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UX:

简化导航：为老年用户设计的界面应减少复杂性，提供清晰的导航路径和明确的指示，以减轻认知负担。

大字体和高对比度：使用大号字体和高对比度的颜色方案，以便老年用户更容易阅读和识别界面元素。

直观的图标和按钮：设计直观的图标和按钮，使功能明显且易于理解，减少老年用户的混淆和误操作。

触摸友好：为触摸屏设备设计时，确保按钮和交互元素足够大，以适应可能存在的手部灵活性减退。

语音交互：集成语音识别技术，允许老年用户通过语音命令进行操作，这对于行动不便或视力受限的用户尤其有用。

个性化和适应性：提供个性化选项，允许用户根据自己的需求和偏好调整界面设置。

易于访问的帮助和支持：提供清晰的帮助文档和易于访问的客户支持，以帮助老年用户在遇到问题时快速找到解决方案。

用户测试和反馈：进行针对老年用户群体的用户测试，确保设计满足他们的特定需求，并根据反馈进行迭代改进。

教育和培训：提供教育资源和培训，帮助老年用户学习如何使用新技术和界面。

考虑认知和感知限制：在设计过程中考虑老年用户可能的认知和感知限制，例如记忆力减退、处理速度减慢和感官敏感度降低。

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Providing assistance to older users of dynamic web content

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Providing assistance to older users of dynamic web content

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Effects of cognitive and physiological changes

Design guidelines and personalization

Adaptability of techniques and tools

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Simplified by design: The Jitterbug phone eliminates common difficulties and challenges when using a smartphone by reducing functional complexity, making it easier for older users to stay in touch with family and friends.

Security features: These phones also include emergency response services, which users can access with the push of a button. This takes into account the specific health risks and safety issues that older users may face.

User experience: Jitterbug's design considerations reflect a deep understanding of the experience of older users. For example, it uses physical buttons instead of a touchscreen, taking into account that some users may be uncomfortable or unfamiliar with touchscreen technology.

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Lively phones launched in 2006 as one of the very first cell phones designed just for seniors. The company's mission is to create simple phones with older adults' needs in mind. More recently, Lively launched the Jitterbug smartphone, along with an integrated set of health and safety services. Thanks to the company's focus on senior-friendly features, older adults have the freedom to run errands, travel, and stay active with a cell phone that fits their unique needs and comes equipped with medical alert technology for added safety.

I've tested out a variety of senior-friendly cell phones over the years as SeniorLiving.org's tech expert. In this review, I'll take you through my experience of buying, setting up, and testing Lively's latest phones, the Jitterbug Smart4 and Jitterbug Flip2. Both competitively priced and easy to operate, their extensive features - like hearing aid compatibility and 24/7 emergency response - all cater to older eyes, ears, and minds. And the fact that Lively operates on the Verizon network,1 a carrier with notable dependability, is a big plus. Read on to learn more about my experience with Lively.

Pros and Cons

The Buying Experience With Lively

Both Jitterbug phones are sold on the Lively website, over the phone, in various big-box stores, and on Amazon. The flip phone and smartphone are very different from one another, so it's easy to compare and contrast the features. Basically, it all comes down to whether you want access to high-tech features and capabilities. Plus, both phones made our best cell phones for older adults list, so you really can't go wrong either way.

I wanted to know more about pricing directly from the source, so I called Lively to chat. I learned that monthly cell phone packages start at $19.99 a month for unlimited talk and text. Health and safety features are also available with each plan. Despite a $35 activation fee, shipping is free, and no long-term contracts are required. Everything is very clear: You simply go online, select your phone, and then add a service plan and accessories to see how much it will cost.

What I Learned from Lively's Customer Service

As for my customer service experience, I learned why Lively received the North America Frost & Sullivan Award for Customer Service Leadership.2 I spoke with a representative named Martin from the Carlsbad call center, and he was exceptionally kind, patient, and forthcoming. Here's what I learned during my chat with Martin:

Lively's call centers: Lively's call centers are only U.S.-based, and the company prides itself on being the top senior phone specialist. It's reassuring to know that a knowledgeable representative will be there to answer my call and my questions at any time.

Helping seniors navigate technology: Martin explained that while other companies are giving up on flip phones, Lively is embracing them, knowing that this is a vital accessory for active seniors. As for smartphone customers, he said the team is also ready to provide additional guidance for those who are new to a touchscreen device. That extra level of support is a must-have in my book.

Getting set up with Lively: When I asked Martin about tips for setting up the Lively phones, he directed me to a page on Lively's website where there are step-by-step setup videos for both phones that include useful diagrams, so you can pause and review as you go. Lively phones are also delivered with a handy user guide that gives a detailed account of every single function and feature. He also let me know I could save $10 on activation fees if I activate my phone online instead of over the phone.

Choosing a Cell Phone

Lively keeps everything simple for older adults. Instead of a long list of phones to choose from, you just have two: the Jitterbug Flip2 and the Jitterbug Smart4. You'll have to choose one of them if you go with Lively, because you can't bring your own phone to Lively like you can with some other providers, including Snapfon. If you'd like to compare these two senior-friendly phone carriers, read our Lively vs. Snapfon guide to see how the two stack up.

Jitterbug Smart4: Best for Those Who Want a Senior-Friendly Smartphone

Compatible with most Bluetooth devices and hearing aids, this comprehensive smartphone appeals to older ears and eyes. Lively has put a lot of thought into age-appropriate functions like a larger touchscreen, list-style menu, powerful speaker, and accurate voice typing (perfect for anti-texters).

The phone's battery has up to 37 hours of talk time, which is impressive; it's 15 more hours of talk time than Lively's previous model, the Jitterbug Smart3. The phone also includes upgraded cameras from the Smart3, including triple rear cameras and a selfie camera. In my experience, the camera quality wasn't as solid as other smartphones I've tested, like the iPhone 14 Pro, but it's still great for capturing photos of your travels or the grandkids.

Internet access, Google Assistant, and a lineup of pre-installed, senior-geared apps round out why this phone is so useful and convenient. During my testing, I did find that the Smart4 was a bit slow. Sometimes, I had to press a button multiple times before the phone would react, so it can be laggy. Still, it's an excellent choice for those who want a smartphone without frills or fuss. The Jitterbug Smart4 costs $149.99, plus the cost of the monthly plan and an activation fee, which is very reasonable for a smartphone.

Jitterbug Flip2: Best for Those Who Want a Simple Flip Phone Without Frills

This straightforward cell phone is universally praised for stylishly offering all the best features for seniors who may not be as comfortable with technology. With a bright screen, bigger textured buttons, a powerful speaker, a simplified menu, and hearing-aid compatibility, the Jitterbug Flip2 really does have it all, except for internet access. It also has a lower-quality camera, but makes up for it by including a magnifier with a flashlight.

Plus, the Jitterbug Flip2 features built-in Amazon Alexa tech, so you can compose texts, make calls, and perform any other tasks on your phone with just your voice. For those with arthritis or other dexterity issues, this is an excellent feature. This model can also incorporate health and safety features like Urgent Response for help during an emergency, or Lively Rides, which connects you to a personal operator who can schedule a Lyft ride for you. The Jitterbug Flip2 costs $99.99, and with the ability to add these vital features, we think it's well worth the price tag. Visit our Jitterbug Flip2 review for a look at our hands-on experience with this senior-friendly flip phone.

Nationwide Coverage

Lively is powered by Verizon, the nation's most reliable wireless network. It offers coverage across the country, including most rural areas. To check coverage in your area, you can visit Lively's coverage page on its website and type in your ZIP code.

Contracts and Warranty

Contracts

With Lively, you aren't roped into a long-term contract or charged any cancellation fees - aside from a $10 restocking fee if you send back equipment. Other plans, like AT&T's senior-friendly plans, require a two-year contract, so this gives Lively an edge.

Warranty

Lively offers a fairly standard warranty. When I spoke with Martin from Lively's customer service team, he informed me that Lively offers an automatic "standard limited warranty." This means you get a one-year equipment warranty for cell phones, including batteries and accessories. Lively will repair or replace the product without charge.

Since the warranty only covers manufacturer defects, accidents like dropping your phone in a puddle aren't covered. However, you can enhance and extend the standard limited warranty by purchasing a Lively Protection Plan for $3.50 per month. It covers accidents, battery replacement, normal wear and tear, and all accessories that came with your original phone purchase. You will still be charged a replacement fee, though. Costs vary, but it's $50 for a replacement Jitterbug Smart4 and $25 for a replacement Jitterbug Flip2. That's still cheaper than the full cost of buying a new phone, so it might be worth it if you're hard on your devices.

Lively Senior Phone Plans at a Glance

Lively offers three phone plans, all of which include unlimited talk and text. You'll also have extra health and safety features with each plan (more details on those later).

Phone plan

Cost

Unlimited talk and text

Additional features

Basic
$19.99 per month

Unlimited talk and text

Preferred
$39.99

Unlimited talk and text

Ask Lively

Lively Rides

Urgent Response

Lively Link

Premium
$49.99 per month

Unlimited talk and text

Ask Lively

Lively Rides

Urgent Response

Lively Link

Nurse On-Call

Care Advocate

Data Plans for the Jitterbug Smart4

If you purchase the Jitterbug Smart4, you'll also need to choose a data package, which adds another monthly fee to your plan. The Jitterbug Flip2 doesn't come with internet access, so you won't need to add a data plan.

Data options

Cost

1 GB data per month

$5 per month

5 GB data per month

$10 per month

Unlimited data

$30 per month

Lively Plan Details

Talk and Text Plans

Cost

You can enjoy unlimited talking and texting with any of Lively's plans, starting at just $19.99 per month. If you want to add additional health and safety features, you'll need to upgrade to the Preferred or Premium packages, which cost $39.99 and $49.99 per month respectively. Compared to other options, like Consumer Cellular's plans, Lively offers comparable prices. You'll also owe taxes and fees each month, which is standard with any cell phone carrier.

Plan Features

You can talk and text as much as you want each month without facing overage charges, no matter which plan you choose. That's why we recommend Lively to seniors who love staying connected with family, and especially for those who don't own a landline. The plan also includes voicemail, call waiting, caller ID, long distance, and roaming. If you purchase the Jitterbug Smart4, you'll also need to purchase a data option separately.

Along with talk and text, you'll also have access to various health and safety features, depending on your chosen plan. The chart above shows you which services are available in which packages, but now we'll look at what exactly each service entails.

Urgent Response: This service provides around-the-clock access to Lively's team of professional Lively Urgent Response agents, who are certified by the International Academies of Emergency Dispatch (IAED - the same company that certifies 911 operators) and thoroughly educated on your personal health history.

Ask Lively: The Lively team can answer any questions about your device, give you directions, help you look up a phone number, and more.

Lively Rides: An operator can order a Lyft ride for you when you need transportation.

Nurse On-Call: This app will save you a trip to the doctor's office, as it gives you immediate access to health care professionals, board-certified doctors, and nurses who can provide medical advice or refill a prescription.

