How Hospice Friends Joined to Create a Game About Death

Fifteen years ago, Lisa Pahl was the hospice social worker that helped Lori LoCicero when Lori’s husband Joe was dying of pancreatic cancer. Over time, the pair became friends and began on a passionate quest to help others be more prepared for death.

The Death Deck was created by the two of them, combining Lori’s personal journey and Lisa’s experience working in hospice care and emergency medicine over the last 17 years.

Their goal is to get conversations around death and grief started and to normalize these conversations. 

Lisa and Lori shared more of their story with us.

At the root of your card game is a strong friendship between two women. Can you share how that came about?

Lori: We had an affinity for each other from the start. Lisa provided compassionate guidance during my darkest hours and continued providing much-needed grief support for the years that followed. After our hospice support ended, I reached out to Lisa, seeking advice on a book I’d written, and our friendship continued from there.

Lisa: We often joke about it, but just to be clear; Lori is the first and only spouse of a former hospice patient that I’ve created a game with. There was something special about our connection from the start. There’s something so beautiful and connecting about sharing a laugh while talking about really hard and painful things. That feeling is what we try to replicate through The Death Deck.

Do you remember what first sparked the idea to create the “Death Deck”?

Lori: After months of grief support dialogues with Lisa about how my unfortunate situation was an all-too-common one, we set out to create something that could help people start talking well before a terminal diagnosis or calling in hospice.

Lisa: One fateful lunch date, Lori brought a binder that she had been working on that was a brainstorm of cards that could help people talk about death and dying. I was intrigued. We began looking around at the conversation games that were around that were in line to what we were thinking. We realized that these products were great for a certain population, but we wanted to reach people like Joe and Lori years before his diagnosis; average people who wouldn’t normally talk about death and dying but would consider it if we made it into a fun game.

It was at Lori’s October birthday party that we solidified our commitment to creating The Death Deck. We were standing by a Halloween graveyard display (what better backdrop for this conversation) overlooking Los Angeles when we agreed we were going to see this project through and create a humorous game about death.

As Lori mentioned, her experience of being unprepared is what I witness every day in my work as a hospice social worker. Completing an advance directive and designating a health care proxy is an important action to take. However, it is conversations that help our loved ones understand our wishes and have the confidence to make decisions on our behalf. The Death Deck was created to begin these very important conversations.

Describe how the “The Death Deck” gets conversations started?

Lisa: By focusing on a wide range of questions (112 cards to be exact with 80 multiple-choice and 32 open-ended) ranging from prompts like “Describe a secret tattoo that appears on your body at the moment of death symbolizing something you stood for,” to “What are your thoughts on writing your own obituary.” The Death Deck asks questions about life, death and the afterlife and opens dialogue beyond, “Do you have a will?” or “Have you made plans for your funeral?”

What role does humor play in your game?

Lori: While our intention is not to make light of death, we have found humor to be an essential element to breaking the ice to get people talking. Many of the cards contain a pun or element of absurdity to draw a laugh and ease players into a comfort level to engage in the questions and subject matter. We’ve found that once people read a card or two and chuckle a bit then they are more open to continuing to play.

Tell us about some of the people and places using the game?

Lisa: We’ve sold decks and played rounds with doctors and hospice care nurses, death doulas and end-of-life coaches, college professors and students, estate planners and life insurance brokers, morticians and funeral directors, and more. Recently, we’ve engaged audiences over Zoom game night events and have played the game in various webinars.

We’ve gotten feedback from players who became inspired to start filling out their Advance Care Directives, others who found comfort in using the game to begin the conversation with their parents, and a couple who — after playing a few rounds — were motivated to finally decide who would get their children if something happened to them — not bad for a day’s work.

What’s next on the horizon?

Lori: We’d love to continue to get The Death Deck into the hands of our end-of-life community to use as a conversation tool. We also want to bring the game to a broader audience of “game playing” adults to help take the taboo out of the topic and begin normalizing these fascinating and valuable discussions on life and death. Beyond that, we have been exploring the idea of creating industry-specific expansion packs of cards to customize gameplay further. And … we’re always up for playing a round or two to get some lively conversations started!

Learn more about Lori’s quest for a perfect cup of coffee and Lisa’s whale-chasing here. You can buy the game on their website. The pair also has released a new EOL deck, specifically designed for use with those with life-limiting diagnosis and advanced age to help individuals explore and discuss their end-of-life preferences.



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