Discussion 2.1: The Bucket List | A Framework for Palliative Care | Let's Talk Health

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Discussion 2.1: The Bucket List

5 months ago

May 6-13th 2018 is National Hospice Palliative Care Week!

Palliative care is about living well, right to the end.

Dr. VJ Periyakoil, the Director of Stanford Medicine’s Palliative Care and Education Program conducted the first ever “Bucket List” Study where she examined the importance of identifying goals a person wishes to accomplish before they “kick the bucket” or die.

She explains: “making a bucket list allows us to reflect on our values and goals and identify important milestones and experiences that we want to have in our lifetime.” 

Sharing your bucket list with your health care provider is useful when speaking about treatment plans. Without an understanding of what important milestones you wish to achieve, your doctor may recommend treatments that get in the way of you achieving your goals.

What is on your “bucket list”: What are the top five things you would like to accomplish or do before you die?



This consultation is now closed. 

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  • palliate101 2 months ago
    I think this is a great question to get people engaged in thinking about their lives and the inevitable end of their lives. Working in palliative care has certainly encouraged me to continuously take stock of my life and answer important questions about my measures of happiness and where to direct my time and energy. If this question can encourage others to do the same I believe that's a huge benefit!
  • Tia 2 months ago
    having processed and integrated life's lessons emotionally, psychologically, spiritually and physically so that I do not suffer ill effects of past events and learned and grown in maturity. To end or at least reduce the silence and isolation of pain and grief in my life and those in my community. From that position, to be able to be meaningfully support my loved ones and those in my community through the same process toward wholeness if they choose to do so. To leave a lasting positive legacy on my loved ones, my culture, my country and my community.
  • bjpalliative 2 months ago
    I've had such a rich and productive life, very little is on my bucket list. The love of family and friends sustains me every single day. I also contribute a significant amount of time volunteering to improve hospice palliative care in my community, so I feel blessed to have that experience. Having suffered with chronic pain for decades, I have developed very sensitive "compassion antennae", which makes life worth living for me.
  • bg 2 months ago
    1. Happily marry and have children (create my own family); 2. Hug and kiss all my family (the one created by me plus my parents; brothers & sisters; nephews, nieces) and tell them that I love them; 3. Say goodbye to all my loved ones; 4. Reconcile with people and ask for sorry; 5. Make a difference (the good) in other people's live (however small is);
  • hospice 2 months ago
    Having conversations are very important and we need to encourage that with patient and caregivers. We are still a death denying society but some movement has been made with much more awareness needed.
  • Maryisarat 3 months ago
    #1. I have to get sorted with my current marital situation - have made big steps in the last year - this year he either steps up - or I get a separation agreement/divorce and I'll suck up the financial loss since I've been supporting him all these years. #2 - get out more - I've started that already but carry on - reach out to friends and plan things #3 - go to Ireland and see my younger cousins - none of them were born when I was there as a kid in 1972 #4 - retire, and then adopt a rescued dog! #5 have sex again (just kidding - maybe not! LOL) [maybe I'll get censored for putting that in - but I'm 58....like to think I have lots to look forward to on many fronts]
  • Mom 3 months ago
    At his age, the only goal for my dad was to stay at his wife’s side. The long term care organization was such a boondoggle that she died separated. Something that will haunt him for the rest of his life. Surely as a society we can do better than that. And, we are not the only family with complaints. There weee alternative options for care out there, but not put on the table.
  • Sherry Moran 3 months ago
    I agree with the concept and have a turning 70 list. I do not want to be on my deathbed regretting things left unsaid or undone.
  • CCBB_1544 3 months ago
    To be able to travel to certain places and countries, and to be able to do so in comfort and without pain.