Lively Link: This app helps unite parties involved in the active aging process, keeping caretakers and family members informed at all times. For instance, if you call Urgent Response, an instant update will go out to all related Lively subscribers, providing them with pertinent details.

Care Advocate: An expert from Lively's care team will help you identify areas of your health that you want to focus on. Then, they will give you a personalized Care Plan to help you set goals and resolve issues.

The different health and safety features are all accessible on the Jitterbug Smart4, but some cannot be accessed on the Jitterbug Flip2 itself. If you have the Flip2 and subscribe to any of the services, you can access them on a computer or on a family member's smart device.

Data Add-Ons

Cost

Older adults who purchase the Jitterbug Smart4 must purchase a data plan. Data costs $5 per month for 1 GB, $10 per month for 5 GB, or $30 per month for unlimited data. That brings the total cost for unlimited talk, text, and data to $49.99 per month if you choose the Basic plan, which is priced the same as Consumer Cellular's unlimited plan, but it is more than T-Mobile's Essentials 55 plan, which costs $45 per month for one line.

Seniors who are unsure which data plan to purchase should talk to their friends and family. They know you best and can help you choose a good fit. If you're still stuck, Lively recommends that seniors purchase 5 GB of data per month. You can always switch to a different data plan if you need to.

Plan Features

Your data plan includes the amount of data specified when you purchase. You use data when you're away from Wi-Fi and use your phone to browse the web, watch online videos, check email, get directions, and more. If you go over your plan allowance, it costs 10 cents per megabyte, which is better than the industry standard.

Lively App

If you want to access Lively's health and safety features but aren't looking for a new phone, you have options! You can purchase a Health & Safety Package, download the Lively app, and access your health and safety features on an iPhone or Apple Watch.

The Bottom Line on Lively

From my experience with Lively's phones and plans, I've found that the company offers simple devices designed for older adults. If you're looking for the latest tech or ultra-fast processing, you'll want to consider a different carrier. On the other hand, if you're looking for an easy-to-use phone that can keep you entertained, connected, and protected, Lively is a great choice. With plan prices starting at just $19.99 per month, there are options for most budgets. However, we'd recommend considering another provider if you have your heart set on a phone that isn't made by Jitterbug.

Frequently Asked Questions About Lively's Phones

How fairly priced is the Jitterbug Smart4 compared to other smartphones?

The Jitterbug Smart4 is very reasonably priced compared to other similar smartphones. Even without any kind of discount, the model is only around $150; some others on the market go all the way up to $1,000.

How much memory comes with each Lively cell phone model?

The Jitterbug Flip2 has 16 GB of built-in storage, while the Jitterbug Smart4 has 32 GB of built-in storage and up to 256 GB of expandable storage.

Can I get fall detection on either of the phones?

No, you can only sign up for automatic fall detection if you have purchased the Lively Mobile+ or the Lively Mobile+.

Do the phones have actual Urgent Response buttons if I subscribe to that service?

Yes, there is a clear, designated Urgent Response button on each of the phones, which you can quickly press during an emergency.

Do Lively phones include damage protection?

Lively's automatic warranty includes one year of protection if the phone is faulty outside of your control. If you were to crack your screen or drop it in water, you would have to repair it on your own dime. However, for $3.50 per month, you can purchase a Lively Protection Plan that provides coverage for screen damage, even if you caused it.

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Jitterbug Phone Reviews 2023: The Jitterbug Flip & Smart Cell Phone

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GreatCall specifically caters to seniors with its phones and services. It uses two basic models for its cell-phone service and allows seniors to customize their monthly plans, based on how much talk, text, and data time they need. There is also an option to add a health and safety packa...

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Aging population

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Virtual agents in retail web sites Benefits of imulated social interaction for older users

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Virtual agents in retail web sites Benefits of imulated social interaction for older users

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The importance of social presence

The impact of perceived risk

Design and experimental methods

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AARP (American Association of Retired Persons) is a non-profit organization that provides information, education and support to people age 50 and older.

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AARP (American Association of Retired Persons) is a non-profit organization that provides information, education and support to people age 50 and older.

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Accessibility Design: The AARP website incorporates a number of design elements to enhance accessibility for older users. This includes larger text sizes, clear navigation, high-contrast color schemes, and simplified layouts and menus, all designed to reduce cognitive burden and improve readability.

Related content: Websites offer content specifically targeted to the needs and interests of older adults, which shows the importance of increasing user engagement through design and content strategies.

Interactive elements: The site also includes various interactive elements such as questionnaires, comment sections and forums to encourage user participation and community building.

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AARP® Official Site - Join & Explore the Benefits

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AARP is the nation's largest nonprofit, nonpartisan organization dedicated to empowering Americans 50 and older to choose how they live as they age.

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Understand the needs of older users

Accessibility and usability

The combination of technology and education

Future research directions

Interdisciplinary perspectives: Design, anthropology, psychology, computer science, etc

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Abstract

This document provides a review and analysis of guidelines and articles relating to the needs of older people with Web accessibility needs due to ageing, and compares these with the needs of people with disabilities as already addressed in WAI guidelines. The focus is particularly on Europe but applies internationally as well. This review is being undertaken in order to inform the development of educational materials which can better promote the needs of people who have accessibility needs due to ageing, and potential development of profiles and/or extensions on WAI guidelines.

Status of This Document
This section describes the status of this document at the time of its publication. Other documents may supersede this document. A list of current W3C publications and the latest revision of this technical report can be found in the W3C technical reports index at http://www.w3.org/TR/.
This First Public Working Draft of the Literature Review of Web Accessibility and Older Adults is an output from the "Web Accessibility Initiative: Ageing Education and Harmonisation (WAI-AGE)" project supported by the European Union's 6th Research Framework Programme (FP6); background on this project is available on the WAI-AGE home page.

This document is intended to provide an overview of currently available literature about the needs of older adults with functional impairments accessing the web. It will compare how well these requirements are addressed and communicated by the WAI guidelines. This early version is intended to elicit comment and feedback on the literature collected and discussed so far. In particular we are interested in whether there are gaps in our coverage, or key resources overlooked. It should be noted that this is a work-in-progress and that not all sections are yet complete.

This document was developed through the Education and Outreach Working Group. The Working Group expects to publish this document as a Working Group Note.

Please send comments about this document to public-comments-wai-age@w3.org (with public archive) by Wednesday 4 June 2008.

Publication as a Working Draft does not imply endorsement by the W3C Membership. This is a draft document and may be updated, replaced or obsoleted by other documents at any time. It is inappropriate to cite this document as other than work in progress.
This document was produced by a group operating under the 5 February 2004 W3C Patent Policy. The group does not expect this document to become a W3C Recommendation. W3C maintains apublic list of any patent disclosures made in connection with the deliverables of the group; that page also includes instructions for disclosing a patent. An individual who has actual knowledge of a patent which the individual believes containsEssential Claim(s) must disclose the information in accordance withsection 6 of the W3C Patent Policy.
Table of Contents

1. Introduction

The World Wide Web ( Web) was invented in 1989 and the World Wide Web Consortium ( W3C) was established in 1994 to lead the World Wide Web to its full potential. By the turn of the century the Web had entered most aspects of our lives from communication to e-Government, e-Commerce and e-Learning, making it much more than just an information repository. By 2006, in addition to online services (banking, taxation, shopping, etc), we also saw the advent of web-based applications such as calendars, office-type applications, forums, chat, blogs, etc. This evolving online world presents ongoing access challenges to people with functional impairments and disabilities.

Tim Berners-Lee, inventor of the Web and Director of the World Wide Web Consortium (W3C), is regularly cited for saying "The power of the Web is in its universality. Access by everyone regardless of disability is an essential aspect" [TBL 1997] and more recently "One Web for anyone, everywhere on anything" [TBL 2004] - this is all part of the Web's 'full potential'. In 1999 the W3C Web Accessibility Initiative (WAI) published the first set of international guidelines for Web accessibility, the Web Content Accessibility Guidelines 1.0 (WCAG), documenting the essential requirements for Web content to be accessible to people with disabilities. Accessibility requirements for authoring tools (ATAG) and user agents (UAAG), including browsers followed. At the time of writing (early 2008), the W3C had advanced drafts available of WCAG 2.0 and ATAG 2.0 along with a specification for Accessible Rich Internet Applications (WAI-ARIA) that will assist scripted Internet applications to become accessible.

Many countries in Europe and elsewhere have legislation in place to reduce discrimination against people with disabilities, both young and old, along with related policies or guidelines applying to online services [Policies]. Furthermore, the European Union ( EU) and the European Commission (EC) have programmes in place to ensure that e-Inclusion for people with disabilities is enhanced among the Member States, and it is also addressing the needs of the elderly and other disadvantaged groups. In particular, they have agreed to "address the needs of older workers and elderly people by ... exploiting the full potential of the internal market of information and communications technology ( ICT) services and products for the elderly, amongst others by addressing demand fragmentation by promoting interoperability through standards and common specifications where appropriate" [EC 2006]. The EC has been addressing the technology needs of the elderly for some time; however under the 6th Framework Programme ( FP6) of research under the Information Society and Technology (IST) programme, several calls have focused on the needs of the elderly in the information society [Placencia-Porrero 2007].

This issue is compounding because the world's population is living longer with a disproportionate number of people soon to be elderly as compared with any other period in human history. The United Nations ( UN) estimates that by 2050 one out of every five people will be over 60 years, and by 2150, one third of the people in the world are expected to be 60 years of age or older [UN 2007; UN 1998]. In Europe in the near future, it is estimated that the EU-25 countries will experience a demographic shift from 2000 when 15.7% of the population was over 64, to an estimated older population of 17.6% in 2010 and 20.7% in 2020 [EC 2007a].

This demographic shift is also impacting the workforce and the EC expects employment rates for older workers to "increase massively from 40% in 2004 for the EU-25 to 47% by 2010 and 59% in 2025" that will "need to be supported by ensuring lifelong access to suitable training" [EC 2007b].

There has been extensive development and adoption of the WAI guidelines for Web accessibility for people with disabilities. However, while these guidelines address many of the requirements needed by the ageing population, the relevance of the WAI guidelines to the needs of older people with functional disabilities caused by ageing does not seem to be well understood.

This review examines the literature relating to the use of the Web by older people to primarily look for intersections and differences between the WAI guidelines and recommendations for web design and development issues that will improve the accessibility and usability for older people. It is intended that the review will:

better inform the ongoing work of W3C/WAI with regard to the needs of older computer users and their web accessibility related needs

inform the development of potential extensions on WAI guidelines and techniques and/or provide direct input into future versions of WAI guidelines

lead to the development of educational resources focussed towards industry implementers, and organisations representing and serving ageing communities

help foster dialog between ageing communities, disability communities, industry, and other interested parties around issues of web accessibility

inform the contributions that W3C makes into the standards development processes in Europe and internationally.

