When Tech In Care Is Evil

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I spent the last two weeks in-and-around a care home in England that looks after people with dementia and terminal illness, and their families – including, this time, mine.

In four wings, each with 12 residents, 24/7 care is provided by teams of trained professionals who work 12 hour shifts. During the day, for each wing, three carers and a qualified nurse work continuously within yards of the residents; at night, cover is provided by a carer and a nurse.

Their hour-by-hour duties include helping people eat and drink;  changing clothes and bed linen; helping people shower and clean; cutting finger and toe nails; helping people use toilets, bed pans, sanitation pads, and commodes; filling in forms; attending staff training sessions.

A lot of the time – a lot – carers sit and talk with the residents, reassure them, read books or magazines together, or simply hold their hands, or hug them.

Twice a day, it’s true, one of the nurses would tour each wing to give medicines to the residents; a few residents needed more intensive medical attention. But I reckon that ninety five per cent of this demanding, time-consuming and emotionally-draining work involved caring – not doctoring, and not ‘curing’.

In my family’s case, we saw a doctor twice during those weeks. The first was when a non-resident General Practitioner (family doctor) popped in for ten minutes, did not sit down, nor look any of us in the eye. He waved a Do Not Resuscitate form around like an election pamphlet, and then left. The second doctor, another GP, came later, at the end – as some regulation or other prescribed –  to pronounce my family member officially dead. He performed this service with grace and tact.

These discordant intrusions by doctors did not matter. Those final hours were peaceful, even beautiful, thanks to the quiet, attentive and  loving care of the people who surrounded us in the home.

A few hours later, when I turned on the television for the first time in weeks, it was to see the UK prime minister, in London, addressing a room full of people clad in smart suits and name badges.

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Speaking in forceful, Churchillian, style, Mr Cameron declared that “we must fight dementia” and announced a £100 million global research project to find a cure. “I know some people will say that it’s not possible”, said Mr Cameron, “but I will not be defeatist. With a big global push we can beat this”.

As I wrote back in December, after the G8 Summit on dementia, the likely outcome of this so-called “race to identify a cure” for dementia will be the creation of a Dementia Industrial Complex. It will  run by-and-for the glossily-clad experts in Mr Cameron’s audience – and it will do literally nothing to support the low-paid care workers that supported my family and thousands of others like it  in recent weeks.

Neither patients nor carers are even represented – not at all – on the much trumpeted World Dementia Council that was set up after the G8 Summit.

It’s dispiriting, but not surprising, to witness politicians parroting the false promises of the Tech lobby. But it’s a tragedy to see that an organisation that once represented carers has jumped onto the same bandwagon.

With its Dementia Friendly Technology Charter, the Alzheimer’s Society has given its imprimateur to the implausible notion that technology – rather than the presence of human beings – is the best way to enable people with dementia to live independently.

It’s doubly depressing that the Society asked a for-profit tech company, Tunstall Heathcare, to write its ‘charter’. Write its own orders would be more accurate. It is Tunstall ‘s corporate mission that, when it comes to dementia care , we can and should, “buy” peace of mind. “Just press the button” promises Tunstall, “and one of our operators will be on the line.” 

And then?

I know I’m emotional right now, but I’ve reflected on this a lot over several years and believe it has to be said: The notion that technology can substitute for the presence and care of human beings in care is not just misguided. It’s evil.

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Food As A Commons

People go hungry not because of a shortage of production, but because the food available is too expensive, or they lack the land to grow it on. In California, the prototype of a combined social, political and technical  solution has been launched which promises to unlock the food system crisis.

Kiel & Dan per thru grill

“This could be it”. The speaker, Dan O‘Connell, is peering through a grill (above) into the cavernous interior of boarded-up corner shop in downtown Fresno, California. His fellow explorer, Kiel Schmidt, concurs: “It’ll take a bit of work, but we’ve got a bunch of people with skills lined up to help”.

For Schmidt and O’Connell, two founders of an organisation called The Food Commons, the building is on their shortlist for a retail store that will make fresh food available to some of Fresno’s 500,000 poorest citizens – for the first time. Within ten years, they plan to open a retail hub in each of the city’s food deserts – and this will be the first.

Our location certainly fits the bill of a food desert. We’ve driven for half an hour past miles of empty Read More »

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How We Meet Is As Important As Why

This is the text of my talk at the OuiShare Festival in Paris today. 

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Did any of you wander around in a group last night – trying to agree on a place to eat?

Welcome to the sharing economy!

Sharing is hard! And that’s just about one meal.

Think about the food systems of a city;  the restoration of a river; the management of waste; or the care of older people.

As we change the way we govern our communities, our cities, and our ecosystems, a variety of different actors and stakeholders – formal and informal, big and small – need to work together – often, for the first time.

Working with people unlike ourselves is not an option. We have to engage with new partners and actors because Read More »

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Keep Your Stuff Alive

The Tending and Grooming Station (below) is a wondrous collection of combs, brushes and other obscure (to me) gadgets. They are used to primp and revive pre-loved sweaters and cardigans that have been disfigured by bobbles and pilling – those unattractive fuzz balls that appear when short fibers misbehave on woolen garments. 

