The trend of an aging population is reflected across Europe. It is estimated that by 2035 nearly a quarter of the population in the United Kingdom will be over 65 years. Aging is traditionally associated with a decrease in mobility and social interaction, and this can have detrimental effects upon well being and access to good nutrition and health. Fortunately there has been much research into the effects of age upon product interaction.

We conducted a systematic review of the research literature, and based on what we learned, we created a framework to organize the issues that directly affect the use and adoption of technology by older users. It is a concise and simple tool, easy to apply across numerous products to aid design thinking and evaluation from an older person’s perspective.

A Quick History Lesson

Historically, the design community has been accused of failing to understand and engage with distinct user groups, preferring to design from their personal experience and capability: If I can do this, then so will all the users of the product I am designing. This, argued many academics (and to be fair, design professionals), risked alienating and excluding significant proportions of the population, as a lack of user understanding was transferred into products that became unsatisfactory, unappealing, and downright unusable for significant groups of users.

However, our experience in design circles today tells us that we are more aware than ever that understanding the user experience helps design more usable products. While application in commercial environments can still be a struggle, the idea that user-centered and participatory design can ensure a better end-product-fit continues to gain momentum. Industry acceptance also grows as the concept of strategically involving users within the design process equates to greater adoption and engagement out-of-the-box, and thus results in significant financial savings in development costs.

Let’s Think about the Users

In various communication-based models of design, the user’s and designer’s interpretation of products or artifacts are considered as mental models. These mental models are based in part upon user expectation and perception—expectation in terms of users’ existing knowledge and prior experience about how the product might behave, and their perception of how further interaction might occur. Both these factors can be influenced by the feedback and messages received from product features, tactile and visual cues, and the context within which interaction occurs.

Assistive technology is usually designed for those with some cognitive or physical impairment, often attributable to trauma or natural atrophy, or to lifelong conditions. However, if the user and context is not realized or understood sufficiently, the danger remains that designers may not truly appreciate the differences in personal capabilities between themselves and the users of the technology.

What’s Age Got to Do with It?

Good question! Successful interaction spans product features, both functional and aesthetic. As we age our eyesight, hearing, dexterity, and grip all begin to deteriorate. In a study conducted some years ago (see More Reading at the end of this article), 30 individuals from the ages of 16-80 were presented with a novel product. The participants were asked to discuss their preconceptions and understanding of the product before performing six tasks, and then again after performing the tasks.

Mental model development was adversely affected with age. The models that the older participants possessed contained less relevant information to drive effective interaction, and their ability to acquire and consolidate new relevant information also declined with age. Increases in age were directly related to decreases in icon and feature recognition—and understanding—both before and after product interaction.

By coding and classifying each individual’s interactional behavior, it became evident that younger participants engaged in greater amounts of skill-based interaction where behavior becomes automatic and almost unconscious, and that older individuals were noticeably slower to complete tasks and indulged in rule- and knowledge-based behavior (see Figure 1).

Figure 1: Behavior activity type classified according to age group, N=30 (Wilkinson, 2011).

Unlike younger participants, older individuals interacted at a more conscious level throughout, considering the effects of their behavior before, during, and after interaction. Accordingly, viewing these factors in combination, we realized that for intuitive interaction, product design must cater to these and other aspects for an aging population if product uptake, adoption, ease of use, and engagement are to be achieved.

So What Did We Do and What Did We Find?

We examined 50 literary articles published between 1992-2014 that referenced assistive technology and older users. Analysis revealed the themes most frequently cited as being affective and influential to the adoption, usability, and success of assistive technology. We also identified concepts that may also adversely affect the uptake and adoption of such technologies.

From the analysis of the published research, we developed the framework shown in Figure 2. The placement of the “User” at the center of the framework (process) mirrors the aim to heighten product engagement by following the principles of user-centered design.

Figure 2: A visualization of older peoples’ needs as a Framework for Design Thinking (Wilkinson & Gandhi)

Although there is no specific order in which design consideration should be applied, it is appropriate to focus on the center of the model (the User) and work toward to the circumference. As a tool, the act of physically focusing upon the user from the start helps to remind us that it is they whom we should be considering throughout.

In the introduction of the four higher level themes, moving clockwise facilitates consideration of the user initially, their experience, the supports they may require, the economic aspects that may apply, and the social implications of any existing system or design. Each of these higher-level constructs is then further segmented (and explained in greater detail below) to foster deeper consideration of the effects these aspects may have for older individuals.

