Examining the role of card game in promoting death awareness in Thailand

Advance Care Planning (ACP) helps individuals express care preferences in case of future incapacitation and has been part of Thailand's national policy since 2014. However, the awareness and uptake of ACP remains low. Peaceful Death, a community-driven organization, aims to improve ACP awareness through innovative death education with the Life Unlocking Card Game, challenging the institutionalised traditional death and dying education. The culturally appropriate card game empowers people with lived experiences and their families, facilitates the socially constructed experience and tacit knowledge around death and dying. It extends beyond medical preferences, enabling participants to document ACP, making their directives legally binding. This paper highlights the development, implementation, and impact of the card game, focusing on its gamified approach to facilitating conversations around ACP in a non-threatening environment. We showcased the use of the card game as an educational tool to raise death awareness, based on one of our projects. From 2019-2021, 283 participants were trained as facilitators. They subsequently conducted nationwide hybrid training sessions. Out of 26,887 trainees, 9,588 had discussed their ACP and completed their advance directives. This project demonstrates a scalable, innovative approach to death education and ACP which has been implemented in a resource-limited context.