Welcome to the FAQs for Go Wish! We've divided these quesetions into two sets - General Questions about CODA Alliance and the Go Wish cards - and - questions about the online version of Go Wish.
General Questions About Coda Alliance and Go Wish Cards
Why did Coda Alliance invent this game?
Coda was funded in 2005 -2006 by Archstone Foundation to develop and test a program to educate assisted living residents, their family members, and assisted living facility staff about end-of-life care options and advance care planning. The Go Wish game was developed within this project, to fill a need for a way to stimulate discussion that would focus in a positive way on values and wishes about end-of-life care. It was also developed as an effective tool for elderly people with limited cognition, and for people with limited literacy and limited skills in the English language, without seeming too simplistic for those with higher education.
How does the game work?
The game is a set of 36 cards, available in multiple languages - English, Spanish, Japanese, Chinese, Korean, Swedish, British English and Brazilian Portuguese, each card with a short statement of things people often cite as being important to them in the last weeks or months of life. To play the game (in the 'solitaire' mode) the individual sorts the cards and ranks priorities about what's important to them, and then discusses or explains to a friend or family member why they made the sort the way they did. The instruction sheet for the game gives other ways to play it in pairs or groups. The point of the game is not to create a written list of "what I want," but to stimulate conversations about what is important and why. Many people remark that when they play the game several times, the way they sort the cards changes a bit, but that this helps them refine their thinking about what their values are and how those values would apply in different situations.
When sorting the cards, what do you mean by "not important?" - Some of these things are very important but you only let me have ten "very important" cards. That's frustrating!
Making really tough choices is hard and having to set aside some things to prioritize others can be frustrating. We've found, though, through working with thousands of people, that coming up with the ten most important cards is incredibly valuable for each individual and those who support, love, and must speak and/or advocate for them.
In the card sorting experience, the phrase "not important" can and should mean different things to different people. To some it means "this doesn't matter to me at all" while to others it means "I've already taken care of that and know that it is settled so I don't need someone who might speak on my behalf to take care of it for me."
The key is to identify the ten most important things you want to make absolultely sure are clear to anyone who might have to speak on your behalf or make decisions for you. Very important items are ones that you may want, as soon as possible, to take legal steps to make sure happen as you want them to happen, if you haven't already done so.
One person who recently used the cards changed her titles for each pile to "Very Important," "Somewhat Important," and "That's Stupid!" For her, the "Very Important" pile included cards that said things she wanted to make absoulety sure anyone who was caring for her understood and did something about. She had already settled her financial affairs, felt at peace with her creator, knew that if she needed to and could she would pray, had a doctor she trusted completely..... but, she wanted her family to know that if she were ever near death, she would like to have them near her if they could get there without too much hassle... that she didn't want to be hooked up to machines to keep her alive... and that if at all possible she wanted to be at home when she died. On her "That's Stupid" pile, among other cards, was the one that talked about wanting to help others. "I've helped other people for 80 years," she quipped "about time they took care of me if I'm dying!"
Can I change my mind?
Of course! The way you feel about things right now may change somewhat or dramatically as your life circumstances change. You should resort the cards whenever the time feels right and communicate your current wishes to whomever you want.
Where have the cards been field tested?
The cards were initially developed as a tool for promoting discussions of values and wishes for advance care planning for assisted living facility residents, their family members and the facility nursing assistants/CNA's. We revised the original set of cards to be more readable for elderly residents with short attentions spans, and in simpler language for nursing aides who have limited literacy and limited skills in English. Coda Alliance board members and volunteers have also tried them out on our friends, family members, neighbors, physicians, nurses, and social workers. Coda Alliance has used them in a variety of community settings such as church lunch-and-learn groups and senior centers. Individuals who have mild dementia and poor eyesight can participate in the game by expressing how much they agree with the statement on each card when they are read aloud. Those with higher intellectual capability use the statements on the cards as discussion starters on the various meanings and implications of the statements and when they might agree or disagree.
Who would use the game?
Coda Alliance is selling the cards to the general public and to health professionals. In health education classes on advance directives and advance care planning, the game helps patients and their potential surrogates compare and discuss priorities that they hold in common, and to discover where their priorities differ. Community members have used these in community meetings, a synagogue social action committee, at family gatherings, and in church lunch-and-learn groups. In all of the groups where they have tried out the cards, people often want to have a set of cards to take home and play the game with their elderly parents or their young adult children, to help them prepare for their possible role as health care agent.
The game is useful for social workers, health educators, or chronic conditions case managers meeting with patients and their loved ones trying to get conversations started about end of life care. Hospice social workers use the cards to stimulate discussions about what the patient still may hope for. With a patient who did have anyone they would want to name as a surrogate, I used the game to give me, the physician, a chance to understand what goals and values were guiding the treatment decisions the patient was making. He also found it helped him articulate his priorities and concerns.
How well do the cards work?
The goal of the tool is to facilitate discussions, and for the end result of getting people to think and talk about positive values and goals for having the best end of life possible, they seem to be wildly successful. When I have used these in large groups, the room reliably erupts in lively conversations. Just about every group I have presented this exercise to has wanted to have the cards to keep. In one large group, where I emphasized that we did need to collect the packs for re-use, there was nonetheless a 30% attrition rate - a testament to this being a desirable commodity.
How do the cards for sale differ from the demo version?
The cards for sale are attractive and durable. The cards are a little larger than the business-cards size, and come in packs with the possibility of 4 different edge colors (so in groups, if a card drops on the floor, it is easier to get it back with the correct pack), and are die-cut with rounded edges so they are comfortable to handle. The boxed set comes with two packs with contrasting colors and with instructions for using the cards for individuals, couples, and in groups to stimulate thought and discussion. Printing of the final product was made possible and affordable by a Kaiser Permanente community contributions grant to Coda Alliance.
How do I order a set?
To access the order form or online payment optons, click here. Proceeds from sales support Coda Alliance's public education programs.
Questions about the On-line Version of Go Wish
What is the difference between the cards in the oline version and the printed decks of cards?
Nothing! They are the same 36 cards.
How do I share my sorted cards with someone?
Print out your sort, along with your notes and send them to someone.
How is my privacy protected?
Nothing in our system shows to whom any sorted set of cards belongs. We don't store any personal information about you in this system.
Go Wish was developed by Coda Alliance, made possible in part by a grant from the Archstone Foundation.