The inaugural Palliative Care, Architecture and Design Symposium held in Liverpool, UK, in November 2018, enabled delegates to explore how architecture, design and technology can improve quality of life for people with palliative care needs. Christian Goodwin, Fulbright Scholar, US-UK Fulbright Commission, London, UK; Palliative Care Institute Liverpool, University of Liverpool, UK and Dr Amara Nwosu, Consultant and Honorary Senior Clinical Lecturer in Palliative Medicine, Palliative Care Institute Liverpool, University of Liverpool, UK, explain.
The world is ageing. Current evidence demonstrates how the UK need for palliative care will increase by 42 per cent by 2040.  Care homes are projected to be the most common place of death  with similar figures expected globally.It is therefore important that living environments are designed to optimise function, quality of life and independence for an increasingly frail population. Technological and architectural innovations offer great potential to improve quality of life, to enable people to live in their homes for longer. 
Futurism is an interdisciplinary field combining mathematics, engineering, art, technology, economics, design, history, geography, biology, theology, physics, and philosophy. Futurists collect data, identify emerging trends, develop strategies, and calculate the probabilities of various scenarios occurring in the future. Forecasts are used to help leaders make better, more informed decisions. We believe it is possible to use futurism to determine how various factors (such as technology, design and architecture) can be used to support palliative care in the future.
On 12 November 2018, 50 delegates attended theinaugural Palliative Care, Architecture and Design Symposium (PADS) in the University of Liverpool (funded by engage@liverpool, University of Liverpool). We applied futuristic thinking to palliative care through a collaborative meeting of academics, clinicians, and the public, to discuss ideas related to design and future provision of palliative care. The following are some of the key ideas arising from the symposium.
Role of Virtual Reality (VR) and new technologies
The symposium included multiple presentations on the role of VR, robotics, and other new technologies. These tools have the potential to improve care through therapeutic, assistive, communication and social purposes. However, it is also possible that these technologies may replace some human contact, resulting in job losses, and decreased contact with healthcare professionals, and increased elderly social isolation. For public health there is concern that technological investment will replace other societal initiatives.Consequently, research on the opportunities and risks of this technology is urgently needed. 
There was discussion that in order for palliative care to benefit from new innovation, that it was important to explore alternative teamwork approaches. This may include transdisciplinary models, which may help to harmonize knowledge between disciplines into a coordinated and coherent whole.
Inequalities in Palliative Care
It is essential to ensure new technology will meaningfully benefit society and not widen existing health inequalities.  Adopters of new technology are generally younger, and more affluent than non-adopters; therefore, it is possible that societal access to these technologies will not be equitable.Consequently, it is imperative to consider these health and social inequalities when designing and implementing new tools.
The Design of Spaces
The spaces where we provide and receive palliative care affect that care. We must carefully consider design of new healthcare environments, in order to identify our own assumptions and biases about design, and question how those spaces might help or hinder palliative care. It is important that human-centred design methodology informs the design of living, communal and social spaces for those receiving palliative care. 
These are just a few of the themes from the presentations and discussions. The shared excitement and resolve to collaborate were encouraging. There was consensus that we also need more opportunities and spaces that allow for this exchange of ideas.
To find out more or get involved
If you would like to learn more about the symposium, or get involved with future collaborations related to this event, please contact Amara Nwosu at the links below. Presentations from the event are available here.
- Download presentations from the symposium.
- Contact Christian Goodwin by email.
- Contact Dr Amara Nwosu by email.
- Follow Amara on Twitter: @amaranwosu
- AmiPal Palliative care podcast.
- Read more posts from Dr Amara Nwosu on the EAPC blog.
- Etkind SN, Bone AE, Gomes B, Lovell N, Evans CJ, Higginson IJ, et al. How many people will need palliative care in 2040? Past trends, future projections and implications for services. BMC Medicine. 2017;15(1):102. doi: 10.1186/s12916-017-0860-2.
- Bone AE, Gomes B, Etkind SN, Verne J, Murtagh FEM, Evans CJ, et al. What is the impact of population ageing on the future provision of end-of-life care? Population-based projections of place of death. Palliative Medicine. 2017; 32 (2): 329-36. doi: 10.1177/0269216317734435
- World Health Organization. World Population Ageing 2017.
- Nwosu AC, Collins B, Mason S. Big Data analysis to improve care for people living with serious illness: The potential to use new emerging technology in palliative care. Palliative Medicine. 2018; 32 (1): 164-6. doi: 10.1177/0269216317726250. PubMed PMID: 28805118.
- Webb A, . What, Exactly, Is A Futurist? Website of Amy Webb2019 [cited 2019 9th January ]. Available from: https://amywebb.io/futurism/.
- Choi BC, Pak AW. Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education and policy: 1. Definitions, objectives, and evidence of effectiveness. Clinical and investigative medicine Medecine clinique et experimentale. 2006; 29 (6): 351-64. Epub 2007/03/03. PubMed PMID: 17330451.
- Bellamy A. 4 Designing dying well: toward a new architectural approach of in-patient palliative care environments. BMJ Supportive & Palliative Care. 2018; 8 (3): 361-. doi: 10.1136/bmjspcare-2018-mariecurie.4.