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Article

Coda Alliance: How to Talk about End-of-Life Care

By Rita Dichele

I have been discussing the last few months having a conversation with your physician regarding end- of -life issues.  I’d like to hone in on another direction that I think might prove helpful.  I am going to focus on a tool that Coda Alliance, a coalition for end-of-life care founded in the early 2000s, has developed for end-of-life conversations. Let’s Talk According to Coda Alliance there needs to be a culture change in how we talk about our end-of -life care.  Coda points out that we talk about our financial planning or our car insurance, but what about talking about a potential health crisis that could lead to death.  When our physician suggests we get our affairs in order, we typically think of our financial issues.  In the meantime, we hear how “talk is cheap”.  In this instance, talking can be potentially a discussion that can lead to a wealth of information. Let’s Play The Coda Alliance has developed a tool for end-of-life discussions. The tool is a card game called “The Go Wish”. The purpose of the game is to start a conversation regarding your end-of-life care wishes. It consists of 36 cards that you can purchase for a nominal cost. This is a game that can be played alone (solitaire) or with another or in groups. It can be played on-line as well.  However, I would advise getting the cards if you are going to do this with your loved one. If you choose to do it alone, on-line might be okay.  Nevertheless, the game is simple card game that was originally designed for cognitive impaired individuals and those persons who have limited reading skills and individuals who do not speak English well.  With that being said, the game is not too simplistic for individuals who have been schooled. Let’s Do It The game can be played many ways. The cards are divided by “very important”, “somewhat important” and “not important”. The beauty of the game is that what I might consider important, someone else might consider not important. It is a time to talk and share. There is an instruction sheet included with the cards. Keep in mind that the goal of the game is to choose ten cards that are “most important” to you. In the game you are prioritizing your wishes. The cards provide 36 final wish suggestions. So…. this is the nuts and bolts of the game. Player A sorts the 36 cards into three piles depending on how important they are.  Player B also sorts the cards into three piles. However, Player B is sorting the cards based on what she thinks Player A’s final wishes might be in order of importance. As you can imagine, this can be a fun game even though it is a difficult topic. It certainly can be a guessing game.  If you choose to play solitaire, you pick out the important cards that identify your final wishes. Next, you take an opportunity to share your cards with someone close to you or your health care proxy. The point of the game is not to write it down but rather start a conversation. As I said, the game can be played on-line. The nice part of playing on-line is that you save your “cards” and either email or tell the other player the file name which can be opened accordingly. Coda likes the on-line version since the other player (s) does not have to be face-to-face or even in the same time zone! Coda suggests that you can play this game as often as you like. It is okay to change your mind anytime.  Everyone at any age should identify their final wishes to someone. This game provides a comfort level to do this and certainly can be an engaging activity that can not only be fun, but beneficial. Let’s Prepare As much as we want to avoid the topic, death is part of life and living and WILL happen. Why not be prepared to have your final wishes granted. Before the health crisis hits, we all need to be aware about end-of-life care at any age!  Are you prepared?   Final Thoughts In many respects the results of playing the card game can be a relief to family members, taking away the future responsibility with having to make difficult decisions when a health crisis occurs. Coda also is sending an important message that it is okay to talk about death and dying. Remember, an end-of-life conversation does not mean a “death sentence”. Having a conversation about your final wishes can be the most responsible and at the same time courageous thing to do for yourself and your loved ones. The Go Wish game can be purchased on:  http://www.gowish.org/ Rita Dichele holds three Master degrees in Counseling Psychology, Health Care Administration, and Human Services.  Ms. Dichele is certified in death & dying and bereavement from the Association for Death Education and Counseling (ADEC).  She is on faculty with A.T. Still University and instructs classes in grief work and long-term care.

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