11 tips to create better UIs for people with Alzheimer’s and PD

People diagnosed with Alzheimer’s, Parkinson Disease or senile dementia should be involved in all stages of planning. Not only will this help you to understand, validate and meet real needs, but it will also improve your empathy for those you are planning for.

However, it can be difficult to find and recruit people affected by dementia. If you struggle to find subjects to include in your research, we recommend the following:

* Visit people affected by dementia rather than bringing them to you. This will help you learn more about their context of use and reduce the burden on them.
* Use online dementia communities such as Dementia Talking Point and Reddit to reach representative people
* Contact local services in your area, including hospitals and special care services.
* Use social media such as Twitter and Facebook
* Consider using specialist research participant recruiters.

Each type of dementia can damage the visual system in different ways. Dementia usually affects older people, although it can affect younger people. This can mean that age-related visual deterioration can also affect the person living with a diagnosis or their carers.
Take this into account when designing digital user interfaces:
* Using high-contrast colour schemes to improve readability,
* Using solid colour backgrounds instead of patterns or images for textual content,
* Avoiding the use of blue, especially for important interface components.

For more information, please check our post on Visual Accessibility (includes a full infographic you can download as quick guide)

People with senile dementia, Alzheimer’s or PD may have difficulty remembering things and become disoriented. Try to make the navigation clear and provide a way back to the home page or the beginning.
This can be achieved by:

* Providing a clear link to the “home” page or the beginning.
* Using clear section breaks to make subdivisions and stages clear.
* Making hyperlinks and states such as “visited link” clear.
* Avoid splitting tasks across multiple screens.
* Avoid hiding navigation off-screen.

People with dementia may have difficulty with language. For example, remembering a word or terminology. Therefore, you should use very clear, specific and unambiguous language.

This means the following:

* Use simple, clear, direct and concise paragraphs, headings and labels and using explicit and engaging content.
* Use dementia-friendly language, such as ‘living with’ rather than ‘suffering from’ dementia.
* Avoid generic calls to action, complex wordplay and jargon.
* Avoid the use of abbreviations and acronyms.
* Do not use loaded words or concepts.

People diagnosed with dementia may be particularly sensitive to visual stimuli, such as photographs or video footage of themselves. It is therefore important to avoid using images that may cause anxiety.

It is also important not to overdo it with symbolism in your design. In short, the things to consider at this stage are:

* Use only a small amount of background imagery, otherwise it can be distracting and confusing as you scroll through the screen (e.g., an excessive number of identical shots).
* Avoid too much scrolling image content, as this can make UI feel slow and unresponsive
* If you need multiple images within a UI element (e.g. a page header), space them out so they don’t appear jumbled.
* Consider using text-based headings instead of icons or emoticons when communicating emotional states (e.g., frowning faces).

When letterforms and words are simple and easy to recognise, it improves readability and comprehension for all people on all devices.

When building a better UI for people with Alzheimer’s or Parkinson, consider the following:

* Using sans serif fonts, as letterforms tend to be easier to read on digital screens.
* Using larger text sizes (and higher contrasts) to provide more information to the eye. This is especially important for older people whose eyesight declines with age.
* Avoid using multiple fonts unnecessarily. This can make the user interface and content confusing.
* Avoid thin or extra light fonts as they’re very difficult to read.

Being able to access digital services while doing other things improves the daily lives of many people with dementia. By using a good user interface, they can work independently by spending less time waiting for information from other sources.

For example, they become more independent in managing their own finances by separating banking tasks from other activities such as making phone calls or writing emails. Or they can even walk down the street without being confronted with advertising messages every few steps, which may result in a massive cognitive overload.

However, some users are less able than others to switch between tasks quickly enough and still focus on what they’re doing. This is where asynchronous interaction comes in with user experiences built around “before”, “during” and “after”: During a chat session or phone call, for example, users can read an article or document on the screen and then scroll back up to see the person they’re talking to.

Interruptions from multiple sources can cause confusion, and people with dementia often have difficulty managing multiple tasks simultaneously. Thus, any good design solutions should be designed for asynchronous interaction (within applications, within websites) whenever possible.