2. Older adults and age-related functional limitations

2.1 Who is an older adult?

Are they 50+ or 65+?

Goldman Sachs [Goldman Sachs 2005], along with many others, have defined 60 as the new 55 in terms of retirement from full-time work as life expectancy, health, and economic expectations increase.

In the WHO document 'Definition of an older or elderly person ' [WHO a] it is suggested that "Most developed world countries have accepted the chronological age of 65 years as a definition of 'elderly' or older person", but goes on to say "The UN has not adopted a standard criterion, but generally use 60+ years to refer to the older population" (e.g. [WHO b]).

The American Association of Retired Persons' ( AARP) 2004 study found that previous studies (undertaken during 2000 - 2004) of the elderly and their use of the ICT and the Web used a variety of definitions, from 50+ years through to 65+ years [Redish & Chisnell 2004]. Bailey [Bailey 2002] [Bailey 2004] reviewed a number of studies and journals and proposed the following classification:

The AARP itself considers 'older adults' to be those over 50 years, while many western countries (including the USA) consider the retirement age to be 65 years.

However, in addition to chronological age defining 'elderly', we need to account for the diversity in ability resulting from the development of functional limitations associated with ageing, and also the diversity of attitude and aptitude, when we are discussing the use of technology, especially ICT and the Web.

2.2 How older adults use the Web

Fox (2004) [Fox 2004] found that older US Web users do product research (66%), purchase goods (47%), make travel reservations (41%), visit government Web sites (100%), look up religious and spiritual information (26%) and do online banking (20%). Morris, Goodman and Brading (2007), in their UK (Derbyshire) study, found that the information searches were often related to hobbies and interests (68%), travel and holidays (50%) and health or medical (28%). Dinet et al. (2007) [Dinet 2007] found from a study of older French users (age 68 - 73 years) that health was the most looked for topic online, the second was recreation and travel and the third most popular was services.

Morris, Goodman and Brading (2007) concluded that the Internet "does enhance the lives of older people" even if the older elderly use the Internet less than younger elderly groups.

2.2.1 How many older users are online?

The Eurostat 2005 community survey on ICT usage in households and by individuals found declining access to the Internet with age, and only 10% of people over 65 years having Internet access (Figure 1; Table 1) [Eurostat 2005]. However, this is low by many countries' measurements, and more detailed country-based statistics are provided in the Appendix.

Figure 1: EU Internet Use by age in 2005
(Eurostat, Community survey on ICT usage in households and by individuals, 2005)

Age Group

16-24 years

25-34 years

35-44 years

45-54 years

45-54 years

55-64 years

Weekly Internet access

2.3 What are age-related functional limitations?

The commonly accepted limitations that often arise during the normal ageing process are:

The ageing process can often result in elderly people experiencing multiple functional limitations.

2.3.1 Vision decline with ageing

Lighthouse International [Lighthouse TAE], Agelight [Agelight 2001] and Salvi, Akhtar and Currie (2006) [SAC 2006] give excellent descriptions of many of the declining vision conditions that most older adults naturally experience, from the yellowing of the eye's lens and presbyopia (loss of elasticity of the lens) to pupil shrinkage. These conditions result in a variety of vision changes:

Decreasing ability to focus on near tasks, including a computer screen

Colour perception and sensitivity; less violet light is registered, making it easier to see red and yellows than blues and greens and often making darker blues and black indistinguishable

Pupil shrinkage; resulting in the need for more light and a diminished capacity to adjust to changing light levels. For example, 60 year old retinas receive only 40% of the light that 20 year old retinas receive [Lighthouse ILE] while 80 year old retinas only receive around 15% [Eye Digest]

Contrast sensitivity; from the age of 40, contrast sensitivity at higher spatial frequencies starts to decline until at the age of 80 it has been reduced by up to 83% (See Figure 2)

Reduction in visual field

Figure 2: Contrast sensitivity decreases dramatically with age for all but low spatial frequencies
(reproduced from [EveryEye 2004])

The Royal National Institute for the Blind ( RNIB) has estimates of eyesight decline in the older population in the UK for people whose declining sight significantly affects their daily life [RNIB 2008a]:

15.8% aged 65 to 74 years

18.7% for ages 75 - 84 years

45.8% for ages 85+ years

In addition to the natural ageing of the eye, two common eye diseases of the elderly can also seriously affect vision:

Cataracts [RNIB 2008b], which is a clouding of the clear lens in the eye resulting in blurred vision and glare sensitivity. This is treatable in it's early stages.

Age-related Macular Degeneration (AMD) [RNIB 2008c], resulting in central vision deterioration and an inability to see fine detail and distinguish colour possibly combined with a sensitivity to glare. AMD is not reversible.

Cause

Percentage of population
(for binocular Visual Acuity < 6/18)

Age-related Macular Degeneration (AMD)

2.3.2 Hearing loss with age

The majority of people who have a hearing loss are older people; they usually notice a gradual age-related reduction and the increasing inability to hear high-pitched sounds [Hearing Concern]. The Royal National Institute for Deaf People ( RNID) estimates for the UK that at around the age of 50 the proportion of deaf people begins to increase sharply and 55% of people over 60 are deaf or hard of hearing [RNID].

16 to 60 years

61 to 80 years

Over 81 years

All degrees of deafness

2.3.3 Motor skill diminishment

Arthritis is a major cause of mobility issues for the elderly and Wikipedia [Wiki MSD] reports that arthritis is the leading cause of disability in people older than 55 years. The US-based Arthritis Foundation reports that 50% of Americans over 65 experience arthritis [Arthritis Foundation 2008] , while Arthritis Care in the UK report that 20% of all adults in the UK are affected [Arthritis Care 2007].

Another age-related condition is Parkinson's Disease, a progressive neurological condition affecting movements such as walking, talking, and writing. The National Institute of Neurological Disorders and Stroke in the US reports that the four primary symptoms of Parkinson's Disease are [NINDS 2008]:

Both arthritis and Parkinson's are likely to cause difficulties with the mouse use, and even other pointing devices, as well as keyboard use for some sufferers.

2.3.4 Cognitive decline with age

Wikipedia's entry on Memory and Aging talks about memory decline in the normal ageing process and states [Wiki MA]:

"The ability to encode new memories of events or facts and working memory shows decline in both cross-sectional and longitudinal studies [Hedden & Gabrieli 2004]. Studies comparing the effects of aging on episodic memory, semantic memory, short-term memory and priming find that episodic memory is especially impaired in normal aging [Nilsson 2003]. These deficits may be related to impairments seen in the ability to refresh recently processed information [Johnson 2002]. In addition, even when equated in memory for a particular item or fact, older adults tend to be worse at remembering the source of their information [Johnson 1993], a deficit that may be related to declines in the ability to bind information together in memory [Mitchell 2000]."

It has also been suggested [Caserta & Abrams 2007] that situation awareness may be relevant to cognitive ageing, affecting older adults' perception and comprehension of their environment.

Cognitive deficits come in many forms as discussed earlier, but among the elderly, dementia, including Alzheimer's Disease, appears to be the most prevalent. Alzheimer's Disease International provides figures showing that the incidence of dementia is nearly 25% among over 85 years olds ( Table 4) [ADI 1999]. Alzheimer Europe (2005) estimate that between 1.14% and 1.27% of citizens over the age of 30 years in the European Union are living with a form of dementia [AE 2005].

Age group

Rate

Alzheimer's organisations suggest that dementia is progressive and that during the course of the disease the chemistry and structure of the brain changes, leading to the death of brain cells (e.g. [ASUK Alzheimer's Society UK, 2003]) They also suggest that people with multiple sclerosis, motor neurone disease, Parkinson's disease and Huntington's disease may also be more likely to develop dementia. Symptoms are identified as including:

The Alzheimer's Forum in the UK publishes tips for coping, including computer tips which include the suggestion of getting a mouse that works properly for the users and adjusting the mouse pointer to suit the user [AF Online].

Many older adults may not suffer from dementia or Alzheimer's Disease, but do suffer Mild Cognitive Impairment ( MCI) or subjective memory loss ([UCSF MAC]; [AA 2006]). The complaints associated with MCI include:

trouble remembering the names of people they met recently

trouble remembering the flow of a conversation

an increased tendency to misplace things

All these complaints are likely to also impact on the use of many Web sites. Other forms of cognitive diminishment may also arise with ageing, for example the effects of stroke can result in conditions similar to intellectual impairment.

2.3.5 Multiple sensory loss and function impairments

Brennan, Horowitz and Ya-ping (2005) [Brennan 2005] report that twenty percent of America's older adults (over 70 years) reported dual sensory impairment and the high levels of dual impairment were shown to increase the risk of difficulty with the 'instrumental activities of daily living' (including using a telephone, and hence probably a computer and the Web). Brennan, Horowitz and Ya-ping's findings highlight the importance of sensory resources for everyday competence and the elderly maintaining their functional independence.

2.4 Attitude and Aptitude

Many authors observed that not all older adults are the same, and that attitude and aptitude can vary significantly across the elderly age group (e.g. [Coyne & Nielsen 2002]; [Gregor 2002]; [Redish & Chisnell 2004]; [Scott 1999]). Ability is often related to experience, for example mouse control for elderly new computer users can be problematic ([Dickinson 2005]; [Hawthorn 2005]).

Morris, Goodman and Brading (2007) [MGB 2007] found that "the barrier is not age, but the respondents' idea that older people cannot or do not use computers". Additionally, many of the survey respondents in their UK study cited a lack of Internet access as a key barrier to use.

However, as Morrell (2005) suggests [Morrell 2005], the post-WWII "baby boomers", who are moving into the category of 'older adult', have often been using ICT at work, and will have greater ability than many current retirees who don't have a history of experience with ICT and may have begun by using the Web for the first time in the 1990's and early 2000's.

2.5 User requirements for an elderly Web user

3. A Review of the Literature

Many studies have been undertaken of the use of the web by older people, some research based, some user observation, some surveys, some expert opinion. Some of these studies have looked at the elderly as a group, others have focussed on specific issues faced by the elderly, including their approach to learning about ICT and the Web. Some of the studies have referenced the work of the W3C Web Accessibility Initiative ( WAI), but many seem to have been undertaken in oblivion of this work and the WAI Guidelines which were first released in 1999.

Many of the studies discovered (see References) identify the sensory impairments that develop with age such as vision, dexterity, and hearing as important, while others identify the issue of cognitive ability and overload as key to some elders' ability to use Web technologies. A compounding issue is that people with accessibility needs due to ageing are less likely to identify themselves as "disabled" than people who experience these changes earlier in life (e.g. [Bjørneby 1999]). As a result, they are less likely to learn of, and to avail themselves of, resources which can help address their needs. The studies listed in the Appendix can be classified in many different ways by the methods used or approaches taken, in their investigations, for example:

Of course, there are always studies that do not fall into these categories.

