How Card Games Can Help Start End-of-Life Conversations

5 ways a final-wishes card deck can help you hold an important discussion

End-of-Life Conversation Cards
Card decks like these can help you hold a meaningful conversation with a loved one about dying and death.. Photo © Chris Raymond

Any parent who has explained the "birds and the bees" to a child probably understands that even though this conversation can prove challenging and uncomfortable at times, having the talk about sex, love and the reproduction process with a son or daughter is very important and necessary. Unfortunately, openly discussing another human condition that everyone will also experience, dying and death, is usually ignored.

This article offers five reasons why using a special end-of-life card game deck can help you hold this important conversation with someone you love.

What is an End-of-Life Card Game/Deck?

Today, countless specialty card decks exist that can help people start a conversation about all sorts of important topics, such as money and personal finances, marriage and relationships, manners and social skills, and more. Unlike traditional card games played with a standard deck of playing cards, these specialty decks focus less on competition and winning and more on social interaction and getting participants to "open up" to each other. While often entertaining, the intent of many of these decks is to encourage honest conversation and dialog.

This is the purpose of an end-of-life card game deck: to encourage and facilitate a meaningful discussion among participants about their views, attitudes, and desires concerning difficult dying- and death-related topics.

Card games such as these can touch on a myriad of important, deeply personal subjects, such as life-saving medical treatments; what matters most as death approaches; the things someone hopes to yet accomplish, aka their "bucket list"; specific funeral, memorial and interment wishes; how he or she hopes to be remembered; etc.

5 Reasons to Use Card Games in End-of-Life Conversations

If you would like to discuss the subject of dying and/or death with someone you love in order to learn about their final wishes but find it difficult to initiate this conversation, then using an end-of-life card game/deck (like those shown in the photograph above) might help you start this discussion for any or all of the following reasons:

1. It's Easier to Suggest

Too often, the most difficult hurdle we face about discussing someone's end-of-life wishes generally exists in our minds as we struggle to figure out how we can even bring up the "taboo" topic of dying and/or death with a loved one. Similar to how many parents tasked with explaining "the birds and the bees" to a child initially dread this talk, it's also common to imagine how a conversation about your loved one's end-of-life needs/desires might play out beforehand. Too often, we use every imagined reservation or perceived problem as another reason to put off this critical conversation and it simply never happens.

The truth is that you will rarely find the perfect time, place or words to initiate an organic conversation about dying or death with a loved one, which is why a themed, focused end-of-life card game/deck might help. Instead of struggling to say, "Hey, Loved One, do you want me to bury or cremate your body?" you might find it easier to suggest, "Hey, Loved One, I'd like to play a card game with you..." to help you discover the answer to this question and so much more.

Please understand that this is not about "tricking" someone into holding this difficult-but-important talk! Obviously, your loved one will quickly realize the nature of this discussion once you begin using this card deck, and while he or she might refuse to play, your conversation will more than likely continue once you've broached the subject.

2. You Can Rely on the Cards

Just as you might find it difficult to even bring up the subject of a loved one's mortality and what he or she might want, using a preprinted deck of final wishes cards can help you ask the question(s) if you have trouble remembering or find it difficult to ask something out loud. While these card decks offer multiple ways to hold an end-of-life conversation (see "Encourages Flexibility/Personalization" below), it's simply easier to rely on the wording of each card regardless of how you decide to use these decks.

As noted earlier, discussing a loved one's end-of-life wishes might prove challenging at times, which is why we tend to avoid this conversation in the first place. Thus, if you found yourself growing emotional at some point, you might forget to ask a question or feel unable to express something verbally that you want or need to know. In these situations, trusting in a final-wishes card deck and its preprinted questions can help you keep your end-of-life conversation moving, and/or help you get through any difficult moments.

3. "I Didn't Think of That"

More than likely, if you were asked to write down every single question you wanted to ask a loved one about his or her final wishes, you might come up with 10 or perhaps 20. One benefit of using a specialty end-of-life card game is that most decks contain dozens of important questions, and many of them touch on subjects you might not otherwise think to ask. The card decks shown in the photograph above, for instance, offer anywhere from 36 to 52 conversation starters.

