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Memento: iPad app

How might we enable patients in palliative care to share their legacies?

 
 

Project Overview

Patients in palliative care experience a lonely and vulnerable journey as they near their end of life, or reach a state of non-recovery. With varying levels of attention from loved ones, they can struggle to find channels of communication that maintain their sense of identity, pride and agency. Inspired by Dignity Therapy, Memento allows patients in palliative care to share their memories, life lessons and values to create a lasting legacy — a deeply personal memento.

My Role

We decided upon this project brief as a group, pulling from our own experiences with aging or recently passed family members. I created the information architecture, UX flows and collaborated on the visual design with my teammates. I helped lead background research and user testing.

 

Scope: 2 months

Categories: User Research, Product Design

Role: Research, User Testing, UX/UI Design, Copywriting

Team: Yumeng Ji, Jennifer Wei,
Xiaoxi Yuan

Tools: Sketch, Principle

 
 
 

THE PROBLEM

Patients in palliative care are often vulnerable and lonely — lacking the personal attention they need from family and medical caretakers.

Dignity Therapy is a promising intervention that requires facilitation that caretakers cannot always afford.

 
 
 

THE SOLUTION

Memento makes Dignity Therapy accessible to any patient with an iPad.

It helps patients deal with emotional pain by creating a legacy of life stories shared with their loved ones.

 
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For Patients

 
 

For Loved Ones

 
 

 
 
 

What is Palliative Care?

Palliative care is a specialized medical care for people with serious illness. This type of care focuses on providing relief from the symptoms and stress. The goal is to improve quality of life for both the patient and the family.

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The Problem

When patients are diagnosed with a terminal illness or suffer from a long-term illness, they are confronted by their end of life. This can be a scary and vulnerable experience.


How will I be remembered? Will I be forgotten?

Patients begin to worry about leaving behind their families, their life and deal with challenging existential distress. They may wonder what legacy they are leaving behind in the world.

Patients often feel vulnerable and alone

In their time of need, doctors, nurses and family members are not always present to provide comfort. Medical caretakers are often outnumbered by patients. Families are also restricted by their own work and responsibilities.

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Our Goals

  1. Empower patients to feel a sense of hope, meaning, resilience

  2. Increase connection between patients, families and friends

  3. Extend a patient’s communication with loved ones over time

 
 
 

The Opportunity

Dignity Therapy is a therapeutic intervention designed to address psychosocial and existential distress among the terminally ill. It consists of 60-minute sessions with a therapist who asks patients about their life history to co-create a legacy document. Family members endorse Dignity Therapy for moderating their bereavement experiences and enabling a sense of meaning and purpose for someone with life-limiting conditions.

Our Strategy

Borrow Dignity Therapy principles and questions for a standalone app that helps patients find closure and a sense of purpose by creating their legacies. The app can be used independently without help from caretakers.

The Dignity Therapy Principles

We researched the different goals of Dignity Therapy to understand how we could frame existing questions into a new framework for Memento.

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How might we use empower patients to rewrite their end-of-life experience by sharing their legacies with loved ones?

 
 
 

Expert Interviews

It was challenging to access palliative care patients for privacy reasons. We spoke with several palliative care nurses, experts who worked with cancer patients and parents in their 40-50’s to understand our user’s perspective.

 
 

Interview Highlights

“It’s always easier when you have family and loved ones around, with a lot of pictures, everyone telling stories about that person.”

—John Lyons, Nurse at Calvary Hospital in Bronx

“For [the family] to hear or read about their loved ones every day thoughts or experiences...It would be the loved one they remember and not the loved one who’s diseased.”

“The nurse’s day is really packed. Even as much as we’d like to chit chat the ratio is 1-6 so this really difficult to spend time with the patient when you have five others.”

—Edi Carmel, Nurse at Mount Sinai RMTI

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Defining Our User

From our desk research and interviews, we narrowed down our target user and the timeframe of their medical and emotional journey we wanted to focus on.

 
 
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Design Principles

Speaking with experts also helped us shape four essential principles that guided our designs. It was especially important to think about the physical and mental abilities of our users, and how we could make the product as easy to use as possible.

 
 
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Patient User Flow

 

Loved One First Time User Flow

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Paper Prototyping

Since we had big time constraints, we used quick paper prototypes for most of our user testing.

 
 
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Usability Testing Insights

During usability testing, we discovered these following issues.

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Issue 1: Too many Start Options

In this earlier version, we had three ways for the user to share a story: record a custom memento, answer a Dignity Therapy question or answer a question from a loved one. This created confusion in user testing, and also created friction between the two types of questions available to answer.

Solution: Prompts

Users now select a prompt that helps set an intention. Once they’ve selected the prompt they can scroll through its related questions, including ones submitted by loved ones. Users can still create their own custom mementos.

 
 
 
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Issue 2: Confusing Menu

We played around with different ways to format the questions. In this iteration, users were uncertain whether they could select the actual cards (tap), and what to expect next. They were also unsure what each category meant and why they should choose one over the other.

Solution: Single Category Questions

Once users select their prompt, they see question options for that specific prompt. This creates a clearer user flow and lets users focus on one idea at a time. We also added a floating action button so users know where to tap to answer a question.

 
 
 
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Issue 3 : Recording

At first, we only had the option to record an answer through audio, assuming that would be easier for users. We quickly realized by speaking with experts, that some people would need to use text because they cannot speak.

Solution: Audio & Text

So we created the option to use text or audio to answer a question. Users choose which option when selecting a question to answer.

 
 
 
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Issue 4: Submitting Questions

We initially had a similar look for this screen as the patient’s recording screen. We also included features to upload or take photos, to create more context for each question. However, we realized that we hadn’t resolved where these questions would show up for the patient. Users also weren’t sure what kinds of questions to begin with.

Solution: Categorized Questions

We realized that it would make more sense to let family members submit questions relevant to the existing 4 prompts. Rather than requiring loved ones to download the Memento app, they can simply submit a question through a unique URL connected to the patient’s account.

 
 
 
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Issue 5: Viewing Memento

This was a quick iteration of a completed Memento. A fast user test revealed a desire to filter through these questions, and brought up other ideas: Does this screen look the same every time? Is it customized to different family members?

Solution

The final Memento has the same look and feel as the rest of the app. We created a word cloud that shows family members the most prevalent words throughout the patient’s answers, that also act as filters for the questions.

 
 
 

Next Steps & Takeaways

For next steps, I would like to test this with elderly patients to evaluate its usability for an older audience. I would also like to understand better our target audience’s emotional reaction to the product, and whether the content resonates with them.

This project taught me to pay attention to accessibility, and to begin with simple features before diving into more complicated ideas that aren’t critical to the core purpose.