Advanced Healthcare Planning from the Chaplain’s Perspective

Few questions evoke as powerful of a response as that of our mortality.  Just last week, the oldest known person on earth died at the age of 115.  The reality is that even if we have a long and fruitful life, we will die.  The question ultimately is not whether we will die; it is how and when we will die that raises anxiety, uncertainty and fear.   

Religion has played a significant role in our dealing with death.  The majority of times the ritual support of one who has died is structured within a particular religious or spiritual tradition.  Questions of meaning and purpose abound.  The relationship between death and spirit is closely intertwined.

There is not a right or wrong approach.  We come from many cultures, traditions and perspectives.  We each have hopes and dreams, burdens and fears.  These inform our responses.  How we die is either by passively letting death “happen to us”, or by choosing to participate in and create this human experience.

Advanced healthcare planning is a tool - a means for communicating what is important to each individual.  Documenting the values of one’s religion, culture, hopes, and dreams are ways of participatory living.  One’s own voice and self-expression are ways to affirm one’s unique relationship with one’s creator and one’s existence and being.

The work of the chaplain is often considered care of souls.  Exploring the mysterious places within our human nature where the spirit resides is the work of religious leaders.  The chaplain is often invited into this intimate conversation at a most vulnerable time.  In the midst of distressing medical news, the chaplain is often invited to care for those in turmoil.  Deepest fears are shared.  Profound losses are mourned and grieved.  Questions of one’s ground of being are raised. The powerless experience of life’s retreat leaves an emptiness and at times raises questions of meaning and purpose. “Why did God put me here?” or “What was all this about?”  This raw vulnerable place can immobilize and bind one who experiences it.

While the removal of this human experience is not possible choices are.  Becoming a participant rather than a victim of circumstance offers a creative response and faithful expression. By voicing one’s own values, hopes, choices and dreams, one affirms that they contribute in life.  One’s own creative power is affirmed - even in the face of tragedy.

The chaplain is committed to interfaith support.  The role of the chaplain is not to advocate a particular faith response.  Rather, the role is that of an advocate to encourage and utilize the individual’s own spiritual resources in order to uphold and empower one’s own unique expression of the core of one’s being.  Advocating for the spirit is to advocate hearing the one, single, individual voice that is part of this greater drama.  The inherit value and dignity of each human being is affirmed through our expression.

Healthcare planning is a step in the direction of creating.  Having the opportunity to plan in advance of a healthcare need is to choose to participate in creation.

A benefit of advanced planning is that one’s choices can be a reflection of one’s culture, values and beliefs and can be made within one’s own community of support.  Before a medical crisis occurs, the chaplain can assist those desiring to plan in locating community resources that are available that would assist in the process of value clarification and inquiry.  Guidance may be given to encourage one in learning more about one’s own traditions in a way that strengthens the bonds within that community.  As a result, the community itself will provide additional support and care.

Initiating this process in advance allows for the impact of such emotional issues to be dealt with over a greater period of time.  Crisis decision-making often requires large shifts of thinking and feeling in a short period of time.  Planning ahead allows for the adaptation and change to occur over a greater period of time.

One’s healthcare decisions also impact the families and communities in which one lives.  One’s decisions - or lack thereof -  require a response from those who become the responsible parties and decision makers in the absence of an advanced plan.  Family members are often placed in extremely difficult decision making circumstances.  The anguish experienced by such decision making brings fears of betrayal, questions of self-doubt, battles with medical professionals and a great deal of uncertainty.

Choosing not to make an advanced healthcare plan is a choice, and it is a choice that places a great demand on loved ones.  Though it is difficult to start the conversation about end-of-life wishes, this very act can be an act of great love and compassion towards those loved the most.  To express one’s wishes is to communicate with these loved ones our hopes and values so if they are ever placed in one of these difficult circumstances, the gift of clarity and choice becomes a way for  the loved one to affirm and support their loved one, maybe for the last time.

If you don’t know how to start this conversation, talk to a chaplain in any healthcare setting.  Your own faith leader is an excellent resource to assist in identifying one’s best resources for offering a genuine expression of faith in the making of healthcare decisions.  To approach this ultimate question is, at the same time, to approach the core of our being.  In making advance healthcare decisions, you yourself become one who “cares for the soul.”