On death and design

Posted on 13/05/2017

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(@ctrlgroup)

If you’re under 60, reasonably healthy and unencumbered by mental illness you probably don’t think about death much. But it’s inevitable and one of the few things you only get to experience once.

That experience matters. How we expire and what we decide before then is important not only to the dying but to the clinicians involved and those they leave behind.

Ctrl group’s mobile health meetup bought together Ivor Williams from the Helix Centre and Cassie Robinson from Dot Everyone to work through some of the contradictions and tensions around end of life care. And when you observe how terminal illness proceeds, there are some surprising

  • Even with an end of life care plan, we don’t always see it coming. People and carers nearly always have to plan/design for situations once they’ve happened.
  • Even when we do anticipate it, the rush and tumble of life might mean that things we wanted just weren’t possible. Also, our views and preferences might change as illness progresses.
  • Conversations about death are difficult we will ever have, and that’s just as true for doctors as it is for patients/families

It was great to learn a bit about how they’ve been researching and designing for end of life situations. been doing (more here). But some of the gems from the meetup were the tangential points.

  • The doctor’s “holy trinity” – smartphone, pager, stethoscope. All the tools they need.
  • OS hierarchy: doctors choose Apple; nurses use Android. But everyone has a smartphone
  • Any healthcare system is complex. Try as we might we can’t redesign the whole system; only small parts of this. Even then, these changes take time to stick and replace the old ways. There are limits to how much a single intervention can change the quality of care someone receives.

  • Forget conversation guides, training modules and motivational interviewing. (From a doctor:) What is the ONE question I can use when I get into the room?”
  • Forms, documents, medical notes become a prism for the challenges faced around end of life care.
  • Culture outlasts us. But culture is also the hardest thing to design for and to change.

For the full write-up, check out Ctrl Group’s blog.

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Posted in: Design, Digital, health