The following is a guest contribution by Nick Jehlen, Partner at The Action Mill.

We, as a culture, are scared to death of death. And we know this is a problem.

We know that there are real dangers if we avoid discussions about death. We risk pain and trauma for ourselves and our loved ones if we don’t talk about what we want at the end of our lives. But we also risk losing out on deeply meaningful interactions with the people around us. We risk missing out on forgiveness and compassion. We risk not being able to say “goodbye” and “I love you.”

So the question is: how do we change? If our culture avoids death, how do we make a shift?

First, we have to understand that culture isn’t some abstract idea – something so big that we’re not capable of moving it. Culture is built on the meaningful things we do together. Our culture is embodied in the holidays we celebrate together and the language we speak to each other. For example, in the U.S., our culture is embedded in the food we eat and how we eat it: a wild mix of ethnic cuisines consumed on the run, increasingly alone or at our desks. It’s also in the events we come together for: the Super Bowl, weddings, funerals, and summer vacations.

If what we want is a culture that is more comfortable talking about death, then what we need are rituals that foster these kinds of conversations, the same way that food trucks foster our interest in a wide variety of good food available on the run. If you want to change a culture, find something meaningful to do together, and do it over and over. 

This is what we have in National Healthcare Decisions Day: a yearly event when we take the time to record our end of life wishes. Having a single day when we do this is important: behaviors are reinforced when you know that many other people are doing them at the same time. Try holding Thanksgiving on a different day: it’s a nice family gathering, but it’s not the same. That’s what Lincoln was after when he established a national Thanksgiving day: he wanted people in the Northern and Southern states to do something together, a ritual of unity to bind up a nation.

National Healthcare Decisions Day, now in it’s seventh year, is a custom still in it’s early stages when compared to Thanksgiving. But it is already having an effect. It is a day when everyone in the growing movement to unhide death and make our wishes known can come together. Many Individuals and organizations are creating rituals to mark National Healthcare Decisions Day, and my design company, The Action Mill, is contributing our own.

About a year ago we started looking at ways we could contribute to this movement to start conversations about living and dying well. We looked for rituals we could adapt, and we kept coming back to Thanksgiving, a day when families (the people we wanted to reach) were having conversations (the behavior we were trying to encourage). And then we noticed something else that was happening alongside those conversations: games. Card games, charades, board games, word games. We play games because they’re fun, but also because they create a great foundation for conversation. You don’t think people get together for poker every week just for the challenge of matching up numbers on cards, do you? No, they get together to tell stories, to have conversations.

So we set out to design a game that would help families have their first conversation about living and dying. We wanted it to be fun, engaging, and challenging. We wanted it to be the kind of thing you get better at the more you play.

That game, My Gift of Grace, was released last December and we’re almost sold out of the first batch. Now we want to make our contribution to National Healthcare Decisions Day: we’re organizing game nights for April 16th around the country. You can get your family together, play with your co-workers, or hold an open event for your community (like the four events already planned in Grand Rapids).

This is just one ritual – we need many. Not every family takes a walk on Thanksgiving, or eats Turkey, or watches football. But we share a number of rituals that are meaningful to us, and by sharing them we build something larger than ourselves: our culture.

So make your own ritual for April 16th, or get a game and join ours at