  • Janus 3 months ago
    Death is a very useful inflection point. Thinking about our ultimate exit ensures that we commit to living well, whatever that means for individuals and our loved ones. If we are strategic, we also prepare for a departure that is dignified and filled with meaning. As my father-in-law always said: "We are not getting out of this world alive." Accordingly, our children are acquainted with our end-of-life wishes. Our will and legal directives set out our express directions. It occurs to me, however, that it would be helpful to share a copy of my associated directives with our family physician, now, rather than later.
  • qualicumgirl 3 months ago
    1. To see my children happily married (or happily not) and settled in careers that give them joy and will look after them financially.2. To have experienced time with loved ones that I would look back on as joyous occasions that I didn't have to plan and organize. 3. I'd like a few more trips to see parts of the world that I've not seen. But they can't be adventure travel, gruelling tests of stamina any more. 4. I'd like to be in control of my own downsizing5.I'd like to be recognized for some of the things I've accomplished in life that somehow never got noticed.
  • plainfancy 3 months ago
    More travel around the world. More schooling.
  • Mairy 3 months ago
    1. stop Kinder Morgan pipeline and the expansion of the tar sands.2. convince the government to end open-net fish farming that is so detrimental to our salmon and other native fish.3. support my kids and grand kids in whatever way I can.4. be well integrated into my communities.
  • MAIDadvocate 3 months ago
    1) would be to be able to go on vacation but I am still caring for my older sister 12 years later.
  • Longgone 4 months ago
    Riverboat CruiseTravel to ArgentinaTriathlon Motorcycle Your of East CoastFort Worth Stock Show
  • Midnight1217 4 months ago
    For me my bucket list is more about the things I'd like to do before I die. E.g. travel. But what I want to accomplish when I know I'm dying is a totally different question, and of course is very dependent on my abilities and the time with which to accomplish it. My main goal would be to spend as much time as possible with my family and loved ones. I would want to have my "spiritual house" in order so the support of a Spiritual Care Provider would be very important to me.
  • Calamitykid 4 months ago
    We hated the term "bucket list" when my teenage son was palliative- we called it a "life list". He was successful in accomplishing much of it in a short period of time with the help of many. Now that he has died.... I don't have a life list anymore. Watching him die and living past that moment was a huge wake up call that the only thing that really matters and transcends death is love. So my list has just that on it. LOVE. All the other stuff - sure, I am living with vigor and learning and doing as much as I can that interests me while I have the gift of being here (probably more than most folks). But if I have to choose between getting the so-called list done, and spending time loving my family and friends - the latter is always going to take priority from now on.
  • keithmnop77 4 months ago
    I've never considered doing a bucket list. I was still in middle-age when I got sick and had to go on LTD and then retire early. The illness has left me too broke to do any of the traveling I'd planned for my life.
  • 40funthings 4 months ago
    I believe our six year old has been around for two years because he always has something to look forward too. He went to Disney land with make a wish. He wanted to start school and he is about to finish kindergarden!!! Birthday parties, a day at the lake, Christmas, everything is a reason to look forward to tomorrow. Currently on his list it is always being achieved and renovated. 1. A day at the ocean. 2. West Edmonton mall and the drumheller dinasours. 3. Swimming lessons. 4. Camping in tent. 5. Playland. We always have easy to complete things like a day at playland and it shows up every year like the pumpkin patch and big events like traveling to a destination. Living everyday is our goal. Watching him be happy and six is a joy.
  • MaryS 4 months ago
    1. Helping to plan my funeral, expressing what is meaningful to me2. Seeing loved ones one more time before I die to express thankfulness and love3. Get outside as much as possible, take a boat ride, or sit by the ocean4. Have a good meal with all the fixings5. Make sure I have alone time to reflect, then share what's important
  • HOME 4 months ago
    By the time you get to end of life palliative care, it is unlikely that bucket list items will be possible.
  • Sandy 5 months ago
    I agree with dcargill's comments. I do not see the relevance of asking respondents for the top five things I would like to accomplish or do before I die.