1. User Experience

Interaction designers aim to create interactive technologies that are enjoyable, pleasurable, motivating, and satisfying. These goals are largely dependent upon users’ acceptance of technology, their perceptions of the technology, and their level of engagement with it.

• User perception. User perception involves the ideas users gain about how devices work and are manipulated purely through their design. If users’ ideas of how interaction is likely to occur based on the product design do not transfer well and the design misleads them, it is likely to result in poor performance and product abandonment.
• User engagement. User engagement can involve physical interaction, social interaction, and activities in terms of entertainment and leisure. Feedback is an important factor for successful engagement, and a lack of feedback may directly contribute to delayed or impaired rates of technology adoption and increased rates of disengagement with technology.
• User acceptability. Acceptability is one of the fundamental requirements of technology stated by older users. The assumption that older adults would use an assistive technology purely because they need it is misguided. However, an interdisciplinary approach toward needs-assessment and design, understanding the user physically and psychologically, and designing accordingly, decreases the risk of subsequent equipment abandonment.

2. Physical and Psychological Supports

Elderly and older adults often require guidance, physical support, health monitoring, and the scheduling of their medicines in their daily life. Therefore, assistive technologies need to provide support and address older user’s individual physical, physiological, and psychological requirements.

• Physical support. Problems with health can be critical for older people as it restricts them from moving freely in the environment. Older adults possessing limited physical capabilities often experience difficulties in conducting daily activities, particularly regarding self-care and mobility. Effective assistive technology has the potential to enhance their ability to perform daily tasks and transform their mobility.
• Emotional support. Some older adults feel using assistive technology is seen as a symbol of dependence and frailness, and felt stigmatized by association. They expressed that a solution that merely addressed a clinical need was not enough; any feature or functionality also had to “look good.” However, well-designed mobility aids can bolster feelings of safety and self-worth by consequently increasing personal independence. This, in turn, can help older adults maintain access to networks of emotional support and facilitate their independence.
• Cognitive support. Assistive technology can support memory loss and dementia by providing support for decision making and activity reminders, and support tasks requiring higher cognitive function. Older adults with cognitive impairments also perform memory tasks more effectively by using external memory aids, so the use of appropriately developed assistive technology in such situations should be encouraged.

3. Economic Aspects

Less financially affluent individuals often avoid using assistive technologies for activities of daily living due to the perceived costs of intervention. Innovation is not the only motivation for design: economic and social issues should also provide an impetus for the design and development of assistive technology.

• Intrinsic cost. The direct financial cost to the user of assistive technology can be high, and this adversely affects rates of user adoption. Designing assistive technology for a more widespread market may assist in reducing the economic barriers and stigma associated with assistive technology use.
• Extrinsic cost. Long term healthcare for the elderly is resource intensive and expenditure in this area is high. However, appropriately designed assistive technologies can reduce healthcare costs, including costs related to institutional care and in-home nursing. They can reduce healthcare practitioner visits as well as slow the rate of decline in patient capability.

4. Social Aspects

An older adult’s quality of life is particularly dependent on a network of social relationships. Failure to consider social aspects can result in the failure of innovative technologies. Well-designed technologies can enhance older adults’ feelings of social connection and reinforce their sense of self-identity.

• Social connection and interaction. It has been argued that technological, economic, and social changes have increased social isolation, and that assistive technologies for the elderly have overlooked this issue. Assistive technologies can be designed to broaden social connectivity functions. Helping users move more easily outside the home, and building connectivity into the design, allows users to maintain access to social networks and encourages both physical and virtual interaction.
• Personal identity. One aspect of personal identity is derived from an individual understanding their precise location within a group or network of relationships. Assistive devices have been viewed by users as a threat to this identity. However, technology designed with enhanced understanding of users’ needs and requirements may help users to reestablish a sense of normality, personal comfort, and individual identity.

Applying the Framework

The framework presented can be used as a benchmarking or scoping tool in thinking about the design of assistive technologies that particularly consider older people’s needs. It can easily be applied across numerous products to aid design thinking and evaluation from an older person’s perspective.

It also reminds us all to think outside the box and outside of ourselves by placing the user at the center of our consideration. The hope is that this will enthuse both designers and users of assistive technology and encourage increasing dialogue between these groups. In doing so, we hope to foster and facilitate an environment where older peoples’ needs are understood and more readily met by the designers of tomorrow’s technology.

Topics: Older adults, User-centered design, Accessibility
Published in: February, 2015 in Open Topics

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