Agreed, on both counts. I can understand the need for them as far as the sick and elderly go, but they're over-utilized, at least in my diocese. But, as you said, things are changing and some of these practices will eventually fade away. And *practices* they are. Not dogma.
I think in our small parish church, they are not really necessary, but on the counter-side of the point, it gives the priest a lot more time for his homily.( A lot more!) And I think the people really need to hear more....
I notice different patterns in how the EMs are trained. In our parish church, it is very ordered. In some they are not.