    Hide replies (4)
    • dcargill 5 months ago
      Bingo. This is a nation wide consultation on how to develop a framework for palliative care in Canada.
    • yvrpcm 4 months ago
      By the time you get to end of life palliative care, it is unlikely that bucket list items will be possible. Typically bucket lists consist of major events: going to Italy, hiking Kilimanjaro, playing on a senior's hockey team. These are not things PC will be able to help with. I think the question is irrelevant and should not take our time. I'm on to the next question!
      • JDAVID 4 months ago
        The importance of a bucket list is to start one now long before you approach end of life.We promote a palliative approach to care which involves identifying goals early on while some of them will be doable.Palliative Care is much more than the last days and weeks of life.
    • PH4PC 4 months ago
      From the Compassionate Community movement, it can be used as a way to get people to engage with the idea that they will die and what is important to them, before a life limiting diagnosis. Maybe it could be used once they get a life limiting diagnosis as well. My experience from using the “Bucket List” activity, is that it can provide a safe space for very uncomfortable Canadians to engage with death and all that comes with it.I would like to rent an R8 and drive the Autobahn.
  • palcare 4 months ago
    A bucket list may be helpful for the person currently living a disease free life. When a person receives a Palliative Diagnosis, I feel the important question to ask is "What is important to you at this time?" Depending on the disease trajectory, this question may have to be asked regularly and the answers may change based on how the persons symptoms are affecting there day to day life.
  • drvho 4 months ago
    This is helpful for identifying the goals of care for the patient, as certain treatments at the end of an illness trajectory may no longer achieve the patient's goals. My job as a palliative care physician often is to give patients and families permission to not follow the oncologist/specialists recommendations for ongoing management if the side effects/harm detracts from the patient's goals. That's the benefit of understanding someone's "bucket list".
  • Marvel 4 months ago
    My bucket list is simple: to be with my children, family to travel, entertain and have meaningful experiences; to complete a video or list of expectations for the family at my death; to experience my own photo journey of life, and others; to share stories with loved ones, ride my bike and take a cruise... if only in my dreams.....
  • paige 2 4 months ago
    if I might say, the preamble statement shows a bias. The last paragraph refers to sharing your bucket list with your health provider. Why do we always default to health care providers? We are part of a compassionate community initiative and are having community meetings to discuss 'bringing death back to life' and having conversations about living and dying well. We find that having these conversations in a community setting-whatever that community is or means-can be very positive. it also takes it away from the ongoing pressures faced by health care providers.
  • respondent 4 months ago
    I think for myself that would be something that would be continuously evolving and I would have to decide when the time arose.
  • sunshinecaregiver 4 months ago
    Spend time with my family and friends doing the following: 1. Travel - anywhere (and some of these are repeat trips) - but particularly Africa, India, the east coast of Canada in the fall, polar bears in Manitoba, train trip across Canada or in Europe, Machu Pichu, eastern Europe etc. 2. Go sky diving (because at that point, why not??). 3. Get a tattoo (because by then I would know it wasn't going to be for very long, haha)! 4. Eat out (if I had an appetite) at a new place as often as possible. 5. Attend my own funeral - this may sound odd but I would love to have a living funeral where everyone who would come to my actual funeral comes and celebrates my life with me. It would be as fun as possible and then when I actually pass away, there wouldn't need to be a big service, just a nice time for my family to spread my ashes or something.
  • eegr18 4 months ago
    I have had a running bucket list that i transfer year too year to the back of my daybook.....I am old fashioned and love the paper daybook !!! it contains big things like trips, pilgrimages and little things like buying a pair of high top sneakers ...in other words things that are completely and easily attainable and others that are expensive and require long term planning
  • 123AbC 4 months ago
    I think bucket lists are limiting. Just do what you can to the best of your ability for as long as you can :)Knowing what is important to you in regards to your having the Best Quality of Life and having those wishes known & followed.
  • Richmond patient 4 months ago
    I have accomplish most of them. Most importantly I want to provide sufficient money for my mother if I am gone.
