"If someone you love were facing the end of their life right now, would you know what truly matters to them in their final days?"

We explored this question in our latest podcast episode. Can you answer it?

The Moment Everything Changes

In our last episode, we talked about The Death Deck, a card game designed to spark conversations about death while everyone is healthy. It's lighthearted, it's thought-provoking, and it's meant for those moments when death feels far away.

But what happens when death isn't far away anymore?

What happens when someone you love receives a terminal diagnosis? When the doctor says "months, not years"? When suddenly, you're facing decisions about feeding tubes, ventilators, and where someone will take their last breath?

That's when you need The EOL Deck.

A Tool Born from Loss and Love

The EOL Deck (End of Life Deck) was created by two women who understand this moment intimately: Lori LoCicero, who lost her husband Joe to pancreatic cancer at age 44, and Lisa Pahl, the hospice social worker who guided her through it.

Lori experienced firsthand what it's like to face the end without having had these conversations beforehand. That unpreparedness, that feeling of not knowing what Joe would have wanted, drove her to create something better.

Lisa, who has supported hundreds of families through their darkest moments, knew there had to be a better way to start these conversations.

Together, they created The EOL Deck, 52 cards designed specifically for when someone is actually facing the end of life.

This Isn't a Game

Let's be clear: The EOL Deck isn't meant to be played as a game. It's not about winning or scoring points or having fun.

It's a conversation guide. A tool. A way to ask the questions that matter most when time is running out.

The deck is designed for three groups of people:

• Families who want to understand their loved one's wishes
• Caregivers supporting someone in their final stage
• Healthcare providers like doulas, hospice workers, palliative care teams, and social workers who need to facilitate these conversations

The Questions That Matter

When we went through The EOL Deck ourselves, we were struck by how specific and thoughtful the questions are.

Not just "Where do you want to die?" but questions like:

• What is your ideal location to take your last breath?
• What would you like to hear in your final moments?
• What would you like to smell in your final days?
• What are you most thankful for today?

That last question, about gratitude, hit us harder than we expected. Santiago's answer about being grateful for our life together, our kids, our boxers, everything we've shared... it got emotional fast.

"Now you got me all sappy again," I said, trying to keep it together.

But that's the thing about these conversations. They should be emotional. They should make you feel something. Because if they don't, you're probably not going deep enough.

How to Use It (The Right Way)

The professional guidance that comes with The EOL Deck is smart. Really smart.

Don't throw all 52 cards at someone who's dying. That's overwhelming and unhelpful.

Instead:

1. Preview the cards first. You know your loved one or patient. Pick the questions that fit this particular person, this particular family, this particular moment.
   
   
2. Start gentle. For patients who aren't ready to talk about their dying process, start with cards about their life and legacy. Don't jump straight to the medical questions about feeding tubes and DNRs.
   
   
3. Let them lead. Santiago had a brilliant suggestion during our conversation: Give the person the deck and let them choose which cards they're ready to discuss. They might surprise you with what they want to talk about. This goes with knowing your person, so only give them the cards if you think it would be helpful.
   
   
4. Make it comfortable. You don't have to do this in a hospital room under fluorescent lights. Have the conversation at home. Play some music. Open the windows. Go outside if they're able.
   
   
5. Take breaks. You don't have to get through every card in one sitting. This is exhausting emotional work. Stop when you need to.
   
   

What We Learned About Each Other

When Santiago answered the question about where he'd want to take his last breath, his answer was immediate: "Outside. Push me outside so I can be in nature. Look at the sky for one last time."

In the past my answer would have been home, but when I really thought about it, I realized I don't want to put bad feelings in the home. Maybe a personal care home instead.

And you know what? It's okay that my answer changed. It's okay that we're still figuring this out.

That's the whole point of these conversations, to explore, to question, to really think about what matters.

The Critical Thing Everyone Should Know

Here's what you need to understand: These cards are conversation starters, NOT legal documents.

After you have these conversations, whether you're using The EOL Deck, The Death Deck, or just talking over coffee, you need to make sure those wishes are documented legally.

That means:

• Advance care directives
• Healthcare proxies
• POLST, MOLST or DNR forms if appropriate for your situation and state
• All the legal documentation that ensures your wishes are followed

The deck helps you figure out what those wishes are. The legal documents make sure they're honored.

Think of it this way: The EOL Deck is for exploration. The legal documents are for protection.

When to Start These Conversations

If someone you love has been given a terminal diagnosis, start these conversations early, while they still have energy and clarity.

Don't wait until the last possible moment when they're too tired to talk or too confused to express what they want.

And here's a practical tip that came up during our conversation: Consider recording the conversation (with permission, of course). When you're taking notes, you might miss something. Or they might say something and then forget because you were too busy writing. Recording lets you focus on really listening.

Plus, having their voice, hearing them say what they want in their own words, that's a gift for the family members who have to make decisions later.

Who This Tool Is Really For

If you're a hospice worker, palliative care nurse, social worker, or end-of-life doula, this tool belongs in your toolkit.

Instead of trying to figure out how to start these conversations from scratch every time, you have ready-made prompts. Questions that have been crafted with care by people who understand this work deeply.

Your patients aren't just a file or a number. They're people with wishes, and at the end of life, they deserve to have those wishes heard and honored.

The Series Continues

The EOL Deck is the second in a three-part series:

1. The Death Deck - For when everyone is healthy and death feels far away
2. The EOL Deck - For when someone is actually facing end of life
3. The Dementia Deck - For planning ahead if living with dementia (we'll cover this in an upcoming episode)

Each deck serves a different moment in life. You can use all three with your family, or just the one that fits your situation right now.

The Conversation You Can't Avoid Forever

Here's the truth: These conversations are never easy.

But they're gifts.

When you know what someone truly wants, not what you think they want, not what you hope they want, but what they actually told you they want, you can show up for them in their final days with confidence instead of confusion.

You can honor their wishes instead of guessing.

You can be present instead of paralyzed by uncertainty.

That's what The EOL Deck offers: A way to have the conversation you can't avoid forever, in a way that's structured, thoughtful, and surprisingly manageable.

So let me ask you again: If someone you love were facing the end of their life right now, would you know what truly matters to them in their final days?

If the answer is no, it's time to start talking.

Resources:

• Order The EOL Deck at thedeathdeck.com
• Listen to our Death Deck episode (Episode 52) on YouTube
• Download advance directive forms for your state at AARP

Listen to the full episode where Santiago and I work through questions from The EOL Deck and share our own answers. Search "Thoughtful Planning" on your favorite podcast platform.

Remember: Every chapter you write today shapes your legacy tomorrow.