Paradoks Pastoral Care: Dominasi Dukungan Komunal dan Marginalisasi Spiritualitas Sakramental dalam Dinamika Harapan Pasien

pastoral care to sustain the healing hope of sick congregants. This study analyzes the model of pastoral care implementation and its impact on the dynamics of hope among patients in St. Johannes Sukamandi Station, an area with restricted access to ordained pastoral personnel. Using a descriptive qualitative method, data were collected through in-depth interviews with 12 chronically ill individuals and 5 lay pastoral caregivers, participatory observation, and analysis of local ecclesial documents. The findings reveal a significant paradox: the most dominant and appreciated forms of service are community visits and social fund assistance, which effectively provide emotional comfort. However, core sacramental services such as the Anointing of the Sick and Eucharistic reception are marginalized due to the scarcity of priests and the limited theological understanding among the faithful. As a result, healing hope is more often sustained by communal-material solidarity than by spiritual-sacramental strength. These findings expand the theory of hope by demonstrating how socio-ecclesial contexts shape patients' sources of hope. Furthermore, the study proposes a participatory pastoral model that emphasizes the urgency of empowering lay ministers and promoting ongoing sacramental catechesis as a holistic solution for spiritual accompaniment.