Towards ‘Hospices Without Walls’

How Could Robotics and Human Centred Design facilitate ‘Enhanced Independence’ and ‘Alternative Access’ in Future Palliative Care Scenarios?


By 2040, 160,000 more people in England and Wales will need palliative care, provided the current mortality trends continue. 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 designed technologically enhanced health and care solutions towards the end of life is inevitable.

Hospices are one main avenue for provision of palliative and end-of-life care. However, they are deemed expensive and essentially unsustainable 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 novel future 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 quick identification of symptoms and mapping societal health, smart sensors to help with diagnostics, and tracking patients’ physical and mental wellbeing.

Palliative & end-of-life care is delicately, and rather uniquely, positioned on 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 major challenges as well as unique opportunities for introduction of AI, particularly robotics. Major opportunities of robotics in Palliative care include Assistive, Therapeutic, Social, and Educational uses.

Additionally, there are wider calls to reclaim and reimagine end-of-life as a ‘human’, rather than a mere ‘medical’ domain. Hence, moving to ‘humanise’ death. Both the robotics and human centred and inclusive approach need a wider transdisciplinary discourse, outlook and collaboration.


Most hospices in the UK are cutting beds and other services, others are closing altogether. The major problem for the hospice sector is that it is expensive and essentially unsustainable in current form, especially in the face of the growing demand. Alternative and enhanced scenarios of hospice care are needed with a key focus 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 without Wall’:

A. How might we enable people to remain as independent as possible, for as long as possible, using robotics in new sustainable hospice care scenarios?

B. How might we extend future hospice care beyond the building and into the community, using robotics?


Phase 1 – ‘Robotics in Hospice Care’ and ‘Human Centred Design in Hospice Care’ roadmaps

Phase 2 – Future robotics-enabled ‘independence and access’ scenarios for Hospice Without Walls concept

Phase 3 & 4 – Two robotics-enabled product & service prototype solutions for Hospice Without Walls concept

Phase 5 – ‘Hospice of The Future’ exhibition

This PhD research is in collaboration with Marie Curie Hospice Liverpool, and is funded by Doctoral Network in AI for Future Digital Health at The University of Liverpool.

Discovering death

I am looking for experts and practitioners to help discover and define the Death Spectrum.

From the moment that the End-of-Life is known all the way to Memorialisation, what are defined and measurable stages.

We are aiming for granular and measurable definitions in the aim to discover opportunities and gaps in current knowledge, to discover who is currently working in those stages and how these stages interplay with one another.

This Spectrum will be updated as and when more information is available and all contributions towards it is greatly appreciated and will be recognised.


In clinical medicine, the “end of life” can be thought of as the period preceding an individual’s natural death from a process that is unlikely to be arrested by medical care.
Lamont, 2005

1: the bed in which a person dies
2: the last hours of life

A box or chest for burying a corpse

The observances held for a dead person usually before burial or cremation

Final Disposition
The burial, interment, cremation, or other authorized disposition of a dead body.
Moncur et al. 2012

1: serving to preserve remembrance : commemorative
2: of or relating to memory

The Australian-modified Karnofksy Performance Status (AKPS)
Abernethy, A.P., Shelby-James, T., Fazekas, B.S. et al., 2005

Social Death
Bogstom, E. 2017

Digital Death
Pitsillides et al., 2012