For example, one of the typical reasons people don't hold an end-of-life conversation is because most of us feel afraid of dying and death and simply don't want to think about our own mortality. Such fears, however, can profoundly shape and influence our final wishes, but would you have thought to ask your loved one to share his or her fears about dying or what scares him or her about death? The answer would probably prove significant and definitely shape this conversation but you might not otherwise know it if you don't ask.

Likewise, end-of-life card decks can pose other questions that might not occur to you, such as:

  • Do you want your death announced on social media, such as Facebook or Twitter?
  • How important is it to die among family members/friends and not by yourself?
  • Have you taken steps to prevent family arguments before or after you die, such as a legal will or advanced healthcare directive?
  • Would you want me or your doctor to tell you the truth about a life-limiting prognosis?
  • What words do you think of when you hear the word "hospice"?

4. Removes the Focus from One Person

How would you feel if someone stood in front of you holding a clipboard and asked you a bunch of deeply personal questions? Uncomfortable? Interrogated? Looking for the first chance to run away? Unfortunately, this is often how an end-of-life conversation can feel to the person doing all of the answering as he or she sits in the spotlight cast by the person asking the questions.

The beauty and power of an end-of-life card game/deck is that it helps eliminate the interviewer/interviewee relationship by removing the focus from one person and, instead, fostering a genuine dialog between two or more people. Often, the very individual who wanted to initiate this important conversation with a loved one will soon find him or herself also sharing personal thoughts and feelings in response to the questions posed by these cards, or in reply to someone else's intimate, revealing response(s).

Moreover, it is not uncommon, once the conversation begins, for other family members and friends who "just want to listen" to also join an end-of-life discussion as they overhear some of the questions posed or the responses given.

5. Encourages Flexibility/Personalization

Most end-of-life card games, including those shown in the photograph above, offer instructions on how to use the deck to take maximum advantage of this final-wishes tool. Some decks suggest that each participant should answer/discuss the same question before selecting a new card, while others propose that individuals sort all of the cards according to what they personally consider most- to least-important before continuing, or something in between.

In addition, card decks like these generally offer tremendous flexibility as to how many people can participate in a given session. While usually intended to facilitate this important end-of-life conversation between two people, nearly every final-wishes card game/deck can accommodate three or more individuals, which can encourage a meaningful discussion between a child and both of his or her parents, for example, or among an extended family, or even a much larger group of people, regardless of if/how they are related.

Moreover (and I share this from personal experience), if you purchase one of these end-of-life card games/decks, it's almost impossible not to shuffle the deck and ponder how you feel about the various questions posed when you're by yourself. In other words, many advance-planning card games/decks, whether by design or just by the nature of their subject matter, will tempt you to "play" solo.

Unintended or not, facing your personal feelings and views about the significant dying- and death-related issues these cards pose while playing "solitaire" can also better prepare you for the eventual end-of-life conversation you want to hold with someone else.

Finally, even though most of these card games/decks provide instructions, don't feel surprised if your end-of-life conversation, once started, deviates and even wanders around "off script" despite the original directions (and that's perfectly okay!) Adhering to the specific instructions provided with a final-wishes card game/deck matters far less than holding a meaningful discussion with your loved one(s) about their views, attitudes and desires concerning difficult dying- and death-related topics.

How to Buy an End-of-Life Conversation Card Deck

Because of the special nature of this conversational tool and its subject matter, you will most likely locate an end-of-life card game/deck online rather than at a brick-and-mortar shop. Most of these card decks are sold consumer-direct by the business or organization that created them. While other decks exist, you can find more information about the final-wishes card games pictured above at:

• The Conversation Game, Conversations for Life
• Fink: Advance Care Planning, Fink Cards
• The Go Wish Game, Coda Alliance
• Heart2Hearts: Advance Care Planning, Discuss Directives
• My Gift of Grace, Common Practice

The author sincerely thanks the above companies for providing complimentary copies of their card decks during the preparation of this article.

"Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life" by the Institute of Medicine, September 17, 2014. Author's collection.

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