  • JenniferM 4 months ago
    I don't have a bucket list. I do however want to point out that some people only get a bucket wish, as they wait to long to start thinking about the end of life
  • Albertababe 4 months ago
    My bucket is empty. I am grateful for the life I have & the people in it --- need to ask for more.
  • Lea 4 months ago
    That is not a priority for me to accomplish. I will ponder this
  • HBh 4 months ago
    I feel complete in my life to date
  • 2012july 4 months ago
    I want to engage with my family and friends - tell them how much I love them. I want to leave good memories with my family of our times together. I want to leave my family prepared financially and with the knowledge they need to wrap up my estate and to continue on with their lives.
  • Apollo Alias 4 months ago
    I would like my inventions to be developed. I would like to end war. I would like to have people appreciating my social observations. I would like to die free of drugs from for-profit companies. I would like to feel safe among people.
  • PalliativeEvangelist 4 months ago
    I'm a great admirer of Dr Periyakoil's work (I was privileged to be selected by her as a patient voice on the Social Media Panel she created for the Journal of Palliative Medicine). However, I believe that more important than the 'bucket list' is ensuring the small but meaningful things are in place until we die. To this end, I'm re-framing 'the end' to focus on the small but meaningful things that can people want in their lives right up until they die. I've been taking a whiteboard to health conferences I attend asking delegates to fill in the blank 'I want to _____ until I die'. It is (and continues to be) remarkable the change in body language when people put mind to things like 'learning until I die', 'being present' (that contribution from Dr Peter Vaughan of Infoway) or how about 'hiking' from Dr Ed Brown OTN. While not all may be feasible, these pleasures can inform what brings comfort, feeling purposeful, and brings meaning right up to the end. www.bestendings.com
  • alliedhealthworker 4 months ago
    This isn't really answering the question, but my two cents (or nickel given that we don't have pennies anymore) is that encouraging providers to speak with patients about "bucket lists" is only useful if they are encouraged to skillfully ask WHY something is on the list to really get at the heart of someone's values. It's a door-opener strategy but what's important behind a door-opener is having the communication skills to really be able to listen to understand rather than listen to prepare a response.
  • Odile 4 months ago
    Commit to daily spiritual practice. Connect more directly with nature. Contribute to diversity and social justice in underserved areas in my community. Publish my creative writing and mentor young writers. Visit non-touristy areas in Italy and press the Restart button on my rusty Italian.
  • peilinda 4 months ago
    keep my brain active and challengedgo back to PEI for a month in summer have all my children and grandchildren home for the holidayskeep mobile as long as possible
  • applebee1 4 months ago
    Don't have a bucket list - dislike this term when used in conjunction with end of life. I, like many boomers, strive to live my life fully - doing things now while I am still able/mobile and can afford it. I have identified goals that will be important to me at the end of my life - celebration of life, no medical interventions when deemed palliative etc. - do not view this as a bucket list.
  • pcforkids 4 months ago
    I don't have a specific bucket list. I would like to remembered as a good parent who raised children who contribute to the world in their own way.
  • Geriatricworker 4 months ago
    personally don't have one, but recently a 96 year old shared she still has 2 more goals on the bucket list to achieve " make it to 100 and remain independent "
  • 2025 4 months ago
    I don't have a bucket list...I should probably start one. I think they are important and can guide treatment goals. I agree with Margaret below there about not having the resources in most palliative or long-term care settings (or seniors care settings in general) to assist folks with what matters most to them.
  • Jake the cat 4 months ago
    No bucket list.
  • Pathos58 4 months ago
    This concept is more relate-able for me in terms of a chronic illness. At end of life, it would be a non-issue. However, the wishes or goals of a patient, i.e. to be able to enjoy family and events, to converse, to interact in some manner would make sense in terms of treatment goals.
