Seniors With Alzheimer's and The Holidays

Just like gifts and fruitcake, parties and family gatherings are a perennial staple of the holiday season. When caregiving during the holidays for a loved one who has Alzheimer's, these get-togethers can be more chore than cheer.

As an experienced caregiver, you have probably adapted your communication style to fit your elderly loved one's capabilities and moods. But, other family members and friends are likely to be unequipped when interacting with someone who has Alzheimer's.

This doesn't mean that you have to shut your elderly loved one out of holiday festivities.

As a caregiver, you are in a position to help make fellow party-goers feel more comfortable interacting with a senior who has dementia—making a holiday shindig merrier for all involved:

1. Give a status update. Send an email, or write a letter with a short primer. Inform the family of the diagnosis and tell everyone attending a holiday gathering how the senior with Alzheimer's is doing. Let party-goers know what to expect in terms of behavior. Explain odd quirks and perhaps share a humorous anecdote involving the senior to help put people at ease. Let family and friends know how much you appreciate their efforts to include a senior with dementia into the holiday celebrations. Including a photo is an excellent way to remind people that they are not interacting with a disease—they are interacting with a beloved family member or friend.

2. Ease apprehension and encourage interaction. People are likely to feel apprehensive about conversing with a senior who has dementia. What do they say? What if the senior forgets who they're talking to or what the conversation is about? Reassure potential guests that positive interaction with the senior is possible and that engaging with their elderly loved one will help them.

3. Offer tips. As the senior's primary caregiver, you are in a unique position to offer guidance to friends and family members who are feeling apprehensive on how to navigate a conversation with a person who has Alzheimer's. Offer up a few tips based on your interactions with the senior. Potential tips may include: asking open-ended questions, speaking from the heart, and reacting with patience to a senior who repeats themselves or loses the thread of a conversation.

4. Tactfully handle damage control. If someone is talking to the senior, and the interaction goes awry, don't panic and do not immediately apologize. Tend to your elderly loved one first. Once you make sure they are alright, explain the situation to the other person or people involved in the conversation. But, avoid talking about the person with dementia if they are within hearing range.

5. Be on the lookout for agitation. People dealing with dementia can sometimes become overwhelmed in settings where there is a lot of activity or lots of other people. If you see your elderly loved one showing signs of anxiety, politely excuse yourself and take the senior to a room with no people to help them calm down.

Apps + Seniors

Why Design with Seniors in Mind?

Being inclusive is a nice thing to do. That should be reason enough for it to be necessary, but it turns out there are plenty of other reasons it makes sense to design with the senior population in mind. 

By the year 2030, 20.6% of the U.S. population will be 65 years of age or older. Worldwide, by 2050, nearly two billion people will be 60 or older—three times as many as in 2000. The elderly population is growing, will continue to grow, and is increasingly using the internet, smartphones, and mobile applications.

The over-65 population also boasts the highest level of household wealth. This isn’t just a growing population—it’s a growing population with money to spend. Most are retired, and their children are done with school and out of the house. If anybody can pay for mobile apps, they can.

So, with money to spare, a growing population seems like something software or mobile app developers would jump on, but for the most part, they haven’t. Seniors are an underserved population. Some health applications have been developed specifically for older people. Still, there are plenty of other software apps out there that seniors want to use but find too intimidating. The solutions needed to include seniors aren’t such a heavy lift. Making some simple adjustments would benefit seniors and developers. 

Design Thinking From A Senior Citizen’s Perspective

As we age, our bodies and minds age along with us; things that used to be easy to do, take more time and concentration. People who never wore glasses suddenly need them. And it’s not as if 65 is some magic number, and when you get there, things suddenly change. Nielsen Norman Group research found that between the ages of 25 and 60, people’s ability to use websites declines by 0.8% per year. Here we will cover some of the most impactful changes we face as we age and how designing apps for seniors can help them overcome these hurdles.

Visual and Auditory Degeneration

As we age, our vision degrades. This usually starts to happen around age 40. It usually begins with presbyopia (farsightedness caused by the eye lens losing elasticity). Other age-related vision problems include cataracts, glaucoma, macular degeneration, and eye floaters. Some of these can affect the ability to see colors properly as well. Here are some design solutions to make your web or mobile app design visually readable:

• Provide large enough fonts (16 pixels on a computer, 18-20 pixels on a mobile device).

• Make text dynamically adjustable.

• Don’t overlay text on images.

• Use sans-serif, easy-to-read fonts.

• Use a single font.

• Provide high contrast.

• Icons should be at least 48px/9mm wide.

• Effectively use whitespace between icons and text.

• Don’t use audio that plays automatically.

• Provide subtitles for all videos.

Motor Skill Changes

Our movements become slower and less smooth as we age. Fine motor control decreases, as does the sensitivity of our fingers. To solve this, make sure that your design elements are clickable and decipherable by following the tips below:

• Don’t make elaborate gestures necessary.

