'Distraction' is a social determinant of health. Human centered design is a solution.

I recently took a single week of FMLA to help out my aging parents.?

Their health has been waning as of late - memory issues, breathing issues, energy issues, joint and mobility issues. My concerns about their health had been growing for a few months, and coupled with the stresses of caring for one another, I decided to fly home to diagnose the situation.

As I flew back to New York and thought about my remarkable parents – these two wonderful people who have given me so much – I reflected on how to care for them as people, not just as patients. I’m a physician, and I often must fight my default instinct of thinking like one: ‘I should diagnose the illnesses and advise on how to treat them.’ Instead, I went home and very intentionally decided to think like a human centered designer: ‘let me observe the totality of their lives and not look for diagnoses to treat but instead design-themes to employ.”

I’ve come to rely on immersive design research to solving hard problems in my professional life: when I needed to learn about nursing homes to form Call9, I went and lived in one (link). When telemedicine laws needed to be changed to allow innovation to thrive and reach our most vulnerable patients, I went and lived in D.C. for weeks lobbying and writing the RUSH Act (link). At IDEO, I get to learn from users everyday. Now, I would apply these same skills to my personal life, living with my parents for a week - observing, experimenting with sacrificial concepts, and designing solutions.?

When my mother told me her ankle hurt, and she wasn’t eligible for another steroid shot for a couple months, suddenly my physician mindset took hold of me: I wanted to review the x-rays myself, to do an exam of her ankle, to review her medical records. When I found out that she wasn’t a candidate for surgery, I emailed my contacts and asked if there was any role for more cutting edge procedures like regenerative medicine with stem cells or autologous platelet injections. I had immediately removed my attention from my mother and prioritized my attention to the ankle; I did what I’ve been trained to do.

But later, I remembered to put myself in the designer's mindset. I looked at her entire life journey, all the things that happened throughout the day, her values and the problems she was experiencing.?

Over the week, I saw a theme: distraction. A web of distractions was making it harder for my parents to do, well, anything. They were each receiving six spam texts to every one legitimate text. My mother adjusted a throw rug in their hallway literally 30 times per day as it slipped a bit after anyone including their dog stepped on it. An incoming robocall that one might instinctually ignore became a problem to for them to solve, setting forth a conversation between my parents if it should be picked up or not, interrupting the normal flow of the day, inserting itself into their lives and replacing the joy of being together with another distraction. The spam was in their email, was in their snail mail, it was everywhere.

I asked questions and learned that ice and elevation did help my mother’s ankle pain a bit, and that walking through parking lots was a big exacerbating factor. So I filled out the paperwork I found online to get her a rear view window disability placard and signed it with my own physician license. We iced the ankle every night and got an ankle-band that had ice built into it - one less thing to think about - and looked at it as a thing that was distracting her, not as a medical thing that I had to diagnose, prognose, treat, and solve. Decreasing the ankle pain allowed her to concentrate more. Parking in handicapped spots meant one less thing to think about and search for.?

Eventually, I started to see her whole life within the design framework of ‘jobs to be done,’ and designed opportunities where tasks that required two or three decisions could be just one: the recycling which their town requires be separated into cardboard and plastic into separate bins was thrown into the same bin in the kitchen, only to be sorted later in the garage; so we simply bought a kitchen can that had two bins - we consolidated two decisions into one.?

We added a service to their emails that unsubscribed them from spam emails they didn’t want to consume and rolled up the many digests, political ads, and meaningful e-briefings which they did want to consume into a single daily infinitely less distracting email. We signed up for a robocall and spam text blocker, for the US Postal Services e-preview service so I could be their partner in monitoring physical spam. We cut up outdated credit cards, signed up for a password protector and storage service, canceled unused newspaper and magazine subscriptions and deleted the apps on their phones and tablets that they no longer used and more.

It worked, and it helped to allow my mother to think more clearly, engage in her day with more joy, and concentrate on the things that matter like her relationships, her own happiness, and her health.??

I learned that week that distraction is a social determinant of health. How might we scale human centered healthcare to declutter the lives of the digitally non-native and co-design more joyful, attentive, and healthy lives with our Aging? How might we do this not only through companies, and healthcare systems, and governments that are often painfully slow to implement, change and innovate, but be empowered to do this ourselves? I learned that week that we all can be designers: we all can improve our own worlds by immersing ourselves in one another’s worlds.

Thank you to my mother and father for bravely signing off on this post. They've dedicated their entire lives to bettering the lives of others and saw this as yet another opportunity to do so.