Designing for Older Adults

Case Studies, Methods, and Tools

Walter Boot, Neil Charness, Sara J. Czaja, Wendy A. Rogers

• Publisher: CRC Press
• Year: 2020
• ISBN:
  9781351683029
• Edition: 1
• Topic: Technology & Engineering
• Subtopic: Industrial Engineering
• Index: Technology & Engineering

Designing for Older Adults: Case Studies, Methods, and Tools

There are many products, tools, and technologies available that could provide support for older adults. However, their success requires that they are designed with older adults in mind by being aware of, and adhering to, design principles that recognize the needs, abilities, and preferences of diverse groups of older adults. Achieving good design is a process facilitated by seeing principles and guidelines in action. Design success requires understanding how to use the methods and tools available to evaluate initial ideas and prototypes. The goal of this book is to provide illustrative "case studies" of designing for older adults based on real design challenges faced by the researchers of the Center for Research and Education on Aging and Technology Enhancement (CREATE) over the past two decades. These case studies exemplify the use of human factors tools and user-centered design principles to understand the needs of older adults, identify where existing designs failed older users, and examine the effectiveness of design changes to better accommodate the abilities and preferences of the large and growing aging population.

Features

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• Reviews important design considerations for older adults and presents a framework for design

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• Provides a series of real-world case studies to ground design principles and guidelines

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• Offers a unique set and broad array of design challenges, from the design of healthcare devices, to computer systems and apps, to transportation systems and robots

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• Gives an overview of emerging technologies, their potential benefits to older adults, anticipated design considerations, and new and emerging approaches to evaluating design

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• Covers these topics with designers in mind, providing the most up-to-date recommendations based on the scientific literature but in an accessible, easy-to-understand, non-technical manner

chapter one

Introduction

The focus of this book is on designing for older adults. At the heart of good design for older adults is an awareness of, and adherence to, design principles that recognize the needs, abilities, and preferences of diverse groups of older adults. Comprehensive design guidelines are presented in our recent book, Designing for Older Adults: Principles and Creative Human Factors Approaches, Third Edition, and the reader is encouraged to consult that book (and other books in the Human Factors and Aging series) for valuable information regarding designing useful and usable systems for older users. While principles and guidelines are important, learning good design as a process is facilitated by seeing principles and guidelines in action, and by understanding how to use the methods and tools available to evaluate design. This book – Designing for Older Adults: Case Studies, Methods, and Tools – is intended to be a standalone book. The goal of this book is to provide illustrative “case studies” based on real design challenges faced by researchers of the Center for Research and Education on Aging and Technology Enhancement (CREATE) over the past two decades. These case studies are instances in which CREATE investigators have used human factors tools and user-centered design principles to understand the needs of older adults, identify where existing designs fail older users, and examine the effectiveness of design changes to better accommodate the abilities and preferences of the large and growing aging population. Presented case studies span many different domains including health, transportation, living environments, and communication and social engagement. Each chapter describes a method or tool vital to good design for older adults as well as important issues to consider in their use, specifically with older adults. After this description, relevant instances are presented in which the method or tool was successfully deployed, followed by a discussion of what was learned in terms of design. Chapter 8 presents an extended case study in which multiple methods and tools are applied to a single design challenge: the development of a computer system specially designed for older adults at risk for social isolation. To provide context for these case studies, methods, and tools, this chapter has three primary aims: (1) to present a conceptual model for design, (2) to discuss the importance of designing for older adults, and (3) to discuss characteristics of the aging population in terms of perceptual, cognitive, and motor abilities; diversity; and technology use, adoption, and preferences.

1.1 Conceptual Framework

Good design can be conceptualized as the process of producing an optimal fit between the demands of a system and the capabilities of the user. The CREATE model (Figure 1.1) recognizes that the capabilities of different users vary, and that, on average, younger adults vary predictably from older adults in important ways that impact their performance of tasks and interactions with technology, including differences in perceptual, cognitive, and psychomotor capabilities. Attitudes and experience can differ between younger and older adults as well. Design should accommodate individual differences and variability in capabilities. Our framework also recognizes that user–system interactions do not occur in isolation but take place in a broader socio-cultural and physical environment that can impact performance. For example, an older adults’ community might offer technology training classes that can increase the efficiency of an older adult’s interaction with a technology system without changing the design of the technology itself.

Figure 1.1 CREATE framework for a socio-technical system.

This framework serves as a general guide for all of what CREATE does with respect to design. The design process, including the methods and tools described in this book, is aimed at understanding the demands systems place on older users, mismatches between demands and capabilities, how redesign might produce a better demand–capability fit, and how the environment might facilitate user–system interactions, all across a variety of activity domains of everyday living. This process includes assessing older adults’ needs and preferences, involving older adults in the design process, implementing usability methods, assessing design through simulation and performance modeling, and designing instructional support. Carefully following design guidelines and engaging in an iterative, user-centered design process helps ensure that the benefits of systems designed to improve productivity, well-being, health, and independence are accessible by all, regardless of age.

1.2 The Importance of Designing for Older Adults

The world is undergoing a major shift in demographics known as population aging. Changing demographics are primarily the result of two forces: declining birthrates and increasing longevity. In both industrialized and developing nations, both the number of older adults in the population and the proportion of the population that is made up of older adults are dramatically increasing and are projected to continue to increase. In the United States, between the years of 2017 and 2060, the number of people aged 65 and older is anticipated to nearly double, from 51 million to 95 million. The fastest-growing segment of the population is the “oldest old” (aged 85 years and older). Worldwide, the number of people 80 years of age or older is expected to triple to 426 million by the year 2050. The year 2018 marked a first in human history: for the first time, older adults (those aged 65 years and older) outnumbered children under 5 years of age. By the year 2035, in the United States, people 65 years of age and older will outnumber all people under the age of 18. That is, there will be a greater number of older adults than children for the first time in the nation’s history. These facts highlight an important issue to consider in the design of systems: the population of users of systems now is different compared to what it was a few decades ago, and will be even more different in the coming decades.

