The ONCE App

ONCE

The ONCE App

ONCE: Using Mobile Technology and Generative AI to Simplify End-of-Life Planning and Spark the Conversations That Matter Most — For Free.

Nashua, NH, USA

USA

Nonprofit

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Too often, the most important conversations about how we want to be cared for at the end of life never happen. Many people feel unsure where to start, worry about upsetting loved ones, or feel overwhelmed by complex medical terminology. As a result, families and doctors are often left to make difficult decisions without knowing what their loved one would have wanted. Nearly 60 percent of Americans do not have a living will, according to a 2020 Gallup poll. And while over 90 percent of adults believe it is important to talk about end-of-life care, only 27 percent have actually had those conversations (The Conversation Project / IHI). The gap is even more significant for underserved and historically excluded communities. A Health Affairs study found that only 24 percent of Black Americans and 29 percent of Latino Americans had completed advance directives, compared to 44 percent of white Americans. These disparities reflect deep-rooted barriers including medical mistrust, stigma, and limited access to planning tools. ONCE was created to change that. With kindness, clarity, and compassion, ONCE guides people through education, reflection, and conversation—helping families make informed choices and offer each other peace and understanding

ONCE is a free, easy-to-use mobile app that helps individuals explore what matters most as they plan for the end of life. It provides a compassionate space to reflect on personal values, document care preferences, and share wishes with loved ones and healthcare providers. With thoughtful prompts and simple questionnaire, ONCE makes end-of-life planning approachable and respectful. Users can learn at their own pace, revisit reflections, and create a personalized summary to share. The app also includes definitions and explanations of medical terminology, along with features for easy sharing, updating, and reminders. A dedicated resource page offers additional information and helpful links. Accessible on smartphones and tablets, ONCE empowers users to make informed choices and communicate their wishes clearly. Future plans to incorporate generative AI will offer multilingual support, culturally sensitive responses, and personalized guidance based on open-ended reflections. By combining technology with empathy, ONCE provides peace of mind for individuals and their loved ones, offering clear, compassionate guidance throughout the planning process.

ONCE is designed for everyone, regardless of religion, culture, or lifestyle. End-of-life planning is a personal journey shaped by our beliefs, values, and experiences, not just about having a will or assets. Many people, especially in marginalized communities, face barriers to planning. Studies show that racial and ethnic minority groups are more likely to die in hospitals and less likely to have their care preferences documented than white Americans. These disparities often stem from a lack of trust in the healthcare system and limited access to culturally sensitive care. Religious beliefs can also shape how people view planning. For some, life and death are seen as being in God's hands, making formal planning feel uncomfortable. In other communities, decision-making is seen as a family matter, and legal documents may seem unfamiliar or unnecessary. Educational and financial challenges add to this. Many people don’t know where to start or can’t afford legal help. Those without assets may not realize planning is still important. ONCE offers inclusive, compassionate support. It helps people express their wishes, regardless of background, and be remembered with dignity.