There is also the cross-over between Accessibility and Usability to consider; for this review accessibility is taken to include the Guidelines and Success Criteria from WCAG 2.0 that address the needs of people with disabilities using the Web, along with those parts of ATAG and UAAG that affect Web usage and participation. A consideration of the cross-overs may lead to more useful outcomes/recommendations for future WAI work.

A majority of the articles discovered (see References) originated from Europe, but a significant number also originated from North America, with a few from Asia and Australasia.

3.1 Existing literature reviews

Most of the scientific papers identified in the References included literature reviews relevant to their particular topics, but a few papers were primarily reviews of previous literature.

Redish and Chisnell (2004) [Redish 2004] reviewed a large number of articles, books, presentations, Web sites and papers published between 2000 and 2004 relating to web design for older adults. They were looking for broad usability issues for older Web users, while this review aims to identify opportunities to extend the existing WAI technical, education, and outreach work to accommodate the overlapping needs of people with disabilities and older adults with age-related functional limitations. Redish and Chisnell were not surprised to find that much of what they found in the literature about older adults on the Web is good usable design for everyone - consistent navigation, clear writing, skim-able text with lists, etc. Another aspect of the elderly that their study reinforced is that older adults are not a homogenous group - something that many others have also commented on (e.g. [Gregor 2002]; [Fox 2004]; [Morrell 2005]).

Redish and Chisnell commented that older adults are actually less homogenous as an age-group than younger adults. Redish and Chisnell grouped their findings into four aspects of design - interaction, information architecture, visual design, and information design. Some of the issues they highlighted include:

Interaction design:

Design convention such as underlined links should be followed

Scrolling and other mouse activities are a learned behaviour and becomes more difficult with age making pull-down menus, scrolling lists, and scrolling pages difficult for some users

Understanding, and accessing, what is clickable can be problematic for some elderly users

Feedback in multiple modes (visual and auditory) may be beneficial

Information architecture:

Clear labelling (of links, headings and menu items) seems to be more important for older users than younger users

Breadth vs. depth - shallow information hierarchies seemed to work better for older users

Redundant links - the studies they reviewed leant both ways

Visual design:

Experienced older users can scan pages as well as younger users, but newer elderly users can find busy pages and pages with irrelevant material (such as adverts) distracting

Older users generally prefer larger text - naturally

Older adults with vision deficits need to be accommodated with suitable contrast along with headings to help them narrow their visual search

Information design:

Skimming and scanning is common across all age groups and vision abilities

Content development, plain language and 'writing for the web' are critical

Redish and Chisnell conclude by suggesting that older adults should be included more in usability studies of Web design.

3.2 Previous approaches to 'senior friendly' Web guidelines

Many investigations this decade have developed or compiled usability guidelines for making Web sites "senior friendly", in addition to the Web Content Accessibility Guidelines from W3C for people with disabilities. As Zaphiris, Kurniawan and Ghiawadwala (2006) suggest, some of these are developed in academia and are theory driven, while others come from the Web industry and are derived from practical experience. A selection of these guidelines published since the release of WCAG 1.0 include:

Morrell (2005) in writing up the experience of compiling guidelines for a site to be used by older adults (www.nihseniorhealth.gov) found adequate systematic and descriptive research to facilitate this, but expressed dismay over the duplication of research by recent studies. This confirms the general feeling that this author has had, that many studies are either "reinventing the wheel" or not surveying and building on the appropriate range of existing literature. Other studies seem to repeat the mistakes of others in their recommendations, e.g. recommending against double-clicking.

Editor's question - retain or remove the H4 headings identifying the guidelines being discussed?

3.2.1 Holt's guidelines (2000)

Holt (2000) created one of the earliest set of guidelines for senior-friendly Web sites where she focussed on addressing some of the functional declines often experienced with ageing. Holt specifically mentions a variety of visual, intellectual, hearing and motor-skill impairments that are common in older adults. This early checklist contained four groups of recommendations concerning:

While the basis of Holt's checklist was not clear, much of Holt's discussion reflected the Checkpoints from WCAG 1.0, while some of it addressed additional issues many functionally limited older adults will experience such as difficulty with pull-down menus and auto-scrolling text. Many of Holt's recommendations are reflected in the other guidelines discussed below.

3.2.2 AgeLight's guidelines (2001)

In 2001, the AgeLight organisation, in consideration of the ageing population and the functional limitations often faced by them, published a set of guidelines to help Web designers accommodate the natural changes in ability often associated with ageing [AgeLight 2001]. These guidelines, described as "interface design guidelines for all ages" were based on focus groups, user feedback, and wide collaboration with practitioners and researchers. The AgeLight guidelines were centred around six aspects of page design:

Under these page design aspects, AgeLight discussed many factors that were captured in WCAG 1.0 - WAI is acknowledged in their resource listing - such as flashing and blinking, relative text size, descriptive links, consistent navigation, colour alone, new browser windows, and frame support. They also discussed a number of additional factors addressing the specific needs of some older people facing various functional limitations such as readability, fine motor control, and cognition such as the use of CAPITALS, large text size, colour schemes, and uncluttered pages. AgeLight also considered some of the software and hardware issues that could assist older users such as different mice and browser adjustments.

AgeLight liken the accommodation of people with disabilities and their assistive technologies to curb-cuts for wheel chair users which benefit a much broader group. Like Holt, AgeLight have emphasised the importance of broad usability for older users, especially those new to ICT and Web technologies.

3.2.3 National Institute of Aging's guidelines (2002)

NIA/NLM prepared a checklist in 2002 [NIA/NLM 2002] for making sites 'senior friendly' compiled from a variety of previous research findings. This checklist includes five groups of recommendations:

Designing readable text for older adults:

Presenting information to older adults:

Incorporating other media:

Increasing the ease of navigation:

Final check (usability testing)

Some of the NIA/NLM checklist items are targeted at overcoming the functional limitations experienced by many elderly users, for example contrast and the use of colour, pull-down menus, scrolling text, and captioning. Other items address a potential lack of familiarity with the browsers and the Web, such as providing 'previous/next' buttons on a page. Some of the NIA/NLM checkpoints duplicate WCAG 1.0 checkpoints (e.g. provide alternatives for multimedia, and provide a consistent layout), while others could be seen to conflict (e.g. use 12 or 14 point text).

The NIA/NLM checklist reinforces a theme that runs across most of these guidelines - usability is crucial for older Web users including readable text and clear language.

Morrell (2005) provides a description of the development of the NIA/NLM Checklist, and its application to the development of the www.nihseniorhealth.gov Web site providing information on health topics applicable to older adults. The usability testing of the NIHseniorhealth Web site and other sites following the Checklist has confirmed its usefulness in making sites senior-friendly.

3.2.4 Coyne and Nielsen's guidelines (2002)

Coyne and Nielsen [Coyne & Nielsen 2002] could be considered to have prepared the first definitive set of senior-friendly Web site design recommendations based on user observation published as "Web Usability for Senior Citizens". Their study of 40 (experienced) users over 65 years derived 65 guidelines in 6 groupings for Web site designs that would better accommodate older users:

Although Coyne and Nielsen's users were experienced, additional usability issues relating to the browser and operating system were discussed, including the issues of users confusing the address field with the site's search field (also observed by Kantner and Rosenbaum [Kantner 2003]). They also recommended a text-resizing button or link on Web pages to overcome older users' lack of familiarity with browser controls.

Coyne and Nielsen emphasised issues often associated with functional impairment related to ageing such as text size, contrast, scrolling, and drop-down menus, as well as general usability. Like the previous guidelines they also raised broader useability issues that will benefit everyone such as their Search recommendations.

3.2.5 AARP's guidelines (2004)

The AARP [AARP 2004] from the investigation and review by Redish and Chisnell [Redish 2004] published a set of heuristics (issues) for the evaluation of web site design for older adults:

The majority of the AARP 's heuristics might just be considered conventional usability wisdom - most of this list is of benefit to all users, not just elderly users or users with functional limitations.

We are also seeing some patterns develop through all these guidelines about using conventional design and interaction mechanisms, an emphasis on clear presentation and writing, and a requirement for readability with the use of white space and good contrast. It is interesting to note that the AARP did not empasise the requirement for large text size like the previous guidelines have.

3.2.6 Kurniawan and Zaphiris' guidelines (2005)

Kurniawan, Zaphiris and colleagues derived eleven categories of guidelines, termed "SilverWeb Guidelines" by Zaphiris, Kurniawan and Ghiawdwala, from their review of previous HCI research:

Target (link) design

Graphics

Navigation

Browser window features

Content layout design

Links

User cognitive design

Use of colour and background

Text design

Search engine

User feedback and support

Clark (2005) [Clark 2005] criticised some of the recommendations as being irrelevant or too general, including:

Double clicking - not required anyway on web pages

Graphics should not be used for decoration - does away with graphic design?

Avoid scroll bars - vertical scrolling is part of the web, "if they meant avoid horizontal scrolling they should say so"

Kurniawan and Zaphiris' guidelines are interesting in that they reflect many of the recommendations of previous guidelines, while based much more on scientific literature rather than user observational studies. Many of these guidelines are similar to the WCAG 1.0 Checklist, while others emphasis the specific needs of older users with functional limitations including clarity and readability of text, clear (large) links, and providing reading time.

3.2.7 Webcredible's guidelines (2006)

Fidgeon [Fidgeon 2006] at Webcredible analysed eight usability sessions they had undertaken with older users (over 65 years) and compared them with eight similar sessions they had conducted with younger Web users (under 40 years).

Some of their findings were that older users used more emotive terms when describing Web sites and were more likely to assign blame, to themselves, when encountering difficulties. They also found that the elderly users often failed to scroll down, thus missing key information, were less likely to understand technical language, but had a higher propensity to use the search facility than their younger counterparts. The older users also required over twice the time to complete tasks than the younger users, maybe because they read all the text on a page before selecting a link and/or because they were more likely to click on text areas that were not links. Fidgeon made nine suggestions for improving the usability of Web pages for elderly users:

Investigate ways to indicate that a page is not finished and requires scrolling

Avoid technical terms if possible

Identify links in a consistent and obvious way

The attention grabbing features on a page should be links

Visited links should change colour

Provide all content as HTML where possible

Make the content as clear and concise as possible

Provide a "make the writing bigger" link and always use high contrast

Provide explicit instruction by using the imperative forms of verbs (e.g. 'Go to more details about XXX')

Some of these recommendations reflect the WCAG 1.0 checkpoints; other are designed to accommodate newer users without Web experience (e.g. scrolling indicators, and text-resizing buttons). Webcredible recommend these design features for all sites and acknowledge a need for further investigation.

3.2.8 Common themes from existing Guidelines

Several other authors (e.g. [SPRY 1999]; [Zhao 2001]; [ de Sales & de Abrew Cybis 2003]; [Moreno 2007]) have prepared guidelines and recommendations for senior-friendly Web sites with most of the same recommendations as others.

