Can we talk? It’s important.

“Tis impossible to be sure of any thing but Death and Taxes,”
~ Christopher Bullock, “The Cobbler of Preston”

With tax day coming up on April 15, most of us are focused on the second thing mentioned in that quote. Taxes are discussed freely – sometimes at volume! – in many social and community settings, with everyone having both experience, and an opinion, on the topic.

That other utter certainty of the human condition – death – is rarely spoken of in public, or private, spaces, beyond hushed whispers, or the pious prose of the funeral eulogy.

I’d like to invite you to change that paradigm. I encourage you to talk to others, particularly your family, about how spelling out what your ideal end of life scenario is, and writing it down for future reference. You don’t have to be actively dying to start thinking about what you’d like to have happen when that time comes. It can even be fun – really! – if you turn it into a game.

You might be surprised to hear that there are not one, but four, actual games available for this very purpose. Here’s the list:

  • The Circle of Life comes from Dying Matters and In the End Care in Britain. This card-based game is aimed at increasing public understanding of how they can plan ahead and make their end of life wishes known. The packs of cards were developed with the public in mind, and cover issues around planning ahead, conversations about end of life, and funeral matters.
  • The Conversation Game also comes from Dying Matters. The game consists of 36 cards, each carrying a short statement about the things people often cite as being important to them in the last weeks or months of life. One of the cards is a ‘wild card’, which aims to encourage the expression of more personalized preferences and prompt further or deeper conversation.
  • The Go Wish Game comes from the CODA Alliance. It’s also a 36 card pack, like the Conversation Game, and can be played as solitaire, in a Go Wish pair with someone who you want to be involved in and aware of your end of life wishes, or online in the Solitaire version.
  • Hello (formerly called My Gift of Grace) is a game that centers around the answers to questions in a booklet, which are then scored on cards. The game can be played by a multitude of players at the same time, with five being the game’s normal setup.
  • BONUS – Engage With Grace – it’s not a game, but it’s a great conversation starter. There’s a single slide for download, which you can use in any setting to get a conversation started. The slide has five questions that are the basis of starting a conversation on your end of life wishes, and how to get them written down and shared with the right people.

If you’re wondering whether playing a game on something like this is a good idea, the American Journal of Hospice and Palliative Medicine published an article in July, 2016, titled, “Can Playing an End-of-Life Conversation Game Motivate People to Engage in Advance Care Planning?” where the authors stated in the conclusion that “This pilot study found that individuals who played a conversation game had high rates of performing Advanced Care Planning (ACP) behaviors within 3 months. These findings suggest that using a game format may be a useful way to motivate people to perform important ACP behaviors.”

So … get your game on. You can play alone, or invite your loved ones to take part. Encourage everyone you love to figure out, and write down, how they want their last months, weeks, or days to unfold. And it’s way more fun – and important – than doing your taxes.

Casey Quinlan covered her share of medical stories as a TV news field producer, and used healthcare as part of her observational comedy set as a standup comic. So when she got a breast cancer diagnosis five days before Christmas in 2007, she used her research, communication, and comedy skills to navigate treatment, and wrote “Cancer for Christmas: Making the Most of a Daunting Gift” about managing medical care, and the importance of health literate self-advocacy. In addition to her ongoing work as a journalist, she’s a popular speaker and thought leader on healthcare system transformation from the ground up.