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Design lessons from the cognitively disabled
- 1. Design pointers from the cognitively disabled A Reminiscence Therapy application design project
- 2. Plan Our project Our project findings Home page example
- 3. Background Sponsor: Callaghan Innovation Opportunities in R&D for aging population Dementia Reminiscence Therapy on a tablet
- 4. Reminiscence Therapy Conversation Access long-term memory Use of prompts Benefits “It makes people happy”
- 5. Our Project: Designing the app Academic research Competitive research Field research for RT design
- 6. Our Findings: Key areas for design Tablets work fine , but gestures may need to be relearned Predictable experience (simple mental model) Keep everything consistent: navigation, design elements, look and feel Make it responsive/instant feedback Low in cognitive burden No distractions or “function-free” elements Remove unnecessary choices Use labels/descriptions in simple language (but not too abstract) Personalise Customise classification systems (people remember their own labels) Use own materials if possible Focus on (re)learnability
- 7. Example using an earlier prototype
- 8. Our re-designed home page
- 9. Reflections It’s very hard to make things simple! Cognitive burden is universal
Editor's Notes
- Good afternoon. It’s my privilege to represent my team today. I am Helen McCormick; my team mates are Sony Chaudhari and Lingling Dong. We were lucky enough to do an app design project this semester; where the app is intended for use by people with dementia. Designing for the cognitively disabled is not a conventional design task so we are sharing some of the things we learned with you today.
- The plan is to tell you about our project’s background so you have the context. Then a little about what we learned through the project through our own and other people’s research Then we’ll look at a short example of how we applied our knowledge to the design of the app’s home page.
- First up – the project. Our industry sponsor was Callaghan Innovation. Callaghan is looking at the opportunities for commercialising products & services that work with elderly people. It’s a really good time to invest in innovation in this area now since the demographics in most western countries, & Japan and China, are indicating a large increase in the proportion of elderly people over the next thirty years. We need innovations to improve the chances that more people spend their old age fit, healthy and in full command of their faculties; While we all hope that medical advances will continue, there are still opportunities to use technology to make existing therapies more widely available. And especially so for people with dementia, which is one of the biggest threats to a health in the elderly. Our project for Callaghan was to design a Reminiscence Therapy application for a tablet.
- A short note about Reminiscence Therapy. I’m going to call it RT for short. RT has been around for a while, and it’s not just for dementia, but there are particular aspects that make it well suited. First up: it’s a conversation. People with dementia often become socially isolated because of the communication difficulties; RT puts a structure around an interaction that makes it easier for both sides. Secondly, it uses long-term memories, which are still accessible (with help) for people with dementia. The therapist uses prompts (old photos, objects, anything) to ask the person a about their life. An example: the therapist hands over a seed packet and asks “Did you ever grow this in your garden?”, and there’s a conversation started Benefits: There is some evidence that RT can improve cognitive function. Dementia causes physical damage to the brain; RT doesn’t fix any of this but it apparently helps people do better with what they have. More importantly, it makes people happy. Both the person with dementia and the caregivers enjoy it. So why not make this activity available on a tablet and bring the generations together.
- To design our app, we hit the books first and researched dementia, design for accessibility and cognitive impairments, and design for usability- to get a general understanding of the aspects we needed to look at We also looked at competing apps to see the approach other people had taken to organising material, and the user interface We also carried out some field work under the supervision of Alzheimers Canterbury, with one of their larger Memory Groups. That’s a group of people with dementia. We invited their caregivers along to our session, and asked people to try out some iPads with reminiscence type applications. It was a great session, with a lot learned on both sides!
- These are our findings from our research: People with dementia (mild-moderate impairment) can use tablets just fine – tap and swipe takes about 5-10 minutes to learn. A simple, predictable experience is needed – not something with layers of depth and decisions at every point; with instant feedback, and fast response. Delays make these people think they’ve broken it. Low in cognitive burden – the less stuff that needs to be processed by the brain, the better; every visual element on the screen needs to be processed. Labels – one-word labels can be quite abstract concepts, open to misinterpretation if your brain is struggling. So more concrete words may be needed, and maybe a short phrase. This came from a paper about designing an information website for people with severe mental illness. Personalising – this is no surprise for a therapy application focused on helping people remember and talk about themselves. For dementia and other severe mental illness, designing for easy re-learning is key. People may not remember what they did or how they did it last time. We don’t have “expert” users who get different functionality as they advance. We just need them to be having fun within 5-10 minutes.
- Looking at an example of high cognitive burden: this is from an earlier prototype I’ll just point out 3 things that create burden (there are more!): 1. The decorative elements – it takes effort to process all those colours and bands in order to decide it’s just decoration. The action buttons are spatially separated from the label. It’s harder to relate things together when they are further apart. Most of the time, you would be in this screen ready to do a therapy session. Once you have set up your materials, you may edit them infrequently. But every time you are in the home page you have to process the 6 Edit buttons and make the decision to ignore them. These are unnecessary decisions which some more thinking can eliminate.
- This is our redesigned home page, using some of the things we’ve learned. It’s not perfect yet but we hope we’ve addressed some of the issues we saw in the earlier version. Overall, we think we have reduced the cognitive burden for the page. 1. No decorative elements. Everything on the screen has a function, even if it’s just to divide the navigation zone at the bottom from the action area. This isn’t pretty because we’ve stuck to high contrast black and white, with red to indicate a tap selection made – a graphic designer may have a more soothing palette while still retaining contrast. And we’d probably reduce the size of the Setup button compared to the topics size. Here the topics (which are defined by the users, in their language) are active links – there is no spatial separation to process. 3. We moved the content management out into a different mode to reduce the amount of unnecessary decision-making. So instead of 6 unnecesary decisions, there is only 1. We have added burden because we allow more text on the screen, so people have to read. But they are topics, labels chosen by the users so will be appropriate language for them. We’ve suggested that the next prototype team test to see if the Big categories (Places, People, Things to do, etc) are necessary or if they just add to burden. So that’s an example of how we put some of the findings to use.
- Just to conclude, We found that designing something to be simple is much harder than we would have thought! I guess that’s why Apple gets the market share it does. Cognitive burden is universal – and you don’t have to have dementia or a serious mental illness to be – temporarily – cognitively impaired. A drink will do it; being hungry or tired, sick, stressed. So if our workplace applications were designed to reduce cognitive burden, would we get more done?