With so many guidelines in existence, it is interesting to ask who knows of them or uses them. Sloan (2006), acknowledging that WCAG 1.0 was the de facto standard for Web site accessibility, undertook a survey of web designers to see which 'senior-friendly' and other usability guidelines Web designers and developers were aware of and used. In addition to Coyne and Nielsen (2002), NIA/NLM (2002) and Kurniawan and Zaphiris (2005), Sloan included:

"Beyond ALT Text: Usability for disabled users" [Coyne & Nielsen 2001]

"Research-based Web design and usability guidelines" from the National Cancer Council [DHHS 2006 - replaced NCC 2004]

"Guidelines for accessible and usable Web sites: Observing users who work with screen readers" [Theofanis 2005]

Sloan's 57 respondents consistently responded "I've never heard of them" to all but the Coyne and Nielsen publications with only a few acknowledging that they had read or used them.

This lack of awareness, combined with the observed repetitiveness within them, confirms the need for this project and publication.

3.3 WAI guidelines

The W3C Web Accessibility Initiative has released several sets of guidelines to help make the Web more accessible to people with disabilities. These include guidelines relating to the presentation of content ( Web Content Accessibility Guidelines), the accessibility of user agents, including browsers ( User Agent Accessibility Guidelines) and the requirements of authoring tools, including blogs and online forums, for the creation of accessible content and for use by people with disabilities ( Authoring Tool Accessibility Guidelines). As the Web has become an interactive medium, the interrelationships between the guidelines and the users become increasingly important to allow access to information and to allow the creation of information.

It is essential that the different components of Web development and interaction work together in order for the Web to be accessible to people with disabilities (Figure 3). These components include [Henry 2006]:

content - the information in a Web page or Web application, including:

natural information such as text, images, and sounds

code or markup that defines structure, presentation, etc.

Web browsers, media players, and other "user agents"

assistive technology, in some cases - screen readers, alternative keyboards, switches, scanning software, etc

users' knowledge, experiences, and in some cases, adaptive strategies using the Web

developers - designers, coders, authors, etc., including developers with disabilities and users who contribute content

authoring tools - software that creates Web sites, including blogs, content management systems, and learning management systems

evaluation tools - Web accessibility evaluation tools, HTML validators, CSS validators, etc.

Figure 3: How the components of web accessibility relate to each other
The draft WCAG 2.0 has twelve guidelines for accessible content:

1.1 Text Alternatives: Provide text alternatives for any non-text content so that it can be changed into other forms people need, such as large print, braille, speech, symbols or simpler language

1.2 Synchronized Media: Provide synchronized alternatives for synchronized media

1.3 Adaptable: Create content that can be presented in different ways (for example simpler layout) without losing information or structure

1.4 Distinguishable: Make it easier for users to see and hear content including separating foreground from background

2.1 Keyboard Accessible: Make all functionality available from a keyboard

2.2 Enough Time: Provide users with disabilities enough time to read and use content

2.3 Seizures: Do not design content in a way that is known to cause seizures

2.4 Navigable: Provide ways to help users with disabilities navigate, find content and determine where they are

3.1 Readable: Make text content readable and understandable

3.2 Predictable: Make Web pages appear and operate in predictable ways

3.3 Input Assistance: Help users avoid and correct mistakes

4.1 Compatible: Maximize compatibility with current and future user agents, including assistive technologies

The draft ATAG 2.0 has seven principles:

PART A: Make the authoring tool user interface accessible

A.1: Authoring tool must facilitate access by assistive technologies

A.2: Authoring tool user interface must be perceivable

A.3: Authoring tool user interface must be operable

A.4: Authoring tool user interface must be understandable

PART B: Support the production of accessible content

B.1: Production of accessible content must be enabled

B.2: Authors must be supported in the production of accessible content

B.3: Accessibility solutions must be promoted and integrated

The draft UAAG 2.0 has 5 principles:

1. Follow applicable specifications and conventions

2. Facilitate access by assistive technologies

3. Ensure that the user interface is perceivable

4. Ensure that the user interface is operable

5. Ensure that the user interface is understandable

At the guideline or principle level, it can be seen that most of these will be required in order for an increasing number of elderly to be able to access and interact with the Web in future. The detail within these guidelines tells Web site developers, Web application developers, authoring tool and blog developers, and browser and users agent developers, how to achieve this.

3.4 Training the elderly to Use ICT and the Web

Dickinson et al. (2005) [Dickinson 2005] suggest that the provision of training courses to overcome the lack of experience with computers and the Web of many elderly people is a necessary short-term approach to encouraging participation in the digital world. Computer and Web training can take the form of formal class-based training, but also informal training by friends and family who act as "coaches". While many community groups and local libraries provide computer and Web training for their elderly citizens , such as SeniorNett in Norway ([Bjørneby 1999]; [Rogneflåten 2004]) there were few studies that reported on this widespread activity. The studies identified around this topic generally related to formal training situations established for research purposes (e.g. UTOPIA [Dickinson 2002]), and provide insights to the problems experienced by the elderly online.

Kantner and Rosenbaum (2003) [Kantner 2003] undertook a study with a small group of people who had undertaken the role of "coach" to the elderly in Michigan in the USA to identify some of the problems elderly computer users encounter, and some of the solutions. They interviewed seven people who coached elderly people (65 years or older) to use computers and the Web and asked them about the top two problems they had observed, and about their training strategy. Ten common problems were observed by at least 4 of the coaches ( Table 5) and a variety of solutions identified. Some of these problems can be attributed to functional limitations associated with ageing while others (e.g. files/folders, operating systems, and typing) are more a result of lack of familiarity with ICT.

Problem

Solutions

Dexterity, including:
Not anchoring the mouse or holding it straight; Moving the mouse during clicking; Tremor or fine motor control during fly-out/drop-down menu use

Demonstrate required action; send to special "mousing class"; suggest trying various mice; checking desk height; Teach alternative keystroke options (Alt keys, Enter, arrows); using two hands for the mouse

Too much information, including:
What is/isn't an advertisement; Prevalence of 'pop-up' ads; Clutter of portal pages

Switching the start page to Google; training in advertisement recognition; training in clicking the "X" to close pop-up windows

Vision

Coaches were able to change the default font size in Word, but didn't know what to do for browsers or at the operating system level.
One coach changed the resolution to 800x600 as a solution and installed glare filters.

When asked about suggestions for making the Internet easier for seniors to use, the suggestions included:

With respect to the accessibility settings available, three coaches had not thought of it, one did not have the authority, and three had adjusted the mouse settings.

Kantner and Rosenbaum recommended that success stories from coaches need to be collected and published so that others can learn from their experiences.

The experience of the University of Dundee [Dickinson 2005] reflected many of the experiences of the Michigan coaches reported earlier by Kantner and Rosenbaum, including a lack of knowledge and confidence, and confusion about searching. The UTOPIA team at the University of Dundee in Scotland was approached to teach a class of older adults to use computers and the Web. Of the twelve initial participants (five were 55-65 years; five were 65-74 years; two were over 75 years), one had hearing loss, one had impaired fine motor control as a result of stroke, one was dyslexic and ten of them required reading glasses. As experienced computer users themselves, the researchers conducting the classes had to recognise that their own knowledge was a potential problem.

To reduce the software complexity, the interfaces to Word, Outlook Express and Internet Explorer (IE) were simplified (e.g. Figure 4). Even with the reduced IE interface, users became confused when trying to search and often used the address bar instead of the search engine input box. The learners were also surprised when search results loaded a PDF document, and often missed the PDF icon often associated with these files. Drop-down lists allowing for search refinement often confused the participant too.
Figure 4: The simplified IE interface used at the University of Dundee
Dickinson et al. endorsed WAI's guidelines in contributing to the accessibility of Web sites to elderly users, but suggested that that browser changes could also make significant differences to older learners' experience. Compared with the simplified IE interface they worked with, (Figure 4) they emphasised the value of the Home button, and questioned the value of the 'forward arrow' and the address bar. The experience at the University of Dundee also emphasised the importance of written combined with hand-on support for older learners.

Hawthorn (2005) [Hawthorn 2005] also stresses the importance of simplifying the interface for older users new to computers and the Web. Hawthorn worked with a group of 25 older users (average age 70 years) to teach them file management skills using a modification of the UTOPIA methodology [Eisma 2004]. Part of simplifying the interface to the learning environment included large fonts, high contrast, and simple sentence structure. Hawthorn found that building a conceptual framework was possible, but that many of the participants required time and active hands-on exercises.

In another UK study of an Internet training project called Care Online, Osman et al (2005) [Osman 2005] report that, while most of the volunteers had no intention of connecting to the Internet before the project, the majority intended to stay connected afterwards. The project included a portal with large buttons, associated graphics and exceeding the accessibility requirements of WCAG 1.0 "single-a' accessibility. Like Hawthorn, Osman et al. found that appropriate training and support was a key to elderly adults Web usage.

3.5 Studies of elderly Web users' specific disabilities
General ageing studies ... to be discussed here or later in Section 3.8?
3.5.1 Mobility

In addition to the studies on the general issues of ageing, some studies focussed on the particular issues of mobility and dexterity with input devices, specifically mouse use. No studies were identified which investigated issues of keyboard use, although casual observation of the authors own elderly family members indicates that this can be an impediment to ICT usage.

Three studies have been considered here dealing with Parkinson's Disease, general ageing and pointing devices, and a possible solution provided via expanding targets.

Keates and Trewin found that seniors take longer to complete tasks, and pause frequently, while initiating movement can be difficult for people with Parkinson's disease. Parkinson's Disease users were also observed to make slight mouse movements while trying to press the button. Both of these groups behaved differently from the behaviours predicted by the theoretical models developed for able-bodied users. Pointing issues reported from this study and another study (Paradise, Trewin and Keates, 2005) [Paradise 2005] included:

Some of these issues are related specifically to using the Web (e.g. menu use) while others are more broadly disability-related (e.g. hand steadiness and losing the cursor) or very broad ICT usability issues.

Jastrzembski et al (2005) [Jastrzembski 2005] undertook a study on input devices and age/hand effects. Their participants were experienced mouse users and they were investigating whether age had any impact on mouse use and whether a light pen may be a better input device for older users. Of their 72 participants, they had 24 young adults (median age 21.7 years), 25 middle aged adults (median age 49.9 years) and 24 older adults (median age 70.9 years). The study involved both clicking, and data entry, to simulate practical Web use.

While previous studies apparently showed preferences for direct pointing devices such as a light pen, supporting the observation that older adults experience declines in spatial abilities and in motor control and coordination, Jastrzembski et al showed that tasks requiring a combination of keyboard entry and pointer were best completed with a mouse unless the user was required to change from their preferred hand. Jastrzembski et al did suggest that adjusting the mouse acceleration could be a tactic for improving 'target acquisition' among older novice users. Jastrzembski et al did not comment on target size.

