Towards 'The Hospice Without Walls'; How Could Robotics and Human Centred Design facilitate 'Enhanced Independence' and 'Alternative Access' in Future

到2040年，如果目前的死亡率趋势继续下去，英格兰和威尔士将有16万人需要姑息治疗。这意味着在未来20年内，姑息治疗和临终关怀需求将增加42.4%。医疗保健系统必须立即开始转型、适应和准备，因为对设计良好的技术增强型医疗保健解决方案的迫切需求是不可避免的。收容所是提供姑息治疗和临终关怀的一个主要途径。然而，它们被认为是昂贵的，而且以目前的形式基本上是不可持续的，特别是在需求不断增长的情况下。改革是不可避免的;机器人技术和以人为中心的设计的共生在哪里以及如何促进替代和新颖的未来临终关怀方案-专注于“增强独立性”和“替代访问”？有证据表明，人工智能可以提高医疗保健的质量和效率;包括快速识别症状和绘制社会健康图，智能传感器帮助诊断，以及跟踪患者的身心健康。姑息治疗和临终关怀是微妙的，而不是独特的，定位在医疗保健提供频谱的一端。凭借其全面和多方面的生理，心理，社会和精神支持网络以及复杂的患者途径，姑息治疗暴露了主要挑战以及引入人工智能，特别是机器人技术的独特机会。机器人在姑息治疗中的主要应用包括辅助、治疗、社会和教育用途。此外，有更广泛的呼吁，以回收和重新想象作为一个“人”的生命结束，而不仅仅是一个“医疗”领域8。因此，走向“人性化”的死亡。机器人技术和以人为中心的方法都需要更广泛的跨学科话语、观点和合作。玛丽·居里是一个在英国注册的慈善组织，自1948年以来，为患有绝症的人及其家人提供护理和支持。玛丽·居里在全国有九家临终关怀机构，是英国国民保健制度以外提供最多临终关怀床位的机构。玛丽居里也是姑息治疗研究的主要资助者，旨在寻找更好的方法来照顾患有绝症的人。为了应对姑息治疗行业不断增长的需求和不可持续的当前供应成本，玛丽居里和姑息治疗作为一个整体，热衷于探索未来的替代模式，如“无墙临终关怀”;允许在替代和增强的环境中监测和支持患者。在进行了初步的研究之后，玛丽居里对进一步研究机器人技术和以人为本的设计很感兴趣。主要途径包括：A.预测服务需求和触发器[机器人：主动和被动数据捕获]B。监测和支持病人在替代设置，包括家庭和护理院[机器人：可穿戴辅助机器人，社会和治疗机器人，环境护理机器人]C。加强对那些直接进入临终关怀的人的护理[机器人技术：可穿戴辅助机器人，虚拟和混合现实机器人，环境护理机器人]3。问题陈述英国大多数临终关怀机构都在削减床位和其他服务，其他机构则完全关闭。临终关怀部门的主要问题是，它是昂贵的，基本上是不可持续的，在目前的形式，特别是在面对上述日益增长的需求。临终关怀的替代和增强方案是需要的，重点是“提高独立性”和“重新定义访问”。因此，两个研究问题的概述，询问在哪里以及如何可以机器人和以人为本的设计，帮助开发的概念“临终关怀withoutWall”：RQ 1。我们如何才能使人们尽可能地保持独立，尽可能长时间地使用，

By 2040, 160,000 more people in England and Wales will need palliative care, provided the current mortality trendscontinue. This means an increase of 42.4% in palliative and end-of-life care needs, within the next 20 years.Healthcare systems must start to transform, adapt and prepare now, as the urgent need for well designedtechnologically enhanced health and care solutions towards the end of life is inevitable. Hospices are one mainavenue for provision of palliative and end-of-life care. However, they are deemed expensive and essentiallyunsustainable in current form, especially in the face of the growing demand. A reform is inevitable;Where and how could a symbiosis of Robotics and Human Centred Design facilitate alternative and novelfuture hospice care scenarios - focusing on 'enhanced independence' and 'alternative access'?There is evidence that Artificial Intelligence can improve the quality and efficiency of healthcare; including quickidentification of symptoms and mapping societal health, smart sensors to help with diagnostics, and trackingpatients' physical and mental wellbeing. Palliative & end-of-life care is delicately, and rather uniquely, positionedon one end of the healthcare provision spectrum. With its holistic and multi-faceted network of physiological,psychological, social, and spiritual support, and complex patient pathways, Palliative care exposes majorchallenges as well as unique opportunities for introduction of AI, particularly robotics. Major opportunities ofrobotics in Palliative care include Assistive, Therapeutic, Social, and Educational uses. Additionally, there arewider calls to reclaim and reimagine end-of-life as a 'human', rather than a mere 'medical' domain8. Hence, movingto 'humanise' death. Both the robotics and human centred approach need a wider transdisciplinary discourse,outlook and collaboration.2. Research Challenge in the Context of the State-of-the-artMarie Curie is a registered charitable organisation in the United Kingdom, providing care and support for peopleliving with terminal illness and their families, since 1948. Marie Curie has nine hospices across the country andprovides the largest number of hospice beds outside the NHS. Marie Curie is also a leading funder of palliativecare research to find better ways of caring for people with terminal illnesses.Responding to growing demand and unsustainable current provision costs across the Palliative care sector, MarieCurie and Palliative care as a whole, are keen to explore alternative future models such as 'Hospices WithoutWalls'; allowing for monitoring and support of patients in alternative and enhanced settings. Having conducted apreliminary study, Marie Curie is interested in further investigating robotics and human centred design. Primaryavenues include:A. Predicting needs and triggers for services[robotics: active and passive data capture]B. Monitoring and support of patients in alternative settings including home and care homes[robotics: wearable assistive robotics, social and therapeutic robotics, ambient care robotics]C. Enhancing the care for those who do access hospices directly[robotics: wearable assistive robotics, virtual and mixed reality robotics, ambient care robotics]3. Problem StatementMost hospices in the UK are cutting beds and other services, others are closing altogether. The major problem forthe hospice sector is that it is expensive and essentially unsustainable in current form, especially in the face of thegrowing demand described above. Alternative and enhanced scenarios of hospice care are needed with a keyfocus on 'improving independence', and 'redefining access'. Accordingly, two research questions are outlined,asking where and how could Robotics and Human centred design, help develop the concept of 'Hospice withoutWall':RQ1. How might we enable people to remain as independent as possible, for as long as possible, usingro