  • Margaret 4 months ago
    The bucket list plan is a great idea, however, the professional care required to carry them out is not available in our rural area. The most one can do is discuss it with a family member but then in most situations, the person who is given the death sentence by a doctor, tries to lessen the burden on their caretakers as we know the professional team available in cities are not available here. The support comes from within our families and communities but people wishing to enjoy their last months of life and live life comfortably at home, instead get shoved into packed hospital with low staffing, where they die afraid and some even alone as family members aren't always able to be with them.
  • Tsawwassen 4 months ago
    I do not have a "bucket list". I do not look at life that way.In my advanced care plan I have identified the capabilities I think are important to me -- for me to enjoy life.
  • Marnie 4 months ago
    Hmmm, if one is in end-of-life care, I think that most, if not all, bucket list items are going to be immaterial and, even in palliative care, that is likely to largely be the case. If one has a serious bucket list, with, say, five things one would like to accomplish or do before one dies; I would be attending to those items as soon as possible and not put them off. I guess that, if one had items such as I want to live to be one hundred (100) and one was close to being one hundred (100) and the health care provider could help or hinder that depending on the choices available, this Bucket List Discussion 2.1 might be meaningful. Otherwise, I have my doubts. For example, I would like to travel to a few places; that is unlikely to happen once I have reached palliative care.
  • Linda Hochstetler 4 months ago
    I'm in my 50's so I have a lot of active goals still on my bucket list. Once I hit my 60's I might change to some travel goals. In my 70's I hope to set goals related to learning new things. So for me, a bucket list should constantly be updated with a bunch of items being completed, and maybe some items falling off.
  • happydeath 4 months ago
    Haven't really thought about this.
  • Debs 4 months ago
    To be loved and to love . To have meaningful relationships that are life giving and supportive . ToHave lived a rewarding full life. To have believed and known my life to be purposeful . To know that my children and their families are well .
  • JMD_1 5 months ago
    1. Live as good as possible 2. Be kind as possible to everyone.3. Travel and enjoy life with family and friends.4. Strengthen my faith and build relationships. 5. Do whatever I can for others and myself.
  • limey 5 months ago
    My life goals change all the time I have some like "living long enough to retire well health and with sufficient money to live comfortably" but I don't think that was what was meant in this context. When working in a Hospice I found those clients who accepted their journey had very simple goals like "I want to see my estranged adult child to make peace before I die". I found the clients and families who were the most distressed were the ones who felt they had unfinished business, watching them with existential concerns made we understand what real suffering is.
  • greyhairedlady 5 months ago
    I do not see the relevance of this question in the present context.
  • dcargill 5 months ago
    I do not see the relevance of this question, to be honest. This is a conversation to have with family and loved ones, not posted on a public forum for consultation about a serious issue like a framework for palliative care in Canada.
    Hide replies (6)
    • admin2 5 months ago
      Hi dcargill, thank you for your comments, and please do not feel pressured to submit an answer. I would like to share some rationale for why we included this question, because you raise a good point.One of the things we hope to achieve through this consultation is increase the comfort level in discussing end of life issues. Dr. Periyakoil's work on bucket lists is extremely useful in reframing the discussion around end of life care and quality of life. We hope that consultation participants will use the question as a prompt to begin to consider their own preferences and create their own bucket list to discuss with family, friends. Here's a link to Standford University's Bucket List Project - including some video testimonials of people's bucket lists. http://med.stanford.edu/letter/bucket-list.htmlThank you.Venetia LawlessHealth Canada
      • dcargill 5 months ago
        Thank you for your reply. I simply feel that if one has a limited amount of time to dedicate to this consultation, this is not best use of time for respondents. Yes, bucket lists matter when individuals are discussing their beliefs and values around ACP, goals of care, etc. but not when trying to develop a construct such as a national framework. As a physician, I have helped many patients realize their "bucket lists" before end of life. Bucket lists are intimate, personal and best discussed in specifics with family and caregivers. The question asks respondents to post their personal bucket lists, their "top 5" as part of a consultation to help develop a framework for the country. I don't think this helps. Bucket lists could have been posted as a part of the background or information about palliative care but as a question, not as helpful. Just my opinion. Other respondents many feel otherwise.