• Most seniors prefer touchscreens and tablets, so be sure your app is tablet-friendly.

• Space icons far enough apart to prevent accidental clicking (44px).

• Clicking and horizontal swiping are acceptable.

• Keep in mind that elderly people generally type with one hand.

• Give feedback to let the user know they have successfully clicked something.

• Scrollbars can be a challenge, giving as many scroll options as possible—clicking on scrollbar arrows, clicking within draggable page portion, dragging the slider, scroll wheel on a mouse, and keyboard arrow keys.

• Clicking is more comfortable than swiping. Swiping is easier than pinching.

Short-Term Memory Loss

Older populations suffer from short-term memory loss. While this presents challenges, it also has an upside—longer attention spans. Seniors citizens will take the time to read all of the information you provide. Therefore, to be able to leverage this fact, you may want to consider the following:

• Always make it easy to go back and go home.

• Give clear feedback on user progress.

• Make updates wisely by not changing everything all at once.

• Put the essential navigation elements upfront.

• It takes seniors longer to read, so don’t have a screen timeout too early.

• Introduce product features gradually.

• Avoid multiple actions on a single screen.

• Give reminders and alerts as cues for common actions.

• Complex skills will be more challenging to learn, so provide easily-accessed help sections.

• Use a simple navigation pattern with a horizontal menu bar.

• Provide one thing at a time—no multitasking.

• Provide a breadcrumb trail as a navigational aid.

Generational Differences in Technology Experience

It’s important to remember that seniors have not been using technology like smartphones their entire lives. This does not mean they can’t, but it does mean some aspects might be more evident to a younger user but not a senior. That’s why you may want to:

• Provide clear instructions for users who need them.

• Make sure all icons also have text labels.

• Don’t use acronyms or technological jargon.

• Provide reminders or prompt boxes for the next steps.

• Strike a balance—don’t assume your user has tech experience, but don’t be patronizing, either.

• Temporary notices are often missed by seniors, especially if they are at the edge of the screen.

• Make it very clear which links have already been clicked.

• Implement descriptive links.

• Make sure privacy and security sections are easy to manage.

• Don’t design interfaces that are inflexible or unforgiving.

• Make apps usable right “out of the box” and don’t require extra set-up by the user.

Thanksgiving Tips for Seniors With Dementia

Thanksgiving is a time for family and friends to gather, give thanks, catch up and share a special meal.

However, when someone in the family is diagnosed with dementia, the dynamic changes drastically. Nowhere is this more evident than at holiday gatherings. The hustle and bustle of a typical family Thanksgiving can cause extreme levels of anxiety for someone with dementia, turning a wonderful day into a confusing and agonizing ordeal. Consequently, it can become a day full of tension for the family caregiver as they watch over their loved one with anxious eyes.

It doesn’t have to be that way. With some planning and preparation, everyone can still enjoy Thanksgiving, including the family member(s) with dementia. However, to be successful, you need to plan ahead and structure the day for the best possible outcome.

Here are some tips we’ve gathered:

• Prepare family and friends. Share your loved one’s diagnosis with those who will be attending your Thanksgiving dinner. Explain the limitations the disease has created. Educate them on the proper way to approach and communicate with your loved one and how to include them in the conversation as much as possible.

• Prepare your loved one. Make sure that they have had enough rest. Keep to their routine as much as possible during the days leading up to Thanksgiving.

• Ask for help. Ask family members for help with shopping and cooking in advance. Many families enjoy a potluck Thanksgiving to which everyone brings a dish. This can be a lifesaver in a household with a loved one challenged by dementia. You might also consider asking a relative who is close to your loved one to help by keeping an eye on his or her anxiety levels as the day progresses. They can be a big help when you are busy with other guests and duties.

• Schedule dinner early in the day. Individuals with dementia are particularly sensitive to the hours between daylight and evening. This is called “Sundown Syndrome,” and, fortunately, there are ways to reduce its impact. One way is to schedule your dinner well before sunset.

• Encourage reminiscing. If your loved one still has longer-term memory intact, consider bringing out some old photo albums and putting them in convenient places to inspire conversation. This can be an excellent way for younger family members to engage with your loved one, as well as with other older family members.

• Provide a quiet place for “down-time.” A short nap or some quiet time off in a separate area provides a nice break for someone with dementia. Ideally, this would be a quiet room away from the main hangout spots, where they can relax. Often, for those in earlier stages of dementia, a short refreshing nap is all that is needed to enable them to rejoin the festivities.

• Plan your own post-Thanksgiving “downtime.” This is so important for caregivers. It would be best if you had time for yourself to unwind and relax. If you are the primary caregiver, consider scheduling some short term “respite” care at a local memory care community for your loved one. That will give you time to tend to your own physical and emotional health and enjoy some time on your own with friends and family members.

If your loved one is living in a memory care community, consider bringing some of your Thanksgiving cheer to them, rather than disrupting their routine by transporting them to your gathering.