What’s on your bucket list? The answer could help patients, physicians discuss advanced care treatment

Female doctor talking to male patient in hospital bed
Asking patients about their bucket lists is a way to start conversations about advance care planning.
(Getty/monkeybusinessimages)

Popular as plot fodder for feel-good movies and as a conversation starter at cocktail parties, the "bucket list" is also a useful tool for doctors and patients when they're talking about care plans.

Asking patients about their goals and aspirations helps ensure their medical care fits their life plans, researchers at the Stanford University School of Medicine say.

The study, published in the Journal of Palliative Medicine, found that about 91% of more than 3,000 participants in an online survey had a bucket list, defined as a list of things a person has not done but wants to do before they die.

It’s a simple framework that doctors can use to help patients make informed healthcare decisions and weigh treatment options based on the potential impact on their life goals.

“When you just Google the term ‘bucket list,’ it’s huge how much interest there is in this. It provides a very nice framework for thinking about your life goals, health and your mortality,” said lead author Vyjeyanthi S. PeriyakoilM.D., a clinical professor of medicine, in an announcement.

For doctors, it’s a good way to personalize care and get patients to adopt healthy behaviors, she said.

Age and spirituality influence patients’ bucket lists, and participants who reported that faith, religion or spirituality was important to them were more likely to have a list.

Researchers found six primary goals in those bucket lists:

  • Planning to travel (78.5%)
  • Meeting personal goals, such as running a marathon (78.3%)
  • Achieving milestones, such as celebrating a 50th wedding anniversary (51%)
  • Spending quality time with friends and family (16.7%)
  • Reaching financial stability (24.3%)
  • Planning to pull off a daring activity (15%)

Talking to patients, especially those with chronic or terminal illnesses, about their care goals can be a vital part of the advance-care planning process. But it’s often difficult to have these conversations, particularly when they're about end-of-life care.

Medicare will reimburse physicians and other providers for discussing advance care planning with their patients and families. But studies show that nearly two-thirds of physicians say they are inadequately trained to counsel patients. 

Discussions between doctors and patients can help ensure treatments don’t undermine or subvert a person’s life goals.

“If a patient wants to attend a beloved grandchild's wedding or travel to a favored destination, treatments that could potentially prevent her from doing so should not be instituted without ensuring her understanding of the life impact of such treatments,” the authors wrote.