GoWish Around the World
Coda Called On to Spread GoWish Internationally
The Coda Alliance used to be the much-needed best kept secret in town. But no longer! Organizations from around the world keep calling on Coda to go international.
The dedicated volunteer group’s pioneering strategy and methodology paid off in a big way.
How? It’s a proven fact that people tend to deal with tough subjects much easier when an element of fun is introduced. And, Coda’s GoWish cards offer just that. The sole purpose of GoWish is to become a conduit enabling anyone to sync with their families and open up about deep feelings and desires related to end-of-life issues – whether death is imminent or just to make sure your wishes are met if something happens. CLICK TO READ MORE
Leading the challenge to educate the public, medical personnel, caretakers, and both political and religious leaders, Coda has joined with similar groups world-wide. The goal -- to change attitudes about the always difficult, and sometimes taboo, discussions surrounding death preparation – for all ages. An idea which not only makes end-of-life much easier, but which research has shown also reduces public costs.
Consequently, calls come in to Coda from around the globe asking them to help multinational groups adapt and institute GoWish for their citizens. Israel is one of those countries -- one where trying to change attitudes about death preparation is extraordinarily difficult and, in some cases, even requires overcoming taboos.
ISRAEL: An Intercontinental Go Wish Partner
According to Yael Ooch, of the Keshet Hamishalot Foundation, people in Israel are afraid to touch the topic of death discussions. She relates that that only about 1% understand Do Not Resuscitate policies; there are no signs on hospices and little information about them. And the awareness of palliative care, or even end of life advanced directives is sorely lacking. In fact, though considered economically a “Western” nation, Israel is only rated 25th on The Economist’s 2015 Quality of Death Index.
“It’s like a horse with blinders, even amidst all the violent news. People have developed a thick skin and are always in survival mode. So there’s not much time to think about what happens “if”,” she continued. “We knew that we needed to create awareness with a deeper meaning for something so important. We knew that we could make life – and death -- much easier for patients and families, So, when we searched for pioneer ways to introduce the topic and decrease the fear, we found Coda.” CLICK TO READ MORE
The team spent two lecture days using the GoWish cards with spiritual leaders, who they found were amazed by the program and most anxious to get it going in Israel.
This led to a close partnership between the Keshet Hamishalot Foundation and Coda Alliance – the idea being to customize GoWish. Why? “With so many religions, cultures, beliefs, and languages, changing attitudes about a sometimes-taboo discussion is a daunting task. We needed “pioneer” ideas and methods to do the trick,” Ms. Ooch explained.
And, since much of the focus is on palliative care, Keshet Hamishalot even worked closely with Coda to add GoWish-like cards related to hospice election along with the many choices the cards already offered.
Keshet Hamishalot programs include:
- “Gong” workshops in hospitals for medical personnel where they introduce Go Wish
- A Tagalong for Philippine caretakers with the Philippine ambassador taking part in Go Wish
And plans to implement GoWish in some other programs chosen from - Cafés of Haderech (which we call death cafes)
- Wish fulfillment
- Screening movies on end-of-life
- A program of “theatre play” for grandparents and grandchildren
- “Days of the Dead” festival (gleaned from the Mexican celebrations) including puppet shows
- A “before I die” wall
“ We know that we’ll learn a lot more from people who’ll be playing with Coda’s GoWish cards,” Ms. Ooch added. “And, of course, we’ll share that information.”
The close bond of France’s end-of-life organizations empowers a strong influence that led to some of the most comprehensive patient laws in the world. Those rules regarding dignity, respect for life and the right to choose are now being enhanced by Coda’s GoWish card “game”.
Partnering with Coda is France’s prominent nonprofit, Jusqu a La mort Accompanier La Vie (which means accompanying life until death) (JaLMaLV). The long-established group, dedicated to supporting palliative care patients, now has as its motto “Until Death, Care for Life” – a motto connected to Coda Alliance. The two organizations have much in common. Run by volunteers, both groups acknowledge that their major goals are: CLICK TO READ MORE
- To change attitudes about death by spreading the word about the importance of “End of Life” discussion.
- In France this is known as “Solidarity” – a dedication to changing societies attitudes about illness, aging and death
- To ease end-of-life family conversations and support the right to choose, by admitting a bit of fun into the process -- knowing that this makes a tough talk easier
JaLMaLV launched the French version of Coda’s GoWish card game on March 16, 2018 in Antibes Juan les Pins, French Riviera at their annual Congressional Palace – as Coda’s representative, Cindy Safe, looked on proudly. Named "À VOS SOUHAITS ", meaning “In line with your wishes” ( pretty close to “GoWish)}, the card’s design included input from two other major nonprofit JaLMaLV partners: SFAP, for end of life, and APICIL, for heavy pain care. These partners, together, can generate enormous GoWish awareness in health fields and welfare care.
In fact, following the massive meeting, cards were distributed to all of the local groups in the country to begin their use in palliative care. But benefits go far beyond just palliative care. Besides accompanying patients and families who need end-of-life assistance, the organization promotes research and education about end-of-life preparation for adults and children.
“We are also doing a sort of public outreach for youth and adolescents,” indicated JaLMaLV president Jean-Marie Schwertz. "It's a reason to discuss, to talk about anticipated directions. There is no age barrier for this conversation.”
DöBra cards can be used as a tool to help reflect and talk about “What is important to me at the end of life?”
The DöBra card game consists of 37 cards, each with a printed statement about something that may be important in the end-of- life, for example: “To be free from pain”, “To have my financial affairs in order”, or “To have my family with me”, as well as ‘wild cards’ to add your own alternatives.