Some of the cases to consider for asynchronous interaction are:

* When using browser tabs, so that content changes in one tab are reflected in other tabs without the user having to click back and forth between them (e.g., when accessing news pages).
* When users can see information from multiple apps at once, e.g. displaying Facebook updates next to WhatsApp messages side by side when reading an online magazine.
* When receiving notifications about emails sent via different services on your device, such as Gmail/ Facebook Messenger /WhatsApp

It’s common to see notifications from different apps all displayed together in a single conversation window – with each app only displaying its own notification. We should try to minimize this cognitive load and provide a method to manage these notifications in asynchronous mode.

When creating user interfaces for people with PD, Alzheimer’s or dementia, we must avoid recognition errors due to unfamiliar objects or behaviours triggered by unexpected events.

Users with memory loss sometimes misinterpret familiar objects. Example: Familiar pets behave strangely due to lack of familiarity and put them in threatening situations, leading to dangerous misunderstandings that need to be corrected immediately.

Simply put, when something unusual happens during normal activities, it can lead to misinterpretation and even risky behaviors, such as defense/attack reactions, runaways, or stress breakdowns.

Over time, repeated occurrences cause some people with Alzheimer’s to develop “cognitive distortions” that can impair their ability to think and make decisions (to the extent sometimes it’s misdiagnosed as schizophrenic events).

For this reason, it is important not to rely on very familiar objects or behaviours, even if you are sure they are safe.

Preserve Locus of Control is one of the golden rules in user interface design.

In the case of this post’s subject, physical and digital dimensions have a somehow direct correlation for people in a confusional state.

Avoid common operating errors that people with dementia make by changing the appearance of physical objects such as clothing and furniture.

People with dementia often forget what things look like, and this can lead to confusion when they enter new rooms (e.g. to cheque a room for safety) where they have previously spent a lot of time.

If there have been significant changes, such as redecorating a room or moving furniture, make sure they don’t get lost among all the other things going on!

Not only will they be confused by the change in environment, they can also get lost quickly if their memory isn’t good enough due to changes in orientation. Simply noting new details before moving into unfamiliar territory should help avoid these problems!

As you probably noticed, we’re talking about skeuomorphism in user interfaces. A digital representation of an everyday’s life physical object may be really confusing for someone who can’t recognize the boundaries of his/her former experiences with such objects.

As you can read in our past article about Universal UX, we must consider cultural differences and sensitivities during the design process in order to create a better UI.

It’s important to consider both ethnic diversity and individualism within societies during project development and testing – this means thinking about potential differences between cultures, including age-related cultural norms, gender expectations, etc., so that your designs work meaningfully in different contexts while respecting users’ unique needs and desires.

Incorporating cultural references allows people with senile dementia to understand everyday situations.

For example, remembering that an object is labelled “chair” and not something else, because the meaning behind those symbols/words is not necessarily shared by everyone who grew up in that country.

A culturally appropriate colour scheme helps to convey emotions such as frustration, sadness, joy, etc.

When communicating textual content between different cultures, it is important not only to understand the basic meanings, but also to use related terms.

In some cases, special translation services are needed depending on whether a user speaks English or Arabic, for example.

In case of need, visual metaphors can help express complex concepts through simple iconography. However, try to avoid iconography unless you really feel your research can’t be complete.

It’s important that you don’t overload users with too much information, which can lead to confusion and make it hard for users to find what they’re looking for!

Instead, try to simplify your designs by reducing unnecessary text or using other methods such as icons (be careful, though!)

Reducing visual clutter makes it easier for people with dementia (and everyone else!) to focus on content (especially if they’re performing multiple tasks at once) as there’s less information competing for their attention.

Using large icons helps people who have difficulty reading small print. However, it’s recommended to use universal icons that everybody recognizes without additional information. Examples of universal icons are: Print icon, email icon, save (diskette) icon, etc.

This approach also works well when designing user-friendly websites that are easy to navigate. If you want users to feel comfortable using your design, you should create navigation systems that help them quickly find what they need at the moment.