The third study reviewed, by Bohan and Scarlett (2003) [Bohan 2003], considered the accommodation of older adults difficulties with mouse use via expanding targets as the cursor approaches. Participants in this study were young adults (median age 20 years) or elderly (median age 81 years), and all reported to be daily computer users. Bohan's and Scarlet's older adults took significantly longer to acquire the 'target' than the younger adults, regardless of target expansion, although early target expansion was found to significantly help the older users almost as much as a stationary larger target.

The first two studies highlighted mouse use issues faced by older ICT users, while the final study suggested a possible Web site technique for overcoming some of these.

3.5.2 Vision

Parker and Scharff (1998) [Parker 1998] in a study of contrast sensitivity and age on readability, found that older adults (over 45 years) performed better with high contrast and positive polarity. In particular, they found that "white text presented on a black background (high-contrast, positive polarity) slows reaction times compared with black text on a white background (high-contrast, negative polarity). At the other [lower] contrast levels, polarity makes no significant difference." They also reported that the effect of polarity was significant for the older age group but not for the younger (18 - 25 years) group.
Editor's Question: Are there some other studies to precede or support this next one of Bernard, Liao and Mills?
Bernard, Liao and Mills (2001) [Bernard 2001] looked at what might be the best font for older adults online bearing in mind the many age-related factors affecting reading. They looked at legibility, reading time and general preference of two types of serif and sans serif fonts at 12 and 14 point sizes. Two-thirds of the 27 participants (mean age 70 years) regularly read material on computer screens, and all had at least 20/40 vision unaided or corrected. Bernard, Liao and Mills found that size was the major factor in legibility as measured by reading efficiency, while a marginal type/size interaction was found for reading speed slightly favouring the sans serif fonts. When just asked about their perception of legibility, the participants indicated that size was the major factor, and overall they had a preference for the san serif fonts.

Bernard, Liao and Mills concluded, not surprisingly, that larger san serif fonts gave the best online reading results for older adults.

Tiresias has some general recommendations with regard to the use of font styles [Tiresias], reflecting many of the guidelines discussed earlier:

Text in upper and lower case is easier to read than all capital letters

Underlining makes the text harder to read by interfering with descenders

Italics are more difficult and slower to read so minimise their usage

Left justified () text is easier to read.

3.5.3 Cognition

There have been many practical and theoretical studies of cognition and Web user interfaces, e.g. Bernard, Hamblin and Scofield (2002) [Bernard 2002], Czerwinski and Larson (2002) [Czerwinski 2002] and Sevilla et al (2007) [Sevilla 2007]. Some researchers have looked specifically at cognition issues as they relate to the elderly, e.g. Savitch and Zaphiris (2006) [Savitch 2006], Caserta and Abrams (2007) [Caserta & Abrams 2007], . Some of these studies deal with general cognition issues for the elderly, while others look at specific situations such as dementia.

Czerwinski and Larson also raise an interesting phenomenon of cognition and the Web that applies to many users, but may apply particularly to elderly users, and is particularly relevant with the move to scripted partial page updates. The phenomenon is "change blindness", where small changes on a page are not noticed by the user. This 'blindness' may be due to distraction, or may be related to concentration and perception. For some users it may actually not even be within the current view, depending on the size of the current browser window and how much of the page is actually displayed. Hudson (2001) [Hudson 2001] suggests that form validation is a particular problem area.

In more elderly-targeted studies, Savitch and Zaphiris (2006) [Savitch 2006] were looking at information architecture issues for people suffering from dementia. They found, in a study involving 10 participants with dementia, that some of them found it difficult to group topics, leading to questions about flat vs. deep navigation systems and the usability of hierarchical navigation systems by this group. While Savitch and Zaphiris suggest that it might be tempting to dismiss the sub-group that couldn't't undertake the grouping exercise, they had no evidence that these people could not use a computer or would not be interested in the information on the Alzheimer's Society Web site as they were very happy to discuss the topics being presented. Savitch and Zaphiris suggest more research is needed around site architecture and navigation system requirements for dementia sufferers.

Berkov (2007) [Berkov 2007] in a small study of Web users with Mild Cognitive Impairment (average age 82 years) who were regular computer users, found that having too many choices on the home page (i.e. a broad navigation system) was confusing for this group.

A study in Spain by Sevilla et al. (2007) [Sevilla 2007] of twenty participants with varying degrees of "intellectual difficulties" ranging in age from 24 to 36 years found that simplified content was a good model. This approach may also assist elderly users suffering from some of the possible effects of stroke such as short-term memory problems and "difficulty in learning new information and problems in conceptualising and generalising" [Brain Foundation 2003]. They present automatic content transformation as a challenge to be solved by the Semantic Web community along with language transformation research.

Gregor and Dickinson (2007) [Gregor 2007] looked at simplified interfaces as a solution to some forms of cognitive impairment, criticising some Web designs for providing 'idiosyncratic means of navigation' and duplicating the functionality of the browser as sources of confusion for some users. They also acknowledged the conflict between on-screen complexity, which can reduce comprehension, and deep interface structure, which places a burden on memory. In a study with novice older Web users, the authors were involved in the development of the "non-browser" in which the browser itself was stripped away to allow the content to fully occupy the screen, and a very reduced set of controls was presented on the bottom of the screen as five buttons (Figure 5) - ideally on a touch screen - such as "go back to start, "go back a page", "look down", "make black and white", and "magnify".
Figure 5: showing the simplified interface from the "non-browser"
Initial studies of eye-movement with older users working with the "non-browser" facilitated users' ability to access the content. This approach is similar to the approach taken by IBM in the development of "Easy Web Browsing" (Figure 6) [Takizawa 2008], but simpler and more drastic visually.

Figure 6: IBM's Easy Web Browsing (CSUN, 2008)

3.5.4 Other aspects

Tolerance

Selvidge (2003) [Selvidge 2003] in a study on tolerance for delays found that older adults (mean age 70.65 years) were more tolerant of delays than younger adults (mean age 20.13 years) in that they waited longer before leaving a site and switched sites less often. Selvidge also observed that the level of Internet experience did not affect tolerance.

Coyne and Nielsen (2002) [Coyne & Nielsen 2002] also found that older users were more forgiving of negative experiences than their younger counterparts.

3.6 Aspects of Web Design affecting the elderly

A study by Johnson and Kent [Johnson 2007] with both younger users (18 - 59 years) and older users (over 60 years) found that designs specifically for the elderly group improved task performance for that group while not detracting from task performance for the younger group. Some of the design aspects targeting the older group were large text size, clearer link text, plain neutral background, input by selection rather than free text, and detailed instructions.

Hawthorn (2003) [Hawthorn 2003], examining the issues that arose during the design of an email system for older users, found that most new older ICT users wanted to "keep it simple so we can learn it". This is in conflict with the techniques used by most designers to support a modern feature rich application, and may also limit the power of an application to serve the requirements of more able and more demanding users. Hawthorn also observes that with the declines in memory, cognition, eyesight and dexterity faced by many ageing people, the ability to adapt to new, more demanding applications is reduced. This observation is probably applicable to the ability of some elderly users to adapt to upgraded browsers and newer Web 2.0 style dynamic online applications.

3.6.1 Forms

Forms are part of our world, and now the Web, and a necessary requirement for e-Commerce, e-Government e-Publishing and most online applications. Even in the paper world, forms are confusing for many users - witness voting, taxes, banking, etc. A form that works on paper may not necessarily work online [Usability.gov forms], however when implemented well, online forms should benefit users. Many people have written about form usability and accessibility (e.g. [Crescimanno 2005]; [Hudson 2004]; [Meadhra 2004]).

Lines and her colleagues from Brunel University ([Lines, Patel and Hones, 2004]; [Lines et al., 2006]; [Lines, Ikechi and Hones, 2007]) looked at a variety of welfare and services forms from the UK local government. Based on a series of interviews with older adults (over 60 years), combined with evaluation of some prototypes, they derived an initial set of seven guidelines, and with a follow-up study, they extended this with six additional requirements. Lines initial requirements were:

Form layout - extra space between questions and answer boxes (not confirmed in the second study)

Simplified question structure - to avoid creating 'excessive' cognitive loads

Question completion assistance - pop-up messages and/or hyperlinked context sensitive help with each appropriate questions

Additional information - including a list at the top of what information will be required to complete the form

Data entry - automatic checking and validation during completion

Form personalisation - presenting only those questions appropriate to the users, e.g. a widow should not be asked for information about her spouse

Form submission - online submission will be easy for many mobility impaired elderly people, and may lead to quicker processing time

Lines second study, with additional forms, led to the following additional requirements:

As can be seen, these requirements mirror many of the requirements for usable online forms identified by many others, but confirm them as necessary for the older person online.

Sayago and Blat (2007) [Sayago 2007] considered two aspects of form design and their impact on elderly users (65-74 years), namely distinguishing between optional and compulsory fields, and the usability of checkboxes, radio-buttons and list-boxes.

While designing a site for a pensioners association in Spain, they found that members had difficulty distinguishing between optional and compulsory fields when the conventional asterisk was used as this was largely invisible to them. In a trial with the conventional asterisk and a form that clearly separated required fields from optional fields, all the participants expressed strong preferences for the "divided online form".

Sayago's and Blat's second evaluation was between checkboxes and radio-buttons vs. list-boxes; they hypothesised that list-boxes might be harder to use due to the number of clicks required. Independently of any previous computer experience, all the participants had difficulty with the list-boxes. The checkbox/radio-button form allowed for a direct selection from the choices, and had larger targets (it used accessible form mark-up) than the list-boxes form with its small down arrow that needs to be clicked to see the available options.

3.6.2 Search

Search has been reported as a key usability feature for many elderly users, but what are the issues for elderly users? Aula (2005) [Aula 2005a] reported on a study of elderly users (mean age 67.3 years) in Finland with varied computer experience using search engines. Some of the problems observed were:

In a follow up study Aula and Käki (2005) [Aula 2005b] had participants use a simplified version of a Finnish search engine, Etsin, in addition to Google. Etsin searches were more successful than Google searches. Aula and Käki concluded that new elderly Web users benefit from simplified interfaces, especially while learning. Dinet et al. (2007) [Dinnet 2007] found that locating relevant information among the search results from search engines was a major problem for elderly users.

Meyer et al. (1997) [Meyer 1997] in a Web navigation study of both older and younger adults relatively new to the Web, found that the older users used the site map more than younger users and that the older users preferred to start from the home page when looking for information.

More recently Chevalier et al. (2007) [Chevalier 2007] investigated the navigation speed, success and satisfaction compared between 20 older (mean age 64 years) and 20 younger (mean age 31 years) experienced Web users on two versions (ergonomic & non-ergonomic) of an e-shop selling music products. The older users took more time than the younger users to perform tasks on the ergonomic site, but a similar length of time on the non-ergonomic site; both groups performed more quickly on the ergonomic site and were more satisfied with it. Chevalier et al. conclude that more research is needed on the specific needs of older users navigating and searching the Web.

