgiveness of all their sins and are formed into God’s people. They become a new creation and are called, rightly, the children of God.
11. ... Disability, of itself, is never a reason for deferring Baptism. Persons who lack the use of reason are to be baptized provided at least one parent or guardian consents to it. ... Parents who receive a prenatal diagnosis of a life-threatening condition should receive the support they need to assure that their child will be baptized “without delay.”
13. ... Like others, adults and children of catechetical age with disabilities should normally receive the Sacraments of Baptism, Confirmation, and Eucharist in a single celebration.
14. ... Catholics with disabilities may serve as sponsors and godparents, and like others who fulfill these roles, they are to be carefully chosen and formed for these responsibilities.

Confirmation
15. “Those who have been baptized continue on the path of Christian Initiation through the Sacrament of Confirmation.” In this way, they receive the Holy Spirit, conforming them more perfectly to Christ and strengthening them so that they may “bear witness to Christ for the building up of his Body in faith and charity.”
18. ... Persons who because of intellectual or developmental disabilities may never attain the use of reason can receive the Sacrament of Confirmation and should be encouraged either directly or, if necessary, through their parents, to receive it. It is important that they receive the pastoral guidance needed, along with the welcome and embrace of the whole community of faith. To the degree possible, those with disabilities should be included along with others during the preparation and celebration of the sacrament. At times, pastoral need may necessitate an accommodated setting and a simpler manner.
20. When those with disabilities who are already baptized Christians desire to become Catholic, they should participate in the Rite of Reception of Baptized Christians into the Full Communion of the Catholic Church, which normally includes the reception of the Sacraments of Confirmation and Eucharist.

Eucharist
21. The Eucharist is the most august sacrament, in which Christ the Lord himself is contained, offered, and received, and by which the Church constantly lives and grows. It is the summit and the source of all Christian worship and life, signifying and effecting the unity of the People of God, providing spiritual nourishment for the recipient, and achieving the building up of the Body of Christ. The celebration of the Eucharist is the center of the entire Christian life. 
22. ... It is important to note, however, that the criterion for reception of Holy Communion is the same for persons with intellectual and developmental disabilities as for all persons, namely, that the person be able to “distinguish the body of Christ from ordinary food,” even if this recognition is evidenced through manner, gesture, or reverential silence rather than verbally. ...Cases of doubt should be resolved in favor of the right of the Catholic to receive the sacrament. The existence of a disability is not considered in and of itself as disqualifying a person from receiving Holy Communion. 
24. Catholics who require nourishment through feeding tubes are encouraged to receive Holy Communion, as are all the Catholic faithful. Christ is sacramentally present under each of the species, and Holy Communion can be received under the species of bread or wine alone. Since the full presence of Christ and his sanctifying grace are found in even the smallest piece of the consecrated host or in a mere drop of the consecrated wine, the norm of receiving through the mouth remains the same for those who otherwise use a feeding tube for sustenance, and Holy Communion is not to be administered through a feeding tube. For these communicants it will commonly be possible to place one or a few drops of the Precious Blood on the tongue.
25. Catholics with Celiac Sprue Disease or other conditions that make them gluten intolerant should be given the opportunity to receive a small fragment of a regular host, and made aware of the options to receive a low-gluten host or to receive under the form of wine alone.
26. When baptized Catholics who have been regular communicants develop advanced Alzheimer’s or other age-related dementias, there is to be a presumption in favor of the individual’s ability to distinguish between Holy Communion and regular food.

Reconciliation
27. In the Sacrament of Penance, the Catholic faithful obtain from the mercy of God pardon for their sins. At the same time, they are reconciled with the Church, which they have wounded by their sins and which works for their conversion by charity, example, and prayer.
28. ... As long as the individual is capable of having a sense of contrition for having committed sin, even if he or she cannot describe the sin precisely in words, the person may receive sacramental absolution. Those with profound intellectual disabilities, who cannot experience even minimal contrition, may be invited to participate in penitential services with the rest of the community to the extent of their ability. 
29. In the case of individuals who are nonverbal or have minimal verbal communication ability, sorrow for sin is to be accepted even if this repentance is expressed through some gesture rather than verbally. Many Catholics experience significant communication difficulties related to autism spectrum disorder, traumatic brain injury, post-stroke complications, and other conditions. Catholics with significant communication disorders may be permitted to make their confessions using the communication system with which they are most fluent.
30. Catholics who are deaf should have the opportunity to confess to a priest able to communicate with them in sign language, if sign language is their primary means of communication. They may also confess through an approved sign language interpreter of their choice. The interpreter has the obligation to observe secrecy. When neither a priest with signing skills nor a sign language interpreter is available, Catholics who are deaf should be permitted to make their confession in writing or through the use of an appropriate portable electronic communication device that can be passed back and forth between the penitent and confessor. The written or digital materials are to be returned to the penitent and properly destroyed or deleted.
31. Pastoral consideration needs to be given to those for whom reception of the sacrament within the confines of the confessional may be problematic. While this would certainly constitute a just cause for Reconciliation outside of a confessional, every effort should be made to ensure that penitents who are wheelchair users have access to both face-to-face and private confessionals, with due regard for the right of the priest to insist on confession behind a fixed screen.

Anointing of the Sick
32. Through the Anointing of the Sick, the Church commends to the suffering and glorified Lord the faithful who are seriously ill, so that they may be relieved of their suffering and be saved.
34. Since disability does not necessarily indicate an illness, Catholics with disabilities should receive the Anointing of the Sick on the same basis and under the same circumstances as any other member of the Christian faithful.

Holy Orders
36. By divine institution, some among the Christian faithful are constituted sacred ministers through the Sacrament of Orders. They are consecrated and deputed to shepherd the People of God, each in accord with his own grade of orders.
37. The existence of a physical disability is not considered in and of itself as disqualifying a person from Holy Orders. However, candidates for ordination must possess the necessary spiritual, physical, human, moral, intellectual, emotional, and psychological qualities and abilities to fulfill the ministerial functions of the order they receive. The proper bishop or competent major superior makes the judgment that candidates are suited for ordained ministry in the Church.

Marriage
41. In the Sacrament of Matrimony, Christians signify and participate in the mystery of the unity and fruitful love which exists between Christ and his Church. They help each other to attain holiness in their married life and in the rearing and education of their children.
44. Couples with intellectual or developmental disabilities who believe they are called to the vocation of married life are encouraged to seek counsel by discussing the Sacrament of Matrimony with their families and pastors. For matrimonial consent to be valid, it is necessary that the contracting parties possess a sufficient use of reason; that they be free of any grave lack of discretion affecting their judgment about the rights and duties to which they are committing themselves; and that they have the mental capacity to assume the essential obligations of the married state. It is also necessary that the parties understand that marriage is a permanent union and is ordered to the good of the spouses and the procreation and education of children. ...A physical disability, in and of itself, does not necessarily constitute an impediment to marriage. Medical and canonical opinions should be sought in determining the presence of any impediments to marriage. It should be noted, moreover, that paraplegia does not always imply impotence, nor the permanence of such a condition, and it is not in itself an impediment. In case of doubt with regard to impotence, marriage may not be impeded.
45. Catholics who are deaf are to be offered the opportunity to express their matrimonial consent in sign language, if sign language is their primary means of communication. ... Likewise, those who are nonverbal or have minimal verbal communication ability should be offered the opportunity to express their matrimonial consent using the communication system with which they are most fluent.