Alice,* a member of my congregation, was 76 years old and in good health when she asked me to serve as her healthcare agent, the person who will make medical decisions for her should she be unable to do so for herself. Widowed and living alone, she had no grown children, although a niece lived in a neighboring state. Her request was prompted by a workshop I led on 5 Wishes , a popular advanced directives document developed by Jim Towey, the legal counsel for Mother Teresa. After the workshop, we discussed her wishes concerning curative and comfort treatments, for burial and her funeral ceremony. She felt comforted that I, as her pastor, would endeavor to follow her wishes as her healthcare agent.
Clergy members are often asked to serve as a formal healthcare agent (also called a healthcare proxy or medical power of attorney) for parishioners like Alice. Normally, I'd file the signed legal documents, often including a living will that informs any decisions I'd make, in a church office file cabinet. However, leaving the documents at church doesn't help that much. I need them at Alice's bedside or in a hospital waiting room. Thus, I'd typically make multiple copies, keeping them at the church and in my home. I don't need to do so any more. The American Bar Association recently introduced a new digital smart phone app, "My Directives," that could help meet that need for clergy who need portable access to a parishioner's healthcare information.
It's a must download for clergy for three reasons:
1) Clergy should complete their own healthcare directives.
The media coverage on the app thus far has focused on the free version, which allows the user to record and save one profile. If you do nothing else, download the free version and complete your personal planning. Taking this step for yourself is very important as the app's website opens with a sobering statistic:
"While most all Americans think it's a good idea to talk with their loved ones about end-of-life care, less than 30% have actually done it."
Each profile includes:
• A checklist of your currently completed healthcare directives as well as contact information for your healthcare proxies. Many helpful websites and tools exist that can help you better understand what advanced directives are, how they work, and how to complete them: The National Institute on Aging offers education and resources, I highly recommend 5 Wishes provided by Aging with Dignity, the website Prepare gives step by step guidance, and The Conversation Project guides you through talking with family members about your plans.
• Once you've completed your advanced directives documents, the app enables your to save scanned versions of those forms, which can include ones downloaded from the sites above as well as POLST (Physician Orders for Life-Sustaining Treatment), a DNR (Do-not-resuscitate order), or an organ donor card. You can also list where you have hard or digital copies of your directives saved.
• Beyond those documents, the app itself provides open text fields to record critical medical information such as blood type, allergies, preferred hospital, and insurance coverage.
Completing the profile prepares you for the inevitable and will help you companion parishioners in completing their own advanced directives, a process that can be intimidating, which leads to my second reason to download the app.
2) Clergy can be a resource for parishioners.
While the free version allows you to save information for one person, the $3.99 version gives you an unlimited number of profiles. For those congregants for whom you serve as legal healthcare agent, the app makes their emergency information and wishes for care available when you need it. However, even when not the healthcare agent, the pastor's possession of a congregant's healthcare documents may help in counseling family members and ensuring that the parishioner's wishes are respected.
The app also helps us remind parishioners (and ourselves!) to keep our directives up-to date through email reminders that nudge you twice a year to review any saved directives. Over time, doctors, addresses, insurance coverage, family dynamics, and health concerns will change. We need to remember to check in with parishioners routinely about any changes to their wishes and to catalogue any new parishioners who may need us to save healthcare information for them.
3) It's easy, private, and portable.
EASY: It took about ten minutes to fill out the foundational fields of data, especially since telephone, email, and address information can be imported from your contacts list. The scanning process was a bit more intimidating but the FAQ section offers step-by-step instructions.
PRIVATE: The app opens with a privacy statement explaining that all information will be stored on your digital device and NOT in the cloud or on an off-site server. When you collect any data, remember to reassure your parishioners that any information shared will be password protected on your device. One caveat: this privacy feature makes backing up your data to your computer or a cloud storage site, like DropBox, important because you will lose all your saved data should you accidentally delete the app or your device dies. That being said, clergy have a duty to password protect wherever this confidential data is stored, on your smart phone or computer, for the sake of the privacy of those you serve.
PORTABLE: In the hospital or nursing home, you have everything at your fingertips on your smart phone or tablet (I actually downloaded the app on my iPad).
The app does lack space to include funeral home information so I would advise scanning and importing any funeral pre-planning documents and even funeral bulletins or obituaries of deceased family members of the parishioner, which can be a valuable resource in the service planning process after death when the grieving family tries to remember what song or scripture they used at Grandma's funeral four years ago.
Finally, now is the time for clergy to take advantage of new digital tools available to help prepare their parishioners for medical emergencies and aging. The next thirty years will be shaped by elder care. With one-in-three baby boomers single, there will be many more Alice's who are living alone, with no grown children, who will need clergy members to serve as a healthcare agent.
*Alice's name has been changed to protect her privacy.
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