Hudson et al. (2008) [Hudson 2008] conducted two studies of young (mean age 20 & 23 years) and older (mean age 61 & 63 years) users use of Web site navigation tools. They found that "Contrary to the assertion that older adults are more prone to disorientation in the WWW, there was no age effect on total pages or repeat pages visited. As well, older adults' navigation benefited from the inclusion of the dynamic side-tree [expanding LHS menu] as much as younger adults and they used it in search at least as much as the young." Hudson et al. did find that the older users took more time to find the information they were seeking. They conclude that cognitive factors, including working memory and processing speed, affect Web navigation performance and that more research is needed as to the optimum ways in which to reduce this. As there is a potential trade-off between increased navigation assistance and page clutter, Hudson et al. also recommend investigating users satisfaction levels and perceived disorientation.

3.6.4 e-Services - Learning, Health, Government, Banking

Australia in 2000 conducted an enquiry into the accessibility of electronic commerce for older people and people with a disability [HREOC 2000]. Scott, Burmeister and Roberts (2002) [Scott 2002] reported on the ensuing initiatives to make Internet banking more accessible for older people in Australia and found an ongoing need for social responsiveness and responsibility toward senior citizens. In reporting on some of the values expressed by seniors they identify independence, security and freedom of choice as some of the reasons for engaging in e-banking activities but that a lack of skills and training combined with Web site inaccessibility were still key barriers. They recommended that the education programs run by senior's computer clubs, University of the Third Age ( U3A), and others could be extended to include e-finance.

3.7 Involving the elderly in Web design and development

Many authors looked at the involvement of the elderly in Web site design and development. These studies all provide some insights into the various ways of drawing upon older people during design and development.

3.7.1 Usability sessions with elderly participants

Making the participants comfortable - making it extra clear up-front what to expect, being extra patient, teaching them something at the end are a few recommendations

Keeping them on track - many older participants had a lot of stories to tell; keeping focussed requires patience and tact

Listen for their beliefs about computers and the Web - this is part of their reality and needs to be accounted for in Web site design

Avoid computer jargon - and take note of the areas, and terms used, on sites that confuse

Give them time - plan for this as older adults can take up to 25% longer to complete tasks than younger people

Thinking aloud - when the task becomes complicated, participants may stop talking; sometimes you need to allow for this and go back later to reflect rather than interrupt the silence

Don't lead - no matter how tempting it is to help!

Teach something at the end - for example changing the text size or some keyboard shortcuts

Newell et al. (2007) [Newell 2007] recommend doing away with the traditional usability laboratory and interacting more with the participants, even if it is necessary to record this (e.g. completed x tasks "with no / minimal / significant assistance"). Newell et al. also investigate the use of theatre professionals in which they encouraged interaction between the participants and the actors to elicit discussion about the issues addressed by the presentation.

3.7.2 Design with the elderly

Gregor, Newell and Zajicek (2002) [Gregor 2002] have suggested that the typical User Centred Design (UCD) process needs to be modified when working with older people due to the greater diversity within the elderly as compared with younger age groups. Gregor, Newell and Zajicek recommend the need for an enhanced UCD methodology, which they refer to as "User Sensitive Inclusive Design", to address the issues of:

3.8 General usability studies involving elderly people

4. Studies that influence WAI work

5. Questions/Topics for further research

Possible ideas:

1. Collecting the experience and solutions used by seniors' training centres and coaches

2. Research on the effect of ageing/impairment/disability on cognitive load

3. Older users use of navigation mechanisms

6. Conclusions/Recommendations

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Appendix - Statistics

A.1 Demographics

The world's population is living longer with a disproportionate number of people soon to be elderly as compared with any other period in human history. The United Nations estimates that by 2050 one out of every five people will be over 60 years, and by 2150, one third of the people in the world are expected to be 60 years of age or older [UN 1998].

In Europe, as elsewhere, the population is also aging. European countries in 1950 had a population of age 65+ of some 45 million; in 1995 the population of age 65+ had already more than doubled to 101 million (approx. 15%); by 2050 Europe will have 173 million people age 65+ (20% of the population).

In the EU-25 countries, this means a change from 2000 when 15.7% of the population was over 64, to an estimated 17.6% in 2010 and 20.7% in 2020 (Figure A.1.1; Table A.1.1). The trends by country are also interesting, and vary considerably (Figure A.1.2). The EU-25 countries had a dependency ratio of approximately 18 percent in 1970, but expected to rise to approximately 27% by 2010 and 54 percent by 2050; across the EU the 2010 prediction ranges from approx 17 percent in Slovakia to 32 percent in Italy (Figure A.1.2).

This trend will put tremendous pressure on society in terms of supporting the elderly population, and any means to assist them to continue contributing to and participating in society, and to "age in place", needs to be adopted.

Figure A.1.1: Population structure by major age group for EU-25 countries (1960 to 2050 estimates)
see also Table A.1.1 below ( EC 2007a)

Age

1960

1970

1980

1990

2000

2010

2020

2030

2040

2050

Figure A.1.2: Old age dependency ratio for EU-25 countries (1970 and 2010, 2050 estimates)
(population aged 65 and over as a percentage of the working age population [15-64 years]) ( EC 2007a)

A.2 Older people online

Australia

Internet access in 2006 in Australia by people living in occupied private dwellings was analysed by age group. The Australia Bureau of Statistics found that people with ages between 5 and 14 have the highest proportion of access, followed by people in the 15-24 age range. They found the proportion tapers off sharply for people over 55 years, with only a quarter of people 75 years or above having access to the Internet in 2006 as shown in Figures A.2.1a and A.2.1b [ ABS 2007].

Figure A.2.1a - Internet access by age group in 2006 for Australian males

Figure A.2.1b - Internet access by age group in 2006 for Australian females ( ABS, 2007)

United Kingdom

In the UK a 2004 survey (Morris, Goodman and Brading, 2007) showed that approximately one-third of older people in Scotland and in Derbyshire in the UK (over 55 years) had used the internet at some point in their lives with use dropping with age (Figure A.2.2). The Office of National Statistics in the UK showed that by 2006 that figured was increasing (Table A.2.1).

Figure A.2.2 - Internet use at any point in their lives (survey from Scotland and Derbyshire UK, 2004)

Between 3 months
and 1 year ago

Spain

In Spain, a 2007 survey by the National Statistics Institute reported that percentage of older people using computers and the internet dropped very sharply for 65-74 years old people compared with 55-64 year olds (Table 2.2.2).

Age groups

used a computer in the last 3 month

used the Internet in the last 3 months

used the Internet at least once a week in the last 3 months

made a purchase over the Internet in the last 3 months

# data[].attributes.attachment_link.title
Web Accessibility for Older Users: A Literature Review

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This document provides a review and analysis of guidelines and articles relating to the needs of older people with Web accessibility needs due to ageing, and compares these with the needs of people with disabilities as already addressed in WAI guidelines. The focus is particularly on Europe but applies internationally as well.

# data[].attributes.body
Topic reading: I read the literature on digital interface design, technology acceptance by older users, and web accessibility.

Key findings: The literature shows that factors such as simplified interfaces, clear navigation cues, and social presence are critical for improving the experience of older users.

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Aesthetic and ethical balance

Understanding the impact of fragmentation

The importance of ethical issues

Prevent negative consequences

Improve your design skills

How do these design decisions affect the experience of specific user groups, such as older users

Provides a comprehensive perspective to help me understand the various factors to consider when designing a digital interface

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Case Selection: I focused on the AARP website as a case study because it was designed for older users and addressed many of the key factors I found in the literature review.
Case Insights: The AARP website shows how age-friendly design can be achieved through its high-contrast color scheme, large font size, and simplified navigation system. In addition, the content and community interaction features it provides also show the importance of user engagement.

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Visual complexity of websites Effects on users

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Visual complexity of websites Effects on users

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Design best Practices:
ensuring accessibility and ease of use is key, and this includes clear visual elements, simplified design, and an intuitive user interface.

Value of social interaction:
providing opportunities for social interaction, such as forums and live chat, can enhance feelings of trust and satisfaction among older users.

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Further research: I plan to further explore how different design elements affect user satisfaction and engagement

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By 2030, around 19% of people in the US will be over 65. Doesn't sound like a lot? Well it happens to be about the same number of people in the US who own an iPhone today. Which of these two groups do you think Silicon Valley spends more time thinking about? This seems unfortunate when you consider all of the things technology has to offer older people. A lot of people in the tech industry talk about "changing the world" and "making people's lives better." But bad design is excluding whole sections of the population from the benefits of technology. If you're a designer, you can help change that!

If you work in the tech industry, it's easy to forget that older people exist. Most tech workers are really young, so it's easy to see why most technology is designed for young people. But consider this: By 2030, around 19% of people in the US will be over 65. Doesn't sound like a lot? Well it happens to be about the same number of people in the US who own an iPhone today. Which of these two groups do you think Silicon Valley spends more time thinking about?

This seems unfortunate when you consider all of the things technology has to offer older people. A great example is Speaking Exchange, an initiative that connects retirees in the US with kids who are learning English in Brazil. Check out the video below, but beware - it's a tear-jerker.

CNA - Speaking Exchange (watch the video on YoutTube)

While the ageing process is different for everyone, we all go through some fundamental changes. Not all of them are what you'd expect. For example, despite declining health, older people tend to be significantly happier and better at appreciating what they have.

But ageing makes some things harder as well, and one of those things is using technology. If you're designing technology for older people, below are seven key things you need to know.

(How old is old? It depends. While I've deliberately avoided trying to define such an amorphous group using chronological boundaries, it's safe to assume that each of the following issues becomes increasingly significant after 65 years of age.)

Vision And Hearing

From the age of about 40, the lens of the eye begins to harden, causing a condition called "presbyopia." This is a normal part of ageing that makes it increasingly difficult to read text that is small and close.

Here's a 75-year-old with his Kindle. Take a look at the font size he picks when he's in control. Now compare it to the average font size on an iPhone. (Image: Navy Design.) (View large version)

Color vision also declines with age, and we become worse at distinguishing between similar colors. In particular, shades of blue appear to be faded or desaturated.

Hearing also declines in predictable ways, and a large proportion of people over 65 have some form of hearing loss. While audio is seldom fundamental to interaction with a product, there are obvious implications for certain types of content.

Key Lessons

Avoid font sizes smaller than 16 pixels (depending of course on device, viewing distance, line height etc.).

Let people adjust text size themselves.

Pay particular attention to contrast ratios with text.

Avoid blue for important interface elements.

Always test your product using screen readers.

Provide subtitles when video or audio content is fundamental to the user experience.

Motor Control

Our motor skills decline with age, which makes it harder to use computers in various ways. For example, during some user testing at a retirement village, we saw an 80-year-old who always uses the mouse with two hands. Like many older people, she had a lot of trouble hitting interface targets and moving from one thing to the next.