Systems that do not consider the unique needs and capabilities of older users are likely to fail in their ability to support their use and adoption by a large and growing segment of the population. Designers need to consider that older adults will increasingly be buying and using their systems. In some cases, failure to consider the older user can result in less positive user experiences as well as lower adoption and use of systems or products by older adults. Further, unless older adults are involved in the design process, designers can incorrectly anticipate the needs and preferences of older users (out of tradition, the title of this book references the processes of “Designing for Older Adults,” but “Designing with Older Adults” may be more appropriate). In some cases, lack of consideration for older users in the design process can result in system use that is slow and error prone. And for some systems, errors can have serious consequences, putting older users at greater risk for injury or death. This is especially true in the domains of healthcare and transportation. To ensure that systems are easy to use and useful for all users, designers must consider older adults as potential users of their systems. In addition to providing a better user experience for older adults, CREATE research has found that good design for older adults typically benefits younger users as well.

1.3 Understanding the Older User

Although there is substantial variability among older adults in terms of abilities, attitudes, experience, and preferences, and this variability should not be ignored, younger and older adults on average vary in predictable ways relevant to the design of systems. Although a complete review of differences is beyond the scope of this chapter, a few of the most relevant differences are highlighted below, along with examples of their implications for design.

1.3.1 Perceptual and Cognitive Abilities

As we age, our perceptual and cognitive abilities change, and these changes can have a large impact on how we interact with systems. Vision changes include changes in visual acuity (the ability to see details, particularly for near distances), decreased peripheral vision, slower visual processing, increased susceptibility to glare, and even changes in color perception. Age-related yellowing of the lens of the eye can make distinguishing between shades of blue, green, and violet more challenging. Hearing loss tends to increase with age, especially for higher frequency tones. Older adults can also experience greater difficulty understanding speech in noisy settings compared to younger adults. For example, older adults are more likely to have difficulty following a conversation in a noisy restaurant or understanding spoken dialogue in a movie in the presence of a background musical score. System design that does not account for age-related changes in vision and hearing, as well as other senses, can disadvantage older users. Examples include systems that feature small, low-contrast text and buttons and systems that provide auditory alerts using low volume, high-frequency tones.

Cognition (our ability to think, reason, and remember) also changes with age. In general, older adults tend to process information more slowly, have greater difficulty managing multiple tasks simultaneously, and sometimes have greater difficulty allocating cognitive resources efficiently in the performance of a task (attentional allocation). They also tend to take longer to learn novel skills, which can impact the amount of training and support necessary for the use of a system. However, the cost of new learning can be substantially less for tasks that are not novel, for example, learning a new version of a piece of software when one is already skilled at using the previous version.

Memory abilities change with age too, including working memory. “Working memory” refers to the ability to simultaneously store and manipulate information in mind, and this ability is important for problem solving, reasoning, and speech and language comprehension. Designs that place high working memory demands on the user, for example, by having them navigate complex menu structures to identify the most appropriate option, can negatively influence older adults’ performance. Prospective memory, the ability to remember to do something in the future, can also be impacted. However, not all cognitive abilities show large age-related cognitive declines. Procedural memory (memory for the steps involved in how to perform a practiced task, the classic example being how to ride a bicycle) is often unaffected by age, and crystallized intelligence (knowledge about the world) remains stable or even increases later in life. Designs that take advantage of what older adults already know can help offset the impact of declines in other abilities. Memory limitations can be addressed by providing “knowledge in the world.” This refers to having information (for example, about the sequence of actions involved in completing a task) displayed as part of the system itself, rather than relying on users to learn and remember these actions.

These are just a few of the important perceptual and cognitive changes related to advancing age that are relevant to system design. In this book, we focus largely on the design of systems for older adults experiencing normative age-related changes in cognition (changes most of us can expect to experience as we age). An even greater challenge is presented when considering how best to design systems for older adults experiencing cognitive impairment. This could be cognitive impairment as a result of mild cognitive impairment (MCI), stroke, traumatic brain injury because of a fall, or Alzheimer’s disease. Although this book will not focus on the design of systems for older adults experiencing cognitive impairment, the same general principles and techniques can be applied.

1.3.2 Anthropometry, Movement Control, and Strength

In addition to perceptual and cognitive changes associated with aging, the body and physical capabilities can change with age as well. System design should consider age-related changes in physical dimensions (e.g., stature, weight), movement control, strength, and endurance. “Anthropometry” refers to the study of human-body dimensions, and anthropometric studies have found that older adults tend to be smaller in stature compared to younger adults, although there is variability with respect to how much, if any, change occurs longitudinally. These trends have important implications, for example, for the design of work and public spaces and the design of personal vehicles (e.g., placement of pedal controls).

Older adults are typically slower in their physical movements, and movements may be less precise and more variable for older adults compared to younger adults. The prevalence of tremor increases significantly with age. Among other implications, these changes have important implications for system “time out” parameters and the size of targets that older adults might need to hit with their finger when using a touchscreen display. These changes also have implications for the choice of a system input device and the parameters of that device (e.g., input gain). The generally slower walking speed of older adults compared to youn...