By Jennifer Hundley Batts Thomas
What will be most important to you at the end of your life? That your family is accepting of your death? That you can keep your sense of humor? That you know how your body will change? That you be touched?
Although it may be a difficult subject to imagine, conversations about end-of-life choices can lead to a better death. Too often patients and their families find themselves in the throes of a health crisis with little-to-no preparation for navigating critical decisions. Life changes quickly and there can be no time for such conversations.
People often have preferences about care at the end-of-life but do not share them. According to a Time/CNN poll, 7 out of 10 people prefer to die at home, but the CDC reports that only 25% of people die at home and nearly half die in a hospital. Perhaps if people began conversations about end-of-life wishes sooner, preferences would be realized more often.
These conversations are not happening on a large scale. Nationally, only 30% of people have an advanced directive, according to the Associated Press. Of those who do have an advanced directive, one study showed that only 25% of physicians knew their patients had an advanced directive. Due to technology systems limitations, advanced directives are often not portable from one hospital to another, and unfortunately decisions that individuals and families do make are not always recorded or captured for future encounters.
The CODA Alliance offers a game, Go Wish, which can serve as a starting point for people and their families to engage in conversations about preferences and comfort at the end of life. Go Wish is available online for free or as a set of cards for purchase.
Go Wish offers a clear approach to tough questions. When I played I was acutely aware that some of the most important questions are beyond the usual “I don’t want to be on machines” or “I do not want to be resuscitated.” Maybe it will be important to you to die at home, to know you will be treated the way you want without the trappings or norms of your health care provider. Perhaps you are fearful of becoming short of breath or you want assurance that you have an advocate who knows your values and priorities. Go Wish may help you think more deeply about your feelings and hopes.
Careful examination about what dying means and what we want and need when we are dying has the potential to bring a greater sense of clarity both to our lives now and at the time of our dying. We can’t know everything about the circumstances we’ll face when we die, but Go Wish is a gentle entry into moving toward the known, including our preferences for one of our most vulnerable experiences, the process of dying.
To be sure, many of us don’t make conversations about dying a high priority. These conversations can be uncomfortable, leading us to speak about our own mortality, a reality many often avoid. Having these conversations and sharing our wishes widely with family, friends, and physicians can help us face death with a greater sense of peace, lessened anxiety, and comfort in the knowledge that our voices and our choices matter.
Don’t wait! Play Go Wish today.
Jennifer Hundley Batts Thomas is a mother of two, teacher of many, and an aspiring chaplain. She’s a lover of books, music, nature, and a good podcast. The coming of 2017 will mark her third year as an MDiv student in the Women’s Leadership Initiative at Central Tennessee.