Richmond hospital uses game to help families discuss death

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RICHMOND, Ind. (AP) — Who haven't you talked with in more than six months that you would want to talk with before you died?

Nobody wants to think about dying. But nationally, there is a growing interest in end-of-life conversations because those talks can make such situations easier for patients, families and health-care providers.

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Interested in generating more staff and community conversations about end of life care, Reid Hospital's continuum of care director, Billie Kester, sought something that would help her do that.

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She discovered "My Gift of Grace," a conversation game that uses questions to inspire thought and discussion. There are no wrong answers, and players can change their answers.

The game was developed by a team from the Action Mill in Philadelphia, Pennsylvania. Kester played it with a small group with positive results.

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After Action Mill team member Jethro Heiko contacted Kester to see if the game met her needs, Kester and Heiko began making plans for him and fellow game designers Rob Peagler and Nick Jehlen to visit Richmond.

The three men facilitated workshops recently with Reid physicians and staff as well as Ivy Tech Community College nursing students and faculty.

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On their website, the Action Mill group explains its motivation: "We believe that with practice, anyone can have good conversations about what they value in life and their wishes for the ends of their lives — and that these conversations make everyone's lives better."

Action Mill also offers statistics from a national survey by The Conversation Project 2013:

— More than 90 percent of the people think it's important to talk about their loved ones' and their own wishes for end-of-life care.

— Less than 30 percent of people have discussed what they or their family wants when it comes to end-of-life care.

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The game and its dialogues help health-care professionals, who regularly deal with death, to understand how it affects them personally and professionally, Kester said.

"It's a great personal reflection to go through the questions," Kester said. "You focus on your impact to your family."

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With the need for advance directives increasing, Kester set aside a day at Reid for staff to help community members complete documents associated with end of life decisions.

An advance directive generally describes two types of legal documents: A living will and a health care power of attorney. The documents allow a patient to instruct others about their future health care wishes and appoint a person to make health care decisions if the patient is not able to speak for himself.

Kester said more than 50 people took advantage of the event. Area residents can receive help with the paperwork by contacting Kester or her staff at Reid. Documents and end-of-life decision guides also are posted on Reid's website.

Ivy Tech nursing students Mariana Aleman, April Beach, Chelsea Cornell and Tanya Fritts found playing "My Gift of Grace" valuable.

They reacted to some questions with tears and to some with laughter.

"We got to see each other a lot more vulnerable," Aleman said.

"You cry together because you feel their same emotions," Cornell said.

"This (nursing) program consumes us. We're on a journey together," Aleman said. "I think we walk away closer, having a closer bond together."

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The discourse revealed personal experiences. Beach remembers that when her father was ill, nobody talked about it.

"It was the elephant in the room," she said. "Now, with my son, we have discussions. Who would carry out my wishes? My son would."

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The exchanges also inspired the students. Beach is now eager to have similar conversations with family, friends, colleagues, co-workers and community members.

"In our careers, we can use some of these tools to reach out to our patients and their families," Beach said. "People are more aware of the process of dying. If you start thinking ahead, you have that control."

Aleman said families who don't talk about dying can end up in situations that cause "unnecessary chaos and pain."

"It makes the process of death a little bit easier to deal with," Aleman said. "Think of the possibilities."


Source: Richmond Palladium-Item,


Information from: Palladium-Item,

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