Cancer forced Paul Steinke and his two brothers to have difficult conversations about palliative care, life and death with their father before he passed away in 1999 and again with their mother when she died in 2005.
“There were things we had to talk about and it was hard to do. Very hard,” said Steinke, the general manager of Reading Terminal Market. “We just did the best we could.”
In an effort to make that discussion easier, a Philadelphia-based design firm dedicated to improving communication and decision-making about end-of-life care brought My Gift of Grace, a "conversation game,” to the public farmer’s market Tuesday.
“It challenges the idea that these conversations are very sad and somber,” said Jethro Heiko, one of Action Mill’s four designers. “While that is true, they can be fun, challenging, transformative.”
Players are prompted with up to 47 different questions, which they answer in writing before sharing with the group.
“The idea is to have them reflect first about their response and then they share it out loud,” said Heiko, who added that the company consulted with palliative care experts and tested hundreds of questions before coming up with their final list.
Question #4 asks: “Who haven’t you talked with in more than six months that you would want to talk with before you died? "
Thirty-three rounds later, Question #47 asks: “What is the last meal you want to eat and who would you like to join you?”
Participants can pass if they would rather not share their response, although the rules state there are no wrong answers.
Players dole out blue “thank-you chips,” which resemble poker chips whenever they want to express gratitude to another person in the game. The results of a coin flip determine if the person with the most or least chips is the winner, but Heiko says the real value of the chips is psychological.
“When you are having challenging or difficult conversations, expressing gratitude can help people stay in conversation,” he said.
More than a dozen people gathered at two tables at Reading Terminal to take part, while onlookers stopped to check out the cards being passed around.
Action Mill has already sold more than 2,000 copies of My Gift of Grace since the product went to market in early December, Heiko said.
Although John Green, director of community relations at the Philadelphia-based Gift of Life Donor Program, has never played My Gift of Grace, he says the game is a creative and innovative way to get families to begin the tough talk.
“Creating something that is very interactive and fun to some degree will help spark conversation so people might be able to let others know what their end-of-life decisions might be,” he said.
Less than 30 percent of American adults have an advance directive, or a legal document that explains one’s end-of-life wishes if they are unable to communicate, according to a study published in The American Journal of Preventative Medicine in January.
“Many times, like a lot of health care decisions, people put this off,” Green said. “They feel young and healthy and say they will make that decision later. But sometimes later becomes now.”
And Heiko adds the game works well for those who are not facing an imminent loss of a loved one.
“Playing the game for me helps me appreciate life every day,” he said.
Steinke, who spent his lunch trying My Gift of Grace, agrees.
“Whether it is this game or another means of talking about it, it can only help,” Steinke said.
Heiko adds, “If families just had one conversation before they were dealing with the crisis, they could provide better care.”