Designing Dementia-Friendly Websites
May 17, 2016 3:48 PM   Subscribe

People living with dementia do not expect web designers to cure the symptoms, and many people recognize that it isn’t always possible to apply each dementia-friendly web design lesson when building a site. But the combined use of some of these lessons can help many people live well with their conditions. It is important to remember that dementia presents in many different forms, its symptoms are varied, and many of these symptoms are also common to other degenerative illnesses, in particular, conditions which hinder the social inclusion of the elderly.
By making websites more accessible to a growing group of users who are so often excluded from the benefits that the internet has to offer, designers are not only supporting people living with dementia, but also those with similar accessibility challenges.
posted by jenkinsEar (23 comments total) 38 users marked this as a favorite
 
IF IN DOUBT, ASK

This is perhaps the most important.

Spend time talking to people to understand their needs and perspectives. When we designed our website prototype, we had no idea how complex it would be to cater to everyone’s individual needs. Over time, we consulted roughly 20 people with dementia and made a few necessary alterations to our site. If you can, budget in some time for co-design and feedback.


This is so important.

And as b1tr0t points out, designing for accessibility that takes into account cognitive impairments is win-win-win.
posted by mandolin conspiracy at 4:05 PM on May 17, 2016 [3 favorites]


My User Experience person on my team has been trying to tell our company that accessiblity is going to be the #1 issue going forward for an increasingly aging population who are connected. So far, it's a hard sell, but I think those who are on top of these design features are going to be sought out a lot in the future.
posted by xingcat at 4:33 PM on May 17, 2016 [2 favorites]


If anything can encourage people to use alternatives to hamburger menus and dropdowns, I'm all for it. But also I'm not sure there's a single point in the article that isn't just good user friendly clean design advice. Particularly the guidelines about images. Too many times the images and other graphic elements with an article pull me out of it or give me incorrect expectations about its content. I can only imagine how offputting a lot of Medium headers, for example, must be for people with dementia or any number of other cognitive challenges. And the sites that suddenly fade in an illustration upon scrolldown! And if it's an animated gif! Those freak me out and I'm just run of the mill anxious and depressed. This comment has just turned into me complaining about newfangled webby sights, but yes, more of this. More options, more accessibility, more brushing away the cruft of messy interfaces, more simplicity without losing meaning.
posted by Mizu at 4:56 PM on May 17, 2016 [8 favorites]


Amen, Mizu.
posted by Johnny Wallflower at 4:59 PM on May 17, 2016


There are no buttons big enough on my keyboard to +1 this enough. Any steps you take to make your website, service, hardware or app more accessible and usable for those with cognitive or sensory deficits will also benefit two other important demographics - 1, everybody and 2, you.

I have no idea how to make this sink in where it matters, though, which is at the nebulous corporate level where purse strings meet projects. I was involved in that smeary wave function at a company which made websites, with some input to design goals, at the time that I lost a decent chunk of my vision, and continued there for some time after. When the smoke had (metaphorically, alas) cleared from the transition from The Eagle-Eye Kid to Mr Magoo, I started to press for more and better attention to the sort of basic design decisions which emphasised clarity and working well with different scales, high contrast options, and navigation which, you know, did what it promised and didn't hide. (Don't get me started on pop-ups and autoplay. You hate them? Imagine what they're like if you either can't understand what's happening or can't see to work out how to stop them getting in your face.)

I made the argument that such things were better for everyone, there was no need to make them limiting factors to delivering the stuff that we wer there for, and it also gave better device independence and guidelines for future developments. Nobody disagreed, but nobody did anything about it either: exactly the same reactive, time-and-resource-constrained driven compromises, lack of testing and lack of discipline in the face of external forces led to exactly the same dog's breakfast of a final product. (Typical conversation: we need to add this commercial component to the page. But that makes it look awful and really mucks up the user experience, nobody will ever get to the content, which is why we're here. Yes, we understand, but do it anyway.)

In my option - and direct experience - the arguments for making things with an explicit and very strong bias towards accessibility for those with deficits are unanswerably good and nobody will deny them. They also won't do anything about them, because of the cash-starved race to the bottom doesn't even have room for normal usability.

Which is unacceptable and short-sighted (ha) and also by the way plain stupid, but in those respects is pretty normal. Whether it will take legislation, or brilliant publicity by disability action groups, or a nuclear airburst of an epiphany by an industry leader, I do not know.

