ToC Makes an Invisible Worldview Shareable. - End of Life Care Association (General Incorporated Association) -

How can we express the invisible worldview of 'the final stage of life'?

The End of Life Care Association (Minato-ku, Tokyo) is led by Dr. 小澤竹俊, the physician featured in the 2017 NHK program 'Professional: Gentle Guidance at Home, Home Visit Physician 小澤竹俊,' which is highly regarded as one of the program's standout episodes. The association works to theorize support during the final stage of life and to spread that work in Japan and abroad.

Still, 'the final stage of life' is an extremely weighty and complex theme, and it was very difficult to put into words or diagrams. Even with a full schedule of frontline medical work and lectures and training across the country, Dr. 小澤 and executive director 千田恵子 continued to feel frustrated, asking how understanding of this theme could spread in Japanese society.

At the end of 2017 they contacted me, saying they wanted to create a Theory of Change (ToC) to break through this situation, and I visited their office in Minato-ku. Over about one year, I worked with Dr. 小澤 and Ms. 千田 in face-to-face ToC creation workshops (WS).

Positioning an essential idea for a 'super-aged, low-birthrate, high-mortality era' within the ToC

Dr. 小澤 and Ms. 千田, who work in the medical field, expressed a strong sense of urgency that Japanese society is steadily moving toward a 'super-aged, low-birthrate, high-mortality era.' They described a plan to organize ideas rooted in the field into a ToC and spread them, so that society's resilience could be raised and people would not lose heart even as the social resources of medical and welfare professionals become more limited. I worked to help them organize this vision and position it within the ToC.

Dr. 小澤 and Ms. 千田 also refined the terms they use in lectures and training around the country during the ToC workshop sessions. I was honored that the ToC could be put to immediate practical use.

They gathered even during the year-end holidays and continued their discussions until late at night. The photo below shows the scene at Dr. 小澤's clinic (Megumi Home Care Clinic, Yokohama, Kanagawa) at the end of 2018.

The invisible worldview, of how we engage with 'the final stage of life' as professionals and as a society, was very difficult to bring into being, and progress was slow. After about a year, a ToC map made of words and diagrams was completed. A designer then joined to advance the visual design, and the ToC was finally completed as shown.

After completion, society came to understand the work better, and the search for resources advanced.

The ToC was born through a difficult process, and what followed was a complete change. Dr. 小澤 had said that when he explained 'the final stage of life,' the reactions from private companies were lukewarm. With the ToC as a communication tool, however, explanations became possible, and communication became much easier.

The association was selected through rigorous screening by SVP Tokyo, a social-contribution body that offers pro bono support to social entrepreneurs, and received grants and management support. For the business professionals who gather at SVP Tokyo, 'the final stage of life,' a theme that rarely comes up within companies, became something they could engage with.

UBS Session No. 17: Dr. 小澤, Representative of the End of Life Care Association, speaking.

In addition, the association received support from major telecommunications and other companies, further strengthening its brand.

The association holds events and courses, both online and in person, that are open not only to medical and welfare professionals but also to ordinary citizens. Please take a look.

The association is actively seeking donations and supporting members. Please join us here! Information on opportunities to collaborate with organizations is also available on the same page.