Talking about advance directives needn't be hard. Make it a game

April 10, 2014 | by Tami Dennis

Using a card game to make decisions about health care, especially as those decisions relate to the end of life, would seem to be a poor idea. It isn’t.


advance directives The GoWish Game can help family members talk about what's important to them at the end of life.


The GoWish Game makes those overwhelming, but all-important decisions not just easy, but natural. On each card of the 36-card deck is listed what seriously ill, even dying, people often say are most important to them.

Some samples:

  • To have my family prepared for my death
  • To remember personal accomplishments
  • To say goodbye to important people in my life
  • To maintain my dignity
  • To have my family with me
  • To know how my body will change
  • To prevent arguments by making sure my family knows what I want
  • To pray
  • To die at home
  • To not be connected to machines
  • To be mentally aware

Dawn Gross, M.D., Ph.D., the Arthur M. Coppola Family Chair in Supportive Care Medicine at City of Hope, is a fan of the game and, more specifically, the conversations it creates among family members.


Here, she recounts the importance of those end-of-life care conversations:

"I became a hospice physician after my father passed away in 2006. My vision is to change the landscape of end-of-life care conversations, such that they are the portals to living inspiring lives now and having wishes come true. One of my most favorite tools for facilitating this conversation is called GoWish, an easy, even entertaining game that uses cards to talk about what is most important to you. The cards help to find words to talk about what is important if you were to be living a life that may be shortened by serious illness. To not assume but rather discover our loved one's wants or values is the key to this tool. It inspires storytelling and deep relatedness. For me, it is the most amazing conversation I will ever get to have. And to keep having for the rest of my life, well, that is pure joy."

The game, from the Coda Alliance, is sure to get attention on National Healthcare Decisions Day, observed this year on April 16. After all, the day itself is meant to “inspire, educate & empower the public & providers about the importance of advance care planning.”


Whether before that day, on it or afterward, families need to talk – and advance decisions need to be made, for everyone's sake. If it takes a card game to have those conversations, start shuffling. 


Learn more about advance directives and City of Hope's supportive care department


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