Merely being staggeringly right and obviously so is no bloody good.
posted by Devonian at 5:07 PM on May 17, 2016 [14 favorites]


I also feel like hewing to these guidelines would streamline a site for other kinds of more complex accessibility. Particularly offering print-friendly formats makes it easier for blind people to get things read in a coherent manner via other plugins and devices. The linked article already mentions their built in audio transcription methods, and with the clear video interface and preference for images to really line up with content, it makes it simpler for deaf people who also want to participate to know that if they want to sign their video will be more viewable. People who have trouble with facial expressions and tone don't have to worry about other peripheral content that is supposed to affect their comprehension of an article - because there isn't any peripheral content. All in all it's interesting how being considerate of one "class" of disabilities can really set you up for being much more considerate of all disabilities.
posted by Mizu at 5:07 PM on May 17, 2016 [3 favorites]


Watching my 94-year-old Dad trying to use his computer was educational. He had been fine with computers in his 80s, but now he really struggled, especially when we had to update his computer.

Software and the web have evolved in precisely the wrong direction for the elderly. Designers think it's a fantastic idea to pop up new windows— that stopped him cold. Word was redesigned so the freaking File menu takes over the whole window, hiding your document. Terrible idea, very disorienting. Anything new ("hey, let's move the Favorites on the other side of the window and change the icon!") can make the site or app unusable.

Looking at their site, I'm not sure they've learned all the lessons yet. E.g. changing the font size to maximum doesn't change all the font sizes. (Hint: if the font isn't annoyingly large to people under 80, it's too small.) Plus it lacks any simple instructions— I'm not sure my Dad would've known to click on the pictures to see the stories, for instance.
posted by zompist at 5:12 PM on May 17, 2016 [6 favorites]


As a simply tired old with just the most incredibly minor signs of dementia (but a terrifying family history) I have to say:

FUCK YOUR REDESIGN. I DON'T WANT TO RELEARN HOW TO USE YOUR PRODUCT.

For people with dementia your redesign is completely devastating as they DEPEND completely on the familiar.
posted by srboisvert at 5:15 PM on May 17, 2016 [16 favorites]


I'm still reading this, but if the number one objective of your web site is to present users with content reached via hyperlink then I think "Make sure hyperlinks are clear" should be the number one key lesson, in bold, blinking caps. Otherwise, you're asking people to start from scratch every time they go to a new web site. Breadcrumbs and buttons like "Home" and "Back" don't matter if you can't find your way off the home page to begin with.

My mom didn't touch a computer until she was around 80, just before she first started showing signs of mental decline. In other words, she had no frame of reference to go by and no way to intuit what to do when presented with anything new. She knew enough to find recipes and lakers news and things like that, but after a while it became harder. I can't tell you how dismaying it was to spend an hour or more showing her how to navigate a site, only to go to the next one and have the very basics of navigating the site literally invisible to her. It made her feel like a total failure and and idiot.

Anyway, the computer died and six months later I got her an ipad but by then Safari itself was too complicated to remember or relearn. She can still usually text me, at least. Maybe there should be a "Mosaic 1.0" setting you can choose.
posted by Room 641-A at 5:26 PM on May 17, 2016 [3 favorites]


Thanks for the link and for everybody's comments, I'm a designer and frequently have to keep these things in mind. It's so fun to include things like GIFs and parallax scrolling and it's hard not to get excited about all the newfangled things websites can do, but clearly these things often come with a risk of leaving people annoyed and confused.

I came across this link recently, an archive of so-called "Brutalist Websites".

"In its ruggedness and lack of concern to look comfortable or easy, Brutalism can be seen as a reaction by a younger generation to the lightness, optimism, and frivolity of today's webdesign."

It strikes me that some of these are simply plain rather than unusable. Others are clearly both...though there are probably just as many overwrought sites that are difficult and annoying to use.

Previously on the blue: Web Accessibility is for Everyone. I commented there with my favorite point of reference to keep in mind while working, An Alphabet of Accessibility Issues.
posted by oh.ghoulin at 5:27 PM on May 17, 2016 [6 favorites]


Mizu+

I designed quite a few sites in the 90s-00s and always tried to get the bosses to go with a KISS (Keep It Simple Sweetheart) principle. I almost always lost and had to add in the latest menu tricks, too many graphics, rollovers, non-standard links...on and on.

I had the same experience with my octogenarian emeritus professor father -- sitting staring at a screen and often asking, "What am I supposed to do with this?" and "How do I ___."

