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Using Human-Centered Design to Improve Serious Illness Care for Older Adults With Advanced Dementia
Lara Chehab1, Sofia Weiss Goitiandia2, Lorraine Pereira3
1Department of Surgery (L.C., A.S.), University of California, San Francisco, California, USA; The Better Lab (L.C., D.P., A.S.), University of California San Francisco, San Francisco, California, USA.
Journal of Pain and Symptom Management
|November 30, 2024
Summary
Human-centered design (HCD) engaged clinicians to develop intervention ideas for reducing high-intensity, goal-discordant treatments in advanced dementia care. This approach generated multiple solutions for improving end-of-life care for older adults.
Area of Science:
- Geriatric Medicine
- Palliative Care
- Human-Computer Interaction
- Design Thinking
Background:
- Older adults with advanced dementia often receive aggressive, non-beneficial treatments.
- Goal-discordant care is prevalent, indicating misalignment between patient wishes and medical interventions.
- Existing interventions to improve end-of-life care have had limited success.
Purpose of the Study:
- To apply human-centered design (HCD) with clinicians to generate intervention ideas.
- To reduce high-intensity, goal-discordant treatments for older adults with advanced dementia near end-of-life.
- To improve goal-concordant care in serious illness.
Main Methods:
- Utilized the inspiration and ideation phases of HCD.
- Conducted in-depth interviews with clinicians for the inspiration phase.
- Employed thematic analysis and structured brainstorming sessions for idea generation.
Main Results:
- Identified seven themes and three design opportunities from clinician interviews.
- Generated 132 intervention ideas through brainstorming sessions.
- Selected nine intervention ideas for further testing.
Conclusions:
- HCD effectively generated intervention ideas at multiple healthcare system levels.
- Involving clinicians, researchers, and designers is key to addressing challenges in serious illness care.
- The process yielded innovative solutions for an enduring problem in geriatric palliative care.
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