Aishwarya Iyengar
Service Designer, User Researcher & Design Educator
HOSPITAL TO HOME | NHS Scotland
The Challenge
People in the UK are living longer, i.e., the number of people over the age of 65 is on the rise. For Scotland alone, it is estimated that the percentage of people aged 65 and over will increase by 62% by the year 2031 and the people aged over 85 and over will increase. However the way health and social care is provided currently will be unsustainable in the future. With the increasing need for care and lack of availability of care professionals, there is a high dependency on the family, friends and the community to step in to take on a significant role in a person's care.
Although it has been identified that older people would be supported by their informal carers to a large extent, it is also important to understand that the carers may have their own needs and wishes which need to be acknowledged. The carer often becomes a person who has to be 'giving' in the relationship and it can lead to having an impact on their mental and physical health.
To understand and foster this caring relationships, families need to have conversations about 'what is important to them' and what they would like to happen in the future. But these conversations are difficult and often avoided. Our challenge was to enable older people and their families have these conversations and have empathy for one another.
How might we enable Families to have difficult conversations about their future in a positive way?
How might we make these conversations enjoyable and not always emotionally difficult?
The Approach - Visual tools
During our research we spoke to several older people and carers with the support of 'visual tools'. Visual tools in this context, refers to something that enables people to represent their thoughts in a physical form through words, drawings or even models. We observed that tools are a useful medium to discuss high-intensive & sensitive areas related to a person's life, that can be emotional and challenging in a one- on- one conversation.
Visual tools, like drawing out their "circle of people" gave our participants enough time to process and collect their thoughts as they were expressing them through not verbally, but visually. It helped us also better understand the person's life story and talk around specific topics wherever it was important to understand closely.
The Design intervention
We created a book called ‘My life book’, a collection of conversation prompts that enables people to have meaningful conversations with each other. The book has four sections, People, Places, Work, Rest & Play and Changing times. These conversation themes need not be sequentially experienced, keeping in mind that people will have a choice as to ‘what’ they want to talk about and ‘when’.
It was identified during research that there are documents that exist to prompt people to talk about their wishes, preferences to help make decisions for their later life. But these were not designed in a way that would make a person ‘want’ to share very personal, intimate and valuable parts of his/her life.
The impact
It was reassuring to see how this conversation tool had an impact on people at an emotional level. The positive and visual approach lightened up people who engaged with it. There were many stories that people have heard several times from each other but this time it brought to light 'why' those experiences are important to the person.
As a subsequence of the positive response we received, My Life Book is being promoted by IRISS, A Research and Social Service Organization to make it available for use across health and social care organizations, even beyond UK Borders!