A “bucket list” can be a starting point to helping people with chronic and serious illnesses think about treatment decisions in relation to their own life goals.
A lot of work has been done on the importance of conversations about the goals of care between clinicians and people with chronic and serious illnesses when embarking on advanced care planning.
Yet, there is a communication gap. Patients may not have the medical knowledge to understand how treatment options will impact on their life goals, and clinicians tend to focus on disease management, without taking short- or long-term goals into account.
It’s a gap that advocacy groups naturally fill, and by encouraging patients to make and talk about their bucket lists they can help them create better advanced care plans.
A bucket list is defined as a list of experiences or achievements a person would like to have or accomplish before they die.
A total of 3,056 people from across the U.S. completed a survey between July 2015 and December 2016. The survey asked participants if they had a bucket list, and if so what was on it.
Data were also collected on sociodemographic characteristics including, age, gender, ethnicity/race, and self-reported importance given to faith, religion or spirituality.
Qualitative and quantitative analyses of the results were carried out.
The majority of those taking part in the survey, 91.2%, reported having a bucket list.
Six keys themes were identified by the researchers.
The desire to travel, either within the U.S. or abroad, appeared on 78.5% of all lists, followed by the desire to accomplish a personal goal, which was listed by 78.3% of participants.
The desire to achieve specific life milestones was the third most prevalent theme, making it onto 51% of bucket lists, and 16.7% listed a desire to spend quality time with family and friends.
A total of 16.1% of respondents had achieving financial stability on their list, and 15% said they wanted to take part in a daring activity.
Goals-of-care discussions about advanced care planning are often clinician-led and can focus on end-of-life treatment choices.
Empowering people with chronic or serious conditions to speak to their healthcare team about their bucket list, however, focuses advanced care planning on the patient.
“It’s important for physicians to talk to patients and find out what actually motivates them,” said Dr. Vyjeyanthi Periyakoil, Clinical Associate Professor of Medicine at the Stanford University School of Medicine.
By discussing how a treatment or surgery might affect the patient’s life, and then discussing what their goals are, the best possible care plan can be laid out.
Interestingly, a Google search for “bucket list” yielded almost 84 million results, compared to 4.5 million for the term “advance directives,” and 533,000 for “advance care planning.”
“Patients don’t see the relevance of an advance directive,” said Dr. Periyakoil. “They do see the relevance of a bucket list as a way to help them plan ahead for what matters most in their lives.”
Periyakoil VS, Neri E, Kraemer H. Common Items on a Bucket List. J Palliat Med 2018 Feb 8. Available at: http://online.liebertpub.com/doi/full/10.1089/jpm.2017.0512 (accessed February 2018).