#tendingandgrooming station

Every object has a dark side – and that’s especially true in fashion. Two-wash-two wear tea shirts have a devastating impact on watercourses, air quality, soil toxicity, and human and ecosystem health, in many parts of the world.

It is one thing to draw attention to the hidden costs of fashion – quite another to figure out what to do about them. Exhortations to “buy less, wash less” are little match, on their own, for a global system whose very survival depends on Read More »

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Talk in Oakland on 16 April

I’m doing a talk in Oakland – followed by a conversation with David McConville  – on 16 April, 7-9pm. 

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We badly need change. Change labs are springing up around the world. Mission accomplished?

Not so fast. Although building prototypes is exciting, and launching a start-up is a buzz, transforming a system is something else again. Are we confusing frantic activity with the achievement of meaningful Read More »

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Blog Tour: Living With Writing

The blog tour is a kind of online relay in which different bloggers write about their work and writing process, and invite others to take up the baton and do the same. My post below follows  the philospher Andrew Taggart, who invited me; Andrew followed Dougald Hine; Dougald followed Emily Wilkinson

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Question 1. What am I working on?
I just agreed with my publisher to complete a 60,000 word book by 30 June. It’s about re-wilding, a leave-things-better economy, and design. So far, it’s going well – I’ve already written six lines. They begin, “It’s Read More »

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Cloud Commuting

A two-year project in Belgium proposes new relationships between people, goods, energy, equipment, spaces, and value. Its design objective: a networked mobility ecosystem 

Mobilotoop taxi-van

The signs on the small van describe the services it supports: Taxi; Pick-up; Delivery; Assistance; Vendor; Security; Rental.

Seven functions, one vehicle. As imagined in a project in Belgium called Mobilotoop the van, when coupled with a pay-per-use leasing framework, and radically distributed computing, becomes an element within an asset-light mobility ecosystem.

Mobilotoop asks, ‘how will we move in the city of the future?’  – and does not worry too much about the design of vehicles. ‘Cloud commuting’, in this context, is about accessing the means to move when they are needed (such as the micro-van, above) rather than owning a large heavy artefact (such as a Tesla) that will sit unused for 95 percent of the time.

The first cross-over project of Design Platform Vlaanderen, this two year research project focuses on potential connections between people, vehicles, places and services that – as a single ecosystem – generates new mobility solutions dynamically, and continuously.

Mobolotoop system

With a focus on connections that bring us not just faster but also closer to one another, Mobilotoop is about a system that enables new relationships between people, goods, energy, equipment, spaces, and value.

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This may all sound abstract, but Mobilotoop is way of thinking whose time has come. Economics, more than green thinking on  its own, will drive the transformation from here on.

Until now, we’ve moved ourselves – and stuff – about the city in ridiculously wasteful ways. A snapshot from The Netherlands: of the 1,900 vans and trucks enter the small city of Breda each day, 90 percent of those deliveries could be done by bike, or e-bike. Once all system costs are included, a cargo cycle can be up to 98 percent cheaper per km than four-wheeled, motorised alternatives that now clog our roads.

Mobilotoop envisions a mobility culture in which every ride is an encounter, every traveller an entrepreneur.

Mobile media, flexible vehicle designs, and adaptive infrastructure, enable everyone to be a user and a supplier of mobility services. Every commuter can deliver a package on her way to work. Every walker might collect sensor data about the quality of the sidewalk surface, or the air. The electric motor on a pedelec might be used to drive a balcony hoist.

Mobilotoop

(above: the Mobilotoop exhibition)

In Mobilotoop’s imagination, radically adaptive use is not only about cash transactions. A borrowed vehicle properly used and returned – or a service well-executed – adds to your reputation as a sharer. This enhanced reputation gives you access to use credits, discounts on services, or the use of  other vehicles, equipment, and workplaces.

(Below: the Mobilotoop book)

mobilotoop book

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A ‘Wild Mirror’ For Desk-Bound Workers

A new scheme in England connects office workers with living systems by means of a ‘wild mirror’: each workspace is twinned with an equivalent area of ecosystem regeneration. 

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The restoration of degraded ecosystems — or creating new ones — is gathering pace in different parts of the world.  According to Richard Coniff, China is planting 90 million acres of forest in a swath across its northern provinces. In North America, too: restoration projects costing $70 billion are under way to restore or re-create more than seven million acres of marsh, peatland, floodplain, mangrove, and other wetlands.

These large-scale, government-led efforts are conceived as green infrastructure by governments in response to such practical issues as flood control. This ecosystem regeneration is Read More »

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Summer Xskool in Sweden

This year’s Doors of Perception Summer Xskool (in August, in Sweden , in partnership with Konstfack and FuturePerfect)  explores what it can mean in practice to move from a ‘do less harm’ approach to sustainability to a practice of  leave things better.

xskool 2013

In what ways can design help people interact with living systems in ways that help both of them thrive? And what practical steps might one take to test the effect of small actions on the system as a whole?

This year’s Doors of Perception summer Xskool explores what it can mean in practice to move beyond a ‘do less harm’ Read More »

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