The cards, developed by Coda Alliance, a non-profit organization in the United States, have been translated and adapted to Swedish with permission the project group for one of the DöBra projects, called Advance Care Planning (SWE-ACP). The cards are used for research purposes in both this project and in the project Death and dying in elder care.
DöBra cards are now available for purchase, through Volante, online book companies, and some bookstores. Please note that the DöBra program does not receive profits for this.
Each deck of Heart to Heart® Cards contains a total of 54 cards, including 2 customizable Jokers (Special Wish cards). Each suit of cards represents a special need. And a different issue is printed on each of the cards, with the exception of the Special Wish cards.
One pack contains 4-deck of four different colors, so players can easily identify their own cards. Each deck contains instructions in both Chinese and English, so they can be used independently.
We also conduct Heart to Heart® Cafés, a communication activity designed to make it easier for a family member, a caregiver, or a health provider to understand what a loved one wants done when life is ending with perfectly healthy people who want family members to know what they would like when their lives are threatened by injury or disease.
Lotus Light Game is a communication activity designed to make it easier for a family member, a caregiver, or a health provider to understand what a loved one wants done when life is ending. However, it is also used with perfectly healthy people who want family members to know what they would like when their lives are threatened by injury or disease. Lotus Light Game consists of choosing and discussing cards on which individual end of life issues are presented. Each Lotus Light Game deck contains 42 content cards and two “Wild cards”. Each content card addresses a separate end of life issue. Each deck contains instructions in both Vietnamese and English, so they can be used independently.
The Supportive Care Services Foundation was born out of a need to address the “medically under-served” in the Vietnamese community. Our founders recognized that one barometer of this fact is that the length of stay on hospice care is very short -between 24-48 hours. This last minute access to such a valuable patient benefit is painful to acknowledge. Patients often arrive on the doorstep of hospice dangerously close to death. The perception becomes that hospice equals death. We felt that one way to change this perception and improve access for this community is by creating educational materials specific to this community. The Supportive Care Services Foundation believes no one should suffer due to lack of access to information.
The Conversations for Life TM Programme offers tools and inspiration for families, professionals and communities to start talking about end of life care now.
Why do we care?
Like you, we each have our stories of love and loss. Some beautiful, others harrowing. Like you, we are also looking ahead to our own future care, want the best, yet know that’s not guaranteed-especially if we do nothing. We were crazy enough to believe we just might be able to make a difference. We combined our visions for what we hoped for our future, our skills and experience as an international healthcare educator and designer, and our passions for social innovation to help people turn their experiences, like ours, into positive actions for change. Why? Because we believe the quality of our lives and our future care depends on it.
Coda Alliance worked with the Japanese Institute for Advance Care Planning (iACP), who developed the Japanese version of GoWish.
• Before the disease is triggered, everyone talks about future treatment and medical treatment in advance. This is called ACP (Advance Care Planning) .
• ACP is a process of discussion involving a wide range of contents, not only the choice of treatment, but also what to worry about and care for each person, and how to spend the last of the visited life someday.
• ACP is "support for patients and their families to deal with various hardships and overcome them".
We are deeply rooted in the community, facing the individuality of each and every one of the local residents is focusing on thinking and discussing "life" and "if" of themselves and important people.
• All our activities are targeted regardless of age and occupation.
• Of course it is necessary to respond to the needs of people who are approaching the end, but on the other hand, we are involved from the stage of thinking about life with a clearance, connecting to the future ACP and at the same time looking at reducing the stress of the community as a whole doing.
• The iACP aims to promote the dissemination and practice of 'Bana' in various regions and communities.
Dr. Kuramoto, an advocate for end of life conversations, was asked to do a presentation to the 5th ACPEL conference of his abstract entitled Advance Care Planning Awareness: Using the Go Wish Card Game to Assess the Modern Japanese View of Life and Death.
Talking with patients about their end-of-life preferences is one of the most important things that happen throughout the follow-up. Still, many professionals find it difficult to start such a delicate conversation.
The Brazilian Society of Geriatrics and Gerontology, through its Permanent Committee on Palliative Care, sought a facilitating resource. "Letters on the Table" (Go Wish ® ) is more than a game. It is an opportunity to listen to patients, facilitating for them the expression of their wishes and preferences towards the end of life.
"Letters on the Table" was developed in the USA as GoWish, a self-applicable game for the lay public, in two modes: Patience and Doubles. However, due to the complexity of the end-of-life issue, the SBGG offers additional guidance [https://sbgg.org.br/projeto-cartas-na-mesa/proposta-de-encontros-teorico-vivenciais-de-carater-informativo-e-reflexivo/] to professionals so that this resource is used in a safer and more consistent way in Brazil.
"Letters on the Table" consists of a box, an instruction manual and 36 cards. The cards and the box exist in two versions, in the colors blue and orange, so that two people can play at the same time without confusing their cards.
This material is a pioneer in Brazil. SBGG has an exclusivity agreement with the Coda Alliance, creators of GoWish, for the development and commercialization of the Brazilian version.
The innovative, advance care planning tool “GoWish” cards are available in Spanish, and include cultural-specific messaging regarding end-of-life wishes. Coda Alliance worked with a variety of hospice and palliative care people to develop the “GoWish” cards which are an easy, entertaining exercise that facilitates end-of-life care conversations. “Translating “GoWish” cards in Spanish is one more way we are committed to helping every person engage in conversations about future healthcare decisions,” said Dr. Menkin, founder of Coda Alliance.
“Not only do patients benefit from discussing their wishes, but “Go Wish” cards help their loved ones feel more confident making future decisions on their behalf, if necessary,” said Dr. Menkin. “Knowing that choices have certain consistency but are not etched in stone helps the patients’ loved ones feel they may have some leeway in making future decisions.”
The Spanish Language version has been available for 11 years.