I gave away several copies of Jakob Nielsen's book...to no avail.
posted by CrowGoat at 5:36 PM on May 17, 2016


Having dealt with two dementia/Alzheimer individuals from onset to death I am of the opinion that there is only a very narrow window where these techniques will be effective. Basically, once the interface begins to become incomprehensible, so do the controls and functions of the device used for access. No amount of simplifying the design will help if the individual can't remember how to use the device to get there or comprehend what the site is about. Dementia is a deep black hole and it only goes one way...
posted by jim in austin at 5:47 PM on May 17, 2016 [4 favorites]


Design Is only one piece of it and not necessarily the biggest. I'm doing some Google Apps Script development, and it is making me feel like I have dementia. The interfaces are all simple, and the actual programming is dirt simple, but the information architecture — how all the various bits fit together — is kafkaesque and byzantine and extremely decision-fatigue-inducing.
posted by lastobelus at 5:52 PM on May 17, 2016 [1 favorite]


Having dealt with two dementia/Alzheimer individuals from onset to death I am of the opinion that there is only a very narrow window where these techniques will be effective. Basically, once the interface begins to become incomprehensible, so do the controls and functions of the device used for access. No amount of simplifying the design will help if the individual can't remember how to use the device to get there or comprehend what the site is about. Dementia is a deep black hole and it only goes one way...

But it's important to remember that this also helps people with learning disabilities or acquired brain injuries with lots of years ahead of them as web users.
posted by mandolin conspiracy at 6:42 PM on May 17, 2016 [1 favorite]


But it's important to remember that this also helps people with learning disabilities or acquired brain injuries with lots of years ahead of them as web users.

True, but that isn't dementia, both the subject of the FPP and the link...
posted by jim in austin at 6:56 PM on May 17, 2016 [1 favorite]


Having dealt with two dementia/Alzheimer individuals from onset to death I am of the opinion that there is only a very narrow window where these techniques will be effective.

I'm going to have to disagree with you on this. The window depends entirely on the rate of progression which is dependent on all kinds of factors.
posted by srboisvert at 6:57 PM on May 17, 2016 [1 favorite]


True, but that isn't dementia, both the subject of the FPP and the link...

I read the full piece. The design principles they're conveying deal with these other things, too.

Since they cite WCAG, note that:

The intent of this Success Criterion is to ensure that visually rendered text is presented in such a manner that it can be perceived without its layout interfering with its readability. People with some cognitive, language and learning disabilities and some low vision users cannot perceive the text and/or lose their reading place if the text is presented in a manner that is difficult for them to read.
posted by mandolin conspiracy at 7:25 PM on May 17, 2016


I thought it was interesting that they called for an explicitly labeled "Home" link. Most other aspects of usability can be advocated for. Especially in light of recent EU legislation (thanks!) and the Americans with Disabilities Act. But this one was one where I thought, that one will be a tough sell.
posted by bleep at 7:39 PM on May 17, 2016


Getting away from the accessibility and design of the site for a minute - if you have someone in your life with dementia, the Meet the Diarists section is pretty amazing.
posted by mandolin conspiracy at 7:48 PM on May 17, 2016 [1 favorite]


Probably 50% of the work emails I send or my time on conference calls consists of me going, "THERE IS TOO MUCH UNNECESSARY SHIT HAPPENING."

Content is only king if it's usable/accessible. Your ads can suck my dick, you're not influencing shit.
posted by fluffy battle kitten at 11:43 PM on May 17, 2016


We talk about this in my house a lot - no dementia here, but my partner has a mental illness that severely affects his cognitive abilities. A lot of the web is straight-up unusable for him these days, even with adblockers. We spitball a lot about what it would take to make the internet usable for people with cognitive issues like his. I think he'll really appreciate this article; thanks for sharing it.
posted by Stacey at 7:27 AM on May 18, 2016


I am reading this article now - it seems like very sound advice. If I were designing a website, I would make sure to keep these principles in mind.

I had two thoughts when starting to read it. One is that many web designers are young, and haven't even thought about issues like making fonts large enough that older people can read them. (I'm 55, and I have been in companies where I was by far the oldest person in the department.)

The other is that some designers might be concerned that designing a website for older people, especially those with dementia, might scare away younger consumers (who, presumably, might want all those bells and whistles).
posted by tallmiddleagedgeek at 8:01 AM on May 18, 2016


I use a browser extension that makes the "remove all styles" browser feature available with a simple Ctrl-Q. As you would expect, most modern web sites look like utter shit with all styles removed, but once you scroll to where the actual content of the page resides, many sites are much easier to read. I find this especially the case when dealing with these design shitlords that think that 55% grey on white for normal text and 56% grey for links (with no underline) is a completely reasonable thing to do. And don't even get me started on fucking sticky headers, an invention that Satan himself would be proud of.
posted by Rhomboid at 1:57 PM on May 18, 2016 [1 favorite]


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