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Article by Siddhi Lama

When Mary, a retired nurse, walked into her audiologist’s office, she was furious. She’d already been back to talk to the dispensing assistants five times that month and she was at her wit’s end.

Like most other older adults, Mary’s health had started to decline with age. She had started using hearing aids over a decade prior and hadn’t had too much trouble with them. But when her last hearing aids broke, they were an old model that couldn’t be repaired. She ended up with a pair that looked sleek, slim, and modern, with a touchpad different modes and volume settings were achieved by swiping, tapping, and pressing.

Although she felt she understood how they worked, it seemed like she was constantly accidentally changing the settings. Just tying her hair back or adjusting her glasses seemed to change the settings on her hearing aids. To make matters worse, there was no sensitivity settings adjustment for this model.

That day, she arrived at the audiologist’s office tired, frustrated, and angry. Maybe it was just her reduced mobility and dexterity – the curse of getting older – but she couldn’t use this product. If she couldn’t find a model that worked for her, she’d rather go back to her older model. Even if they weren’t fully functional, at least her old hearing aids had never given her this much trouble.

Mary’s experience is not a unique one. According to Pierre-Jean Cobut, CEO and Cofounder of Spry Health, medical devices have often failed to take patients’ needs, especially their social needs, into account. “It is so important for individuals as they age to have access to products that are designed with their needs in mind, so they can keep on living a quality of life they deserve,” said Cobut.

The unfortunate truth is that most products in our society — both medical and otherwise — are designed without taking age-related changes into consideration. This doesn’t mean that products need to be exclusively designed for specific populations, though. Truly inclusive design benefits everyone, not just the elderly.

Age-related changes to consider in inclusive design

As we get older, our bodies start to experience a variety of changes. Our vision, hearing, and motor control begin to decline, and our muscle strength and cognition are gradually altered. Certain age-related changes can be partially mediated. For instance, regular strengthening exercises can help reduce age-related muscle loss. Most changes, though, are a normal part of aging.

Any individual one of these changes might not be problematic. However, according to Jeff Johnson Ph.D. and Kate Finn Ph.D., co-authors of Designing User Interfaces for an Aging Population, the issue is that older adults often experience multiple age-related declines at the same time. “Faced with an inaccessible app, website, or appliance, older adults may not be able to compensate for one disability by using another sensory system.”

Age-related changes can impact people in a myriad of different ways. Even something as simple as your fashion choices may affect you as you age. “Style has a bearing on the way that glasses can be dispensed,” said Peter Beverley-Smith, a member of the British College of Optometrists. “A lot of the time people want to have larger frames, like aviators.”

The trouble with these large frames is that, given their size, the lens radius needs to be bigger than the aperture. “This means that a lens can end up being really quite thick and quite heavy.”

While this may seem like it’s merely a fashion issue, it’s much more of a problem for the older population because of the increase in age-related vision changes like presbyopia, cataracts, glaucoma, and macular degeneration. “We’ve had to say, I’m sorry, we can’t make those frames up for you because the lens size is so big.”

The issue with dispensing glasses isn’t just a matter of just vision-related changes. Even if an optical team can make your lenses, there’s the question of whether or not they should. “As you age, your skin thins a bit, and there’s less padding, which can affect the type of glasses you’re able to wear.” Given the increase in wound healing issues that occur as you age, something as simple as the wrong frames can actually lead to serious issues. In these cases, the optical team is forced to decide whether or not a product is suitable for the consumer.

Applying inclusive design to healthcare products

Some companies and designers have taken the importance of age-related changes into account when designing new products. Rather than ignore age-related issues, these products aim to be inclusive for even the most vulnerable of people — but that doesn’t mean that there aren’t still challenges along the way.

Cobut’s attempt to tackle this problem inspired the development of The Loop System, a wristband capable of alerting healthcare teams to patients’ subtle cardiopulmonary changes. “The elderly with pulmonary conditions like COPD have traditionally been provided with devices that are boxy and difficult to navigate. These individuals want to manage their condition, but have run into several roadblocks — one being the design and function of medical devices.” Cobut found that having a device that was easy to read and understand gave patients daily reassurance amidst very challenging and even scary conditions.

Yet, in the team’s research, they found that certain design elements still needed to be addressed as they moved forward with their product. “Many individuals had difficulty with fine motor skills, and a strap with a pin-and-hole was a challenge for them.” Simply swapping the pin-and-hole model for a velcro strap greatly improved user experience.

Inclusive design benefits everyone

Rather than creating more of the awkward, complicated, or bulky products that are often created with older users in mind, companies should focus on inclusive design. Ultimately, the goal should be the creation of products and services users can age with and that appeal to various populations.

A large portion of design inclusivity is purely about simplification. Johnson and Finn recommend minimizing the need to scroll through a series of pages or menus. Reducing this complexity and aiming for a one-screen design can go a long way in making a product easier to understand and navigate, regardless of a person’s age.

When considering inclusive design, most people think about making visual improvements for older users. Designers consider using larger font sizes, reducing the amount of text, or increasing the contrast between the text and the background. However, “although visual design is an important part of making digital systems accessible to older adults,” Johnson says that, “other design considerations are at least as important.”

If a piece of information is important, it should be available in multiple ways. For example, if the important information is provided in the form of a video, the video should come with captions. Additionally, transcripts should be provided in case the captions move too quickly for readers. Or, if the information is written out, there should be a way for the user to listen to the text through a “read aloud” function.

Although many products today involve some sort of tech component, inclusive design applies to all aspects of design. Take curb cuts on streets, for instance, designed to help people in wheelchairs navigate cities.

“In addition to making city streets and sidewalks accessible to wheelchair users, curb cuts help people pushing strollers and shopping carts, pulling roller bags, riding bikes and scooters — even kids on skateboards and hoverboards. In fact,” Johnson says, “we can say with confidence that curb cuts help more people who are NOT in wheelchairs than they help people in wheelchairs. That is the sort of win-win design that we strive for in universal or inclusive design.”

This article is sponsored by Spry Health. COPD is the fourth leading cause of death in the United States – devastating communities and crippling the financial infrastructure of health systems with episodic, reactive, and costly care. Spry Health delivers an FDA cleared solution that enables care teams to prevent costly exacerbations. Spry Health has developed the clinical-grade wrist-worn Loop that remotely collects continuous SpO2, respiration rate, and heart rate. Using machine learning, Loop Analytics contextualizes the data and identifies early signs of deterioration. It gives clinicians the information they need to intervene and provide targeted care to patients, enabling better health outcomes and avoiding costly hospitalizations. Clinical trials have shown a 95% reduction in costs and a 92% compliance rate. Are you ready to create better care and outcomes for your COPD patients? Try out the Loop for free.

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