        • Nikki 5 months ago
          You have a good point about time. I looked up Dr. Periyakoil’s work to see what it’s about and “bucket list” doesn’t really describe it for me but I think its helpful in palliative care.
        • janets 5 months ago
          I think that where it fits in with this discussion is in looking at supports and staff for palliative care services. For example, occupational therapists primarily work in this realm - making peoples goals happen, by looking at the physical, cognitive, emotional, and spiritual factors of a person, and matching that with the environment and the activity. Unfortunately there aren't enough occupational therapists in palliative care to help with these things.
      • Nikki 5 months ago
        http://med.stanford.edu/letter/bucket-list/bucket-list-toolkit.html admin2: the link you added didn’t work. I had to add spaces behind the above link to get it to work ;)
        • admin2 5 months ago
          Sorry about that Nikki - thanks for correcting!
  • Camper68 5 months ago
    My bucket list includes travelling to all continents; seeing the Pope at St. Peter’s Square in Vatican City; writing a children’s book and publishing it; completing at least one triathlon and being involved in Girl Guides for as long as I can be
  • tracym 5 months ago
    I agree it's important to clarify one's needs, hopes, and expectations. Tell people what you want.
  • jo 5 months ago
    #1 is to ensure funding is available in support of my palliative care requirements.#2 spending quality time with close family and friends, and taking photos#3 travel as much as possible with close family and friends - the environment is relaxed and individuals are focussed on enjoyment and not on daily grind.
  • Pat 5 months ago
    1. explain my will to my family2. have time to talk with family and friends - that could require health providers to alert me as soon as they think I may be needing intubation or meds that will make it harder for me to talk3. leave the hospital - whether to hospice or home, but I really really do NOT want to die in hospital - and I would hate to be caught in a situation where "the system" prevents me from leaving (e.g., no beds available, homecare program not equipped to provide care)4. have a full discussion about Advance Care planning5. have access to good food! no unnecessary dietary restrictions, better access to choice of foods - include dietitians in palliative care, so they can assess needs and coordinate this aspect of care; there is too much emphasis on meds - palliation should be about comfort food and comfort hygiene care
  • valeighgirl 5 months ago
    I don't have a specific bucket list- I try to live everyday to the fullest and have few regrets; those I do have, I try to learn from them. I work with individuals at the end of their lives so I try to take advantage of the fact that I am living, every single day.
  • DRED 5 months ago
    For me, I have had a full life and feel good about how I have lived it and interacted with others. There will always be things that I don't get done ... but I don't believe in bucket lists .. they didn't get done because my life is full and busy and new things are being added regularly ... so be it if there are things I didn't achieve, it has been a great ride.
  • Tiredns 5 months ago
    My bucket list is mostly unattainable but I do want to see my kids settled and my dogs taken after. Not much of a list but priorities change with a serious diagnosis.
  • Emelle 5 months ago
    All 5 have to do with caring and sharing with family, friends and other loved ones.
  • cam 5 months ago
    I am responsible for my "bucket list" and find this a private matter between myself and family and not something to share with a group.
  • snicolson 5 months ago
    Do some travelling, continue to learn, see my children settled, successful and happy.
  • Anonymous Username 5 months ago
    The Serenity Prayer.
  • Julie Gray 5 months ago
    lets not wait till there is a risk of dying to prepare a bucket list. Get on it asap and tick it off as soon as you can. Live as if you were dying everyday!
  • NurseDar 5 months ago
    A bucket list is a great way to begin to thinking about one's values and things of utmost importance. As for discussing the top 5 things on the list with a health care provider I think it is really driven by the seriousness of one's illness, prognosis and options for treatment.