Gina King and Maggie Martin are the creators of Circle of Life, a board game that teaches aspects of end of life care to anyone working in health and social care. Here Gina explains how they came up with it and how it is played.
How was the game developed?
The aim is to introduce the concept of end of life care to professionals and the public. Its philosophy is for people to not to think of it in a morbid way, but as of something that is part of life and part of living.
I work in the NHS and I teach in care homes, and they do not have an environment that is conducive to formal teaching. You could be in a sitting room or you could be in a staff room, so you need to think about the equipment. We had difficulties with the setting and also the subject matter, which was around advanced dementia and communication and thinking about what the residents would like in their future care, so we thought we needed to create an interactive workshop.
I thought about a board game because it can be done with groups of people, in a more relaxed setting, like what you would do as a family, maybe on a Sunday, and that helps people enjoy it. It was about using something interactive, not dependent on a PowerPoint, that would initiate group working but enabling the maximum amount of teaching to the staff and that could be flexible to fit with any environment.
We have sold it across different care settings from hospices to care homes to hospitals, I just had an order from a library. We have also sold it to Thailand, Taiwan and Australia.
How is the game played?
What I have found in my experience is a lot of the time you will have a fantastic PowerPoint but if you have a learning style where you do not like reading and writing, you do not absorb that learning. The greatest learning you can do is from each other, so the game enables small groups working together, in pairs or in larger teams – we have done it in a room with 80 people so there is no holds barred in terms of numbers – that actually have to work together to find the answers. We read out the question, the possible answers and they work out which is right, so it is a bit like a game show quiz where they have to confer. Whichever team gives the correct answer wins the card, and whoever wins the most cards wins the game.
It is often the quietest person that is right most of the time so it builds their confidence. It builds on the natural competitiveness that we do not think we all have – in the beginning people are unsure and then this crescendo builds up, you get laughter and learning.
What challenges are there to end of life care training?
People do not want to talk about it, in my opinion. Professionals are the worst and they hide behind their uniform, they believe it is going to be difficult to discuss with patients, clients and residents, and actually they just need to have a bit of confidence. I know from body language, a few simple opening questions and listening to the triggers that people are keen to talk about it, not all the time, but I think it is professionals being scared to talk about it because of their own mortality, thinking that talking about it brings death closer, and also scared that they are going to upset who they are looking after.
In my experience as a specialist nurse having worked in end of life care for years, I can talk to people on buses, even if they do not know who I am, and I get their life story, I just ask “how are you?” I think it is our own fear that sometimes inhibits us from going forward, and that is the biggest barrier. That is where the game works well because it takes away the fear.
For more information visit Circle of Life
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