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Poker and Planning - Update 6/24

Integrate end of life planning workshops with activities that seniors enjoy and do regularly, such as gathering to play card games.

Photo of Bettina Fliegel
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Who is your idea designed for and how does it reimagine the end-of-life experience?

The idea is designed for all seniors, but thinking in particular about seniors in low income, low resource, communities who may not have had an opportunity to plan ahead due to lack of access to professional guidance. Combining social opportunities with end of life planning workshops might be a way to bring people in. Attracted by fun, and the opportunity to learn side by side with peers, this might be a way for more seniors to assert control of their wishes for end of life.


Create opportunities for all seniors to be informed on advance directives and the importance of writing a will.  Give them the resources and opportunity to do this work.  Inform them on the options and expenses involved around death and burial.  In this way seniors can make informed decisions, create action plans and take steps to assert their wishes for end of life care.  This can help to alleviate anxiety and economic hardship for seniors, and their families going forward.  

Bring the conversation to seniors either where they are actively socializing, or create an opportunity to socialize alongside doing this work.  This might function to bring this conversation to a larger audience as it will be side by side with some fun!

Parks and Recreation Senior Programs.

Elderly Chinese men and women playing cards and Chinese Checkers, Columbus Park, Bayard Street, Chinatown, NYC. 2011


How to Facilitate This?

Community Centers can host "Poker and Planning Parties."  They can engage local professionals - community nurses, legal aid attorneys, funeral and burial staff, as well as financial advisors might participate.   

Federally Qualified Community Health Centers and Community Health Worker Programs (CHWs) also can play a role, as hosts and facilitators.  CHWs are working with seniors in their communities in a variety of ways.  Might "Poker and Planning Parties"  become an extension of this work?

(ex. - Photo below links to the specific CHW program noted.)

Un Paso a la Vez (“One Step at a Time”) is a new program in South Texas that uses Community Health Workers (CHWs) to help low-income, older Hispanic adults maintain independence with dignity.

Remote Communities - If a community is very remote perhaps the professional speakers can be present via video chat.  

Resources can be shared and referrals made for individual counseling sessions.


  • Would professional participation be pro bono?  
  • Might communities apply for grants to fund these workshops?  
  • Might local businesses sponsor this idea?


June 24 - UPDATE

While reading Justin's post on creating a local dying resource guide for Louisville, KY, I was directed to his work with the Conversation Project. 

This project helps folk think about what matters most at EOL, and takes them from contemplating their wishes, to speaking with loved ones, through to creating formal documents to outline their EOL desires.

Poker and Planning Parties can include this approach as a guide.  The parties can start by presenting information to open a conversation and take participants through this process. The parties will be a series of events, 3 or 4 parties.  In this way information can be presented with time for participants to think about issues in between, reflect on what they have learned, share, and take action.  As the series progresses professionals will present information needed to make informed decisions on care.   


What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

Feedback on the idea from professionals that may participate. What are the possible grants that might fund this? How many sessions would be necessary to share information and address concerns and questions?

Tell us about your work experience:

I work in healthcare as a pediatrician. I have experience in inpatient, outpatient and emergency care settings as a clinician, teacher, and as an administrator. My experience has been primarily within underserved urban communities, most recently with adolescents in the juvenile justice system.

This idea emerged from

  • An Individual


Join the conversation:

Photo of Alisa Ahmadian

Hi Bettina. I love the simplicity of this idea and think that your idea to use existing gathering places is spot-on. My elderly Iranian grandfather found great solace and community in a center for Persian seniors here in the Bay Area, CA. Thinking about his experience, I'm wondering how "Poker and Planning" can reflect the multiculturalism of senior populations, taking into account those that do not speak English, or who might feel more comfortable playing games that they are more accustomed to? 

Photo of Bettina Fliegel

Hi Alisa.  Thanks for your comment.  Yes, I agree.  We should consider multiculturalism.  As I was looking at images for the post I noted that there are other games that some groups of seniors play regularly, for example - dominoes in the Latino community.   I really like the idea of card games because people talk over them.   What games did your grandfather enjoy with his peers?  Whatever games folk socialize over I think would work.  
Where there social workers at the senior center that your grandfather attended?  For the workshops there would need to be translators, or professionals from the same cultural community that speak the same language.

Photo of Alisa Ahmadian

Hi Bettina Fliegel sorry for the delay in my response to you-- I've been out of the country. My grandfather plays an Iranian card game called "hokm" (probably the most popular card game in Iran!). I don't believe that there are social workers there, but there are program leaders on staff. Because it is a center serving primarily Iranian seniors, all staff speak Farsi fluently. 

Photo of Pearl Sequeira

Hi Bettina,

The Robert Woods Foundation has funding opportunity on integrating  Cost-of-Care Conversations in clinical practice, particularly for vulnerable Patients. This Call for Proposal fits within the design mandate of rapid testing, message research and consumer involvement, when compared to the traditional scientific research and academic publication route. The deadline is July 27, 2016. This may be of interest to you and your organization.

Photo of Bettina Fliegel

Hi.  Thanks so much for sharing this information!

Photo of Justin Magnuson, MA, LMT


Did you see today's feature idea "Social Advance Care Planning?" I told Nick about your project, I think this is a great idea. 


Photo of Bettina Fliegel

Thanks for pointing me in that direction!  Yes, it is I think very similar.  I just posted a comment there!
Thanks for the positive feedback!

Photo of Lee-Jung Kim

@Bettina Fliegel I love the idea of mixing “playing” and “planning”. I wonder if we can even mix the playing with other games...or other activities... perhaps dance night? Why not use both mind and body, right? Is the goal of this idea to bring people together to create the feeling of community while planning for the end of life?

Photo of Bettina Fliegel

Hi Lee.  Thanks for your comment!  The goal is to get information to people who need it to make informed decisions on end of life planning in a manner that works for them.  In this case bringing it to situations where they are already gathering and also in a way that is affordable, hopefully the workshops will be no or low cost, and any follow up consultations will be affordable.  That is the primary goal.  I can see how you are looking at it as a way to bring people together.  I was looking at it as a way to capitalize on people already coming together.  I like the idea of people being together to receive this information as they can then talk amongst themselves and perhaps sort through things in a supportive community.  I like the idea of games that are played in groups, and quietly, because that can support conversation about what they have just learned or been exposed to in the workshops.  Dancing might not work well early in the process,  although a celebratory dance later on might be a fun thing to plan.  What do you think?  Celebrate making productive and life enhancing plans for end of life?