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The Quantified Impermanent Self

A tracking and "biofeedback" tool for living a good life that allows for a good end of life.

Photo of Jim Rosenberg
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Who is your idea designed for and how does it reimagine the end-of-life experience?

This concept is for any individual. It reimagines the end of life as something that we are aware of each day as we live, using approaches from the quantified self to help you set values-based goals and track the values-based and emotional health of your choices day by day.

It's easy to lose the forest of life for the trees of living. Bills to pay, dripping sinks to fix, dinner to cook, startups to invent, kids to get to bed, and on and on.  How can we stay more aware of the big picture of life as we are living? How can we better follow our deepest values each day, as though we were truly present with the fact that we are all impermanent and life will end?

The Concept

The Quantified Impermanent Self (QIS) extends the idea of wearables like FitBit to help us track our "path to the end of life." Wearables and connected apps, like FitBit and Nike +, help you set goals, measure activity, and understand feedback so you can change your behaviors. Generally speaking they are focused on the physical and the well-prescribed: sports activity, posture, nutrition, medication regimes, and cognitive behavioral therapy interventions such as reducing alcohol use. The QIS uses the same model but measures how well your moment to moment choices fit your values and long-term desires for your life.

With the QIS app you would use a guided assessment to identify your values and set goals for the most important expressions of those values in life. This assessment would be based on existing work from psychology, spirituality, and research on the reflections of those at the end of life (such as the five things people say most often at the end). Then, rather than adding sensors to your body to track activity, heart rate, etc. the QIS would add sensors to your digital life -- your email, social media feeds, calendar, etc. Perhaps it could even add sensors to your physical life by listening to your conversations or watching you via a smartphone or wearable. The QIS artificial intelligence / machine learning system would assess and provide feedback on how your daily decisions and use of time track to the values and expressions you hold most dear. At the end of the day you could look at how many moments you spent teaching, or discovering something new, or paying attention to your wife, or helping a neighbor -- whichever expressions of a value-based life you defined in your assessment and goals.

The QIS could take advantage of the best practices in wearables and behavior change. There could be a gamified interface for those who want challenges, levels, badges and the like. There could be social connectivity to share with your community or other people around the world working on expressing the same values in their lives. There could be periodic reflection and resetting of goals. And so on.

Impact on the End of Life Experience

How does this reimagine the end of life experience? First, a life lived more fully from deep values and with awareness is a life that will allow for a much more peaceful and accepting end of life, for the person who is dying and for his or her community.

Second, the QIS opens a space for talking about planning for the end of life and exploring questions about death and dying. It would be natural in the assessment and in periodic reviews to ask questions about mortality. How would you feel about your life today if you were to die now? How  do you want to leave your family at the end of your life -- are you doing the things that are most important to you to make that outcome happen? And the QIS could track preparations (e.g. life insurance, advance directive, conversation with your family about your plans, etc.) as part of its assessment of your behavior.

Third, the QIS could have an "acute" mode for guiding people when they truly reach the end of life or face that possibility, whether from illness or old age. The acute mode would include an assessment to help a person take stock of where they are now (building on their history with the QIS) and set goals for how she wants to live during this last stage of life. The QIS could support the goal of fighting too -- the QIS could recognize and support the goal of beating back the illness and it could connect that goal with other goals such as family time, connection, etc. It can be hard to keep track of what matters to you and the quality of life you want within all the tactical care activities and demands. The QIS could help you see how you are doing day to day, week to week, month to month.

Engaging Users

The language we use around death is a big part of the overall challenge. All of the language in this post -- the Quantified Impermanent Self, the path to the end of life, etc. -- is about the end of life experience and impermanence. For this post I wanted to be more explicit with the language. In practice I imagine we would talk about the tool and the experience differently to open the door to more people e.g.  helping you "live to your values." We could then ask questions that use awareness of death to help people make better decisions about life. 

Another challenge is how we make a tool like this available and effective for the broadest community. It needs to be designed to add value to the lives of people in different economic situations, with different degrees of control over their work and how their days are spent, and who come from very different value systems.  

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

1) Create a user experience map
2) Create a paper mockup and use to discuss with 5 to 10 people

What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

If there are people in the community with expertise that applies to the design of the assessment, that would be really interesting. I'd love to get ideas for the body of knowledge and the frameworks we could use to help set the goals against which QIS would track progress.

A reality check on the AI / machine learning possibilities from any experts out there would be really interesting too.

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Photo of Janice Dean
Team

Hi Jim, Love this idea. The art of living often translates to the art of dying. And knowing that we lived well and aligned with our values gives satisfaction. Just wanted to share my feelings/reactions: I am both intrigued and also concerned at the idea of using a Fitbit-like device for assisting with our decision-making. Is the machine helping us to be accountable to ourselves or are we creating a dependency on the machine to follow-through? Classic ethical question. If there was a way where we can create a healthy balance between the two and at the same time cultivate the self-awareness within ourselves, through using the machine as an assistive tool, that to me would seem ideal.

Photo of Jim Rosenberg
Team

Thanks Janice. I appreciate the challenge you've brought up. We need a tool like this to be a support, providing information and helping us reflect, without becoming a crutch or a replacement for reflection. Nothing is ever simple is it? :-) Thanks so much for helping me think about this concept from another angle. 

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