End-of-life Planning
An interactive museum exhibit that uses behavioral nudges to encourage end-of-life planning among adults of all health statuses.
Project Overview
A medical crisis can leave someone unable to communicate their healthcare decisions, making it crucial to decide, discuss, and document end-of-life preferences well in advance. This project aims to understand the psychological and social factors preventing individuals from completing their advance directives by qualitative research and design a service outcome to promote awareness and facilitate the process of end-of-life planning.
Duration - 4 months
Skills applied - User Research & Insight Synthesis, Systems Mapping & Analysis, Co-creation, Rapid Prototyping, Concept Prioratization, Experience Design.
Team - Atchayaa Krishnan, Evelyn Syau, Isabel Alexander, Sneh Chandan
Institution - M.A in Design Focused on Health, The University of Texas at Austin
Challenge
How could we understand the psychological and social barriers that prevent individuals from completing their advance directives, and design a service that promotes awareness, normalizes conversations around end-of-life planning, and supports people in documenting their healthcare preferences with confidence and clarity?
Outcome
A Museum Exhibit that guides individuals (>18 year old) through the stages of Awareness, Belief, Knowledge, and Action would Increase Psychological readiness around and ultimate Completion of Advance directives.
Define
Document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment.
Living Will
Medical Power of Attorney
A Legal document that names your health care proxy, a person who can make health care decisions for you if you are unable to communicate these yourself.
What is an Advance Directive?
Advance directives are legal documents that provide instructions for medical care and only go into effect if you cannot communicate your own wishes.
Advance directives provide many benefits, including the opportunity to receive care consistent with one's preferences, better communication with one's healthcare team, decreased utilization of unwanted intensive treatments, less costly care, and improved satisfaction at the end of life.
Value of Advance Directive
The Problem
Despite its immense value in ensuring patient autonomy, only one in three Americans completes an advance directive. This low participation highlights a critical gap in awareness, motivation, and emotional readiness for end-of-life planning.
Research
Contextual Interviewes
We led 10 in-depth interviews with users and experts to map how people find, interpret, and act on end-of-life planning resources. Insights spanned emotional readiness, cognitive load, and real-world planning behavior, including a home visit where a participant shared his advance directive stored in a closet lockbox.
Intercept Surveys
We complemented our in-depth interviews with short public intercepts across Austin, using an interactive survey board where participants strung responses to seven questions about awareness, belief, knowledge, and action around advance directives. While most agreed on their importance, only a third had completed one, a gap that reflects national trends.
75%
Awareness of Advance Directives
100 %
Beliefe of Importance of Advance Directives
37%
Have knoweldge on Advance Directives
31%
Has taken action to complete Advance Directive
Comunity Immersion
We immersed ourselves in Austin’s end-of-life planning ecosystem by attending community events such as a Death Café, an AARP advance care planning workshop, and a virtual meet-up for death doulas. To understand how advance directives play out in real emergencies.
Stakeholder Mapping
Stakeholder mapping helped us to gain an overview and understanding of the various systems and stakeholders involved in end-of-life planning and the completion of an Advance Directive by the user. The goal is to explore how these systems interact with each other and the services offered to the user when engaging with each system.
Ecosystem Mapping
A bird’s-eye view of the ecosystem surrounding advance directive completion, mapping key stakeholders, influencing factors, and system interactions to uncover opportunities for smoother processes, informed decisions, and more open end-of-life conversations.
Data Synthesis and Insights
After synthesizing our primary research, we arrived at the following insights, which highlight the interconnected challenges and potential avenues for improvement related to end-of-life planning.
01
Society Punts the responsibility of EOL planning to the individual.
End-of-life planning often falls solely on individuals to navigate, resulting in a fragmented and non-collaborative process across medical and legal systems
02
Money Sells, Death does not.
People are far more familiar and comfortable creating financial wills than medical ones. It’s easier to plan for tangible assets than to confront the abstract and emotional idea of death.
03
Confronting complicated bureaucracy often leads to cognitive overload.
End-of-life planning demands emotional and cognitive readiness. Many people postpone completing advance directives, assuming death is distant, while others find the process confusing and burdensome due to inconsistent formats and complex paperwork.
04
Confronting one's mortality often leads to emotional overload.
Shame plays a complex role in end-of-life planning, it can arise from anticipating future loss or reflecting on past experiences. For some, it motivates action; for others, it reinforces avoidance.
05
There are conflicting desires for standardization and personalization when it comes to EOL Planning.
Traditional advance directives often reduce complex end-of-life choices to binary decisions, leaving little room for cultural nuance. As a result, many people feel excluded from the process or experience care that conflicts with their cultural values and beliefs.
Ideate
Brainstorming
We generated the following "how might we" statements in response to our research insights, then did a speed round of brainstorming to come up with a variety of initial design concepts.
Concept Prioritization
We prioritized concepts using an impact vs feasibility matrix and combined the most promising ideas into an interactive museum exhibit designed to engage users from multiple perspectives.
Hypothesis
A Museum Exhibit that guides individuals (>18 yo) through the stages of Awareness, Belief, Knowledge, and Action would Increase Psychological readiness around and ultimate Completion of Advance directives.
Design - Key Prinicples
1. KAB Model (Knowledge–Attitude–Behavior Model)
2. Experiential Learning
3. Centralization of existing resources
KAB Model
Inspiration
We envisioned a circular museum layout symbolizing connection, closure, and the cycle of life. Inspired by circular museum spaces and IKEA’s guided flow, the design directs visitors through a curated sequence of experiences while allowing flexible exit points.
Service Blue Print
Prototype
2D Prototyping
Sketches by Sneh Chandan
Test
Classroom Prototyping
We built a low-fidelity prototype of the museum concept to gather feedback from interviewees. Using simple mock-ups of interactive games, video testimonials, and resource materials, we tested how effectively the exhibit could engage visitors and encourage end-of-life planning.
Prototype Testing
Change Management
"It's always too soon
until it's too late."
© 2026 by Atchayaa Krishnan..