In the general population, a mouse is more accurate than a finger. But in our user testing, we've seen older people perform better using touch interfaces. This is consistent with research that shows that finger tapping declines later than some other motor skills.

Key Lessons

Reduce the distance between interface elements that are likely to be used in sequence (such as form fields), but make sure they're at least 2 millimeters apart.

Buttons on touch interfaces should be at least 9.6 millimeters diagonally (for example, 44 × 44 pixels on an iPad) for ages up to 70, and larger for older people.

Interface elements to be clicked with a mouse (such as forms and buttons) should be at least 11 millimeters diagonally.

Pay attention to sizing in human interface guidelines (Luke Wroblewski has a good roundup of guidelines for different platforms).

Device Use

"If you want to predict the future, just look at what middle-class American teens are doing. Right now, they're using their mobile phones for everything." - Dustin Curtis

It's safe to assume Dustin has never watched a 75-year-old use a mobile phone. Eventually, changes in vision and motor control make small screens impractical for everyone. Smartphones are a young person's tool, and not even the coolest teenager can escape their biological destiny.

In our research, older people consistently described phones as "annoying" and "fiddly." Those who own them seldom use them, often not touching them for days at a time. They often ignore SMS' entirely.

Examples of technology used by the elderly (Image: Navy Design) (View large version)

But older people aren't afraid to try new technology when they see a clear benefit. For example, older people are the largest users of tablets. This makes sense when you consider the defining difference between a tablet and a phone: screen size. The recent slump in tablet sales also makes sense if you accept that older people have longer upgrade cycles than younger people.

Key Lessons

Avoid small-screen devices (i.e. phones).

Don't rely on SMS to convey important information.

Relationships

Older people have different relationships than young people, at least partly because they've had more time to cultivate them. For example, we conducted some research into how older people interact with health care professionals. In many cases, they've seen the same doctors for decades, leading to a very high degree of trust.

"I regard it like going to see old pals.... I feel I could tell my GP almost anything." - George, 73, on visiting his medical team

But due to health and mobility issues, the world available to the elderly is often smaller - both physically and socially. Digital technology has an obvious role to play here, by connecting people virtually when being in the same room is hard.

Key Lessons

Enable connection with a smaller, more important group of people (not a big, undifferentiated social network).

Don't overemphasize security and privacy controls when trusted people are involved.

Be sensitive to issues of isolation.

Life Stage

During a user testing session, I sat with a 66-year-old as she signed up for an Apple ID. She was asked to complete a series of security questions. She read the first question out loud. "What was the model of your first car?" She laughed. "I have no idea! What car did I have in 1968? What a stupid question!"

It's natural for a 30-year-old programmer to assume that this question has meaning for everyone, but it contains an implicit assumption about which life stage the user is at. Don't make the same mistake in your design.

Key Lessons

Beware of content or functionality that implicitly assumes someone is young or at a certain stage in life.

Experience With Technology

I once sat with a man in his 80s as he used a library interface. "I know there are things down there that I want to read" he said, gesturing to the bottom of the screen, "but I can't figure out how to get to them." After I taught him how to use a scrollbar, his experience changed completely. In another session, two of the older participants told me that they'd never used a search field before.

Generally when you're designing interfaces, you're working within a certain kind of scaffolding. And it's easy to assume that everyone knows how that scaffolding works. But people who didn't grow up with computers might have never used the interface elements we take for granted. Is a scrollbar a good design for moving content up and down? Is its function self-evident? These aren't questions most designers often ask. But the success of your design might depend on a thousand parts of the interface that you can't control and probably aren't even aware of.

Key Lessons

Don't make assumptions about prior knowledge.

Interrogate all parts of your design for usability, even the parts you didn't create.

Cognition

The science of cognition is a huge topic, and ageing changes how we think in unpredictable ways. Some people are razor-sharp in their 80s, while others decline as early as in their 60s.

Despite this variability, three areas are particularly relevant to designing for the elderly: memory, attention and decision-making. (For a more comprehensive view of cognitive change with age, chapter 1 of Brain Aging: Models, Methods, and Mechanisms is a great place to start.)

Memory

There are different kinds of memory, and they're affected differently by the ageing process. For example, procedural memory (that is, remembering how to do things) is generally unaffected. People of all ages are able to learn new skills and reproduce them over time.

But other types of memory suffer as we age. Short-term memory and episodic memory are particularly vulnerable. And, although the causes are unclear, older people often have difficulty manipulating the contents of their working memory. This means that they may have trouble understanding how to combine complex new concepts in a product or interface.

Prospective memory (remembering to do something in the future) also suffers. This is particularly relevant for habitual tasks, like remembering to take medication at the right time every day.

How do people manage this decline? In our research, we've found that paper is king. Older people almost exclusively use calendars and diaries to supplement their memory. But well-designed technology has great potential to provide cues for these important actions.

For older people, paper is king. (Image: Navy Design) (View large version)

Key Lessons

Introduce product features gradually over time to prevent cognitive overload.

Avoid splitting tasks across multiple screens if they require memory of previous actions.

During longer tasks, give clear feedback on progress and reminders of goals.

Provide reminders and alerts as cues for habitual actions.

Attention

It's easy to view ageing as a decline, but it's not all bad news. In our research, we've observed one big advantage: Elderly people consistently excel in attention span, persistence and thoroughness. Jakob Nielsen has observed similar things, finding that 95% of seniors are "methodical" in their behaviors. This is significant in a world where the average person's attention span has actually dropped below the level of a goldfish.

It can be a great feeling to watch an older user really take the time to explore your design during a testing session. And it means that older people often find things that younger people skip right over. I often find myself admiring this way of interacting with the world. But the obvious downside of a slower pace is increased time to complete tasks.

Older people are also less adept at dividing their attention between multiple tasks. In a world obsessed with multitasking, this can seem like a handicap. But because multi-tasking is probably a bad idea in the first place, designing products that help people to focus on one thing at a time can have benefits for all age groups.

Key Lessons

Don't be afraid of long-form text and deep content.

Allow for greater time intervals in interactions (for example, server timeouts, inactivity warnings).

Avoid dividing users' attention between multiple tasks or parts of the screen.

Decision-Making

Young people tend to weigh a lot of options before settling on one. Older people make decisions a bit differently. They tend to emphasize prior knowledge (perhaps because they've had more time to accumulate it). And they give more weight to the opinions of experts (for example, their doctor for medical decisions).

The exact reason for this is unclear, but it may be due to other cognitive limitations that make comparing new options more difficult.

Key Lessons

Prioritize shortcuts to previous choices ahead of new alternatives.

Information framed as expert opinion may be more persuasive (but don't abuse this bias).

Conclusion

A lot of people in the tech industry talk about "changing the world" and "making people's lives better." But bad design is excluding whole sections of the population from the benefits of technology. If you're a designer, you can help change that. By following some simple principles, you can create more inclusive products that work better for everyone, especially the people who need them the most.
Payment for this article was donated to Alzheimer's Australia.
Further Reading

(cc, ml, al, il, mrn)

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Designing For The Elderly: Ways Older People Use Digital Technology Differently - Smashing Magazine

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By 2030, around 19% of people in the US will be over 65. Doesn't sound like a lot? Well it happens to be about the same number of people in the US who own an iPhone today. Which of these two groups do you think Silicon Valley spends more time thinking about?

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We recently re-built an eCommerce website selling wheelchairs, mobility scooters and stair lifts. As the target group were elderly and disabled people, we had to consider that some users may have poor eyesight and difficulty with hand-eye coordination.

In this post I want to share some of what we learned from this experience. The tips below will help you build for a wider audience possible by making your website available to everyone.

The website usability challenge

Standard website usability requirements are a simple, clean design, intuitive navigation, responsive design and AMP pages for fast mobile loading.

Developing a website for disabled and elderly users requires extra thought. Here are some common problems that web designers may have never even considered:

Sufferers of epilepsy may have problems with flashing colours on screen and fast movements such as rollovers and slideshow.

People with poor hand-eye coordination struggle to use a mouse with precision.

Color blind users may not see the difference between two coloured area of a website

Users with poor eyesight and blind internet users will really struggle with a standard website (yet as we shall see later, it is perfectly possible to build a website for blind user).

Tips for building a website for disabled and elderly users

1. Use large clickable areas

Much like you would when designing a website for a mobile phone user, ensure that all clickable areas (such as links and popups) are extra large with ample spaces between clickable areas with no overlaps. This will help the users locate the area and make sure they can click it without hitting the wrong link by mistake.

2. Use high contrast colours

Whenever the use of colour to distinguish one area of a page from another is necessary for usability, make sure you use high contrast to allow colour blind and visually impaired users to see the difference.

3. Write clear, practical and to the point content

Ensure your contents are clearly written, simple and straight to the point. Blind and visually impaired users often use screen readers - waffly content is not helpful.

4. Write your pages for screen readers

Again, as blind and visually impaired users will be using a Screen Reader, here are a few techniques to optimize your page for their Screen Readers:

Use image alt tags. Whilst the image alt tag is commonly cited as a SEO tool. It is also used by screen readers to describe what is in an image.

Write front loaded paragraphs. This means putting the conclusion at the beginning of the page/ paragraph to allow the user to skip it if they are not interested in the content.

Start with the important information on each page with an accurate page title and clear opening paragraph.

Remove anything that is not necessary. Blind users cannot skim read an article as easily, so keep out irrelevant content and add only links that are useful. The user should be able to easily find a link to exactly what they need in one click (without having to go through lots of pages.

5. Make links stand out

Many websites use subtly coloured links on their content instead of the traditional underline on mouseover. Whilst this is more aesthetically pleasing to some, it wont help colour-blind users

6. Resizable text - use it!

Ever seen the A- A+ buttons on a website? They are used to increase/ decrease the size of text on a page. They are not used by most people, but if your website demographic includes the elderly or people with poor eyesight, you should use a font resizer. Most CMS aoftware such as WordPress and Joomla offer this functionality as standard - you will just need to switch it on to get it working.

7. Absolutely no flashing lights and fast movements

If you have features such as colour changes on mouseover, or quick movements such as slideshows, make sure that they employ gentle movements and soft changes. This will prevent unnecessary stress in some users and avoid causing issues for users with problems such as photosensitive epilepsy.

8. Use simple and highly intuitive navigation

This applies to all websites, but is particularly to users who find web pages complex and stressful, for example people who suffer from dyslexia. When building a website for disabled and elderly users, make the navigation simple and intuitive. Use simple menu titles and a well structured hierarchy.

Put your website to the test

Once you have built your website for disabled and elderly users, it is essential that you put it to the test - collect client feedback and act on it.

If you get your design right, you may well see new clients flocking to your website as it is one of the few sites out there that is so easy to use.

Tests for your website

Here are a list of excellent tests to see how well it has been built. They include page speed tests, a broken link checker, Schema checker and a HTML error spotter.

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Designing a website for disabled and elderly users

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How to build a website for disabled and elderly users - web design for blind, colour blind, and people with other internet usability problems.