Designing Healthcare Websites for Seniors

Written by Andrew Kaufman on August 12, 2012.

When I first got a used laptop for my grandfather, I thought that it’d be a great way for him to keep his mind sharp, get updates from family and friends, and enjoy all of the videos, music and content that he could ever want. And it was!

old person using computer​He signed up for Facebook, started watching every video of Leonard Bernstein he could find on YouTube, and (of course) started sending me emails with subject lines like FWD:FWD:FWD:100 Stars You Didn’t Know Were Jewish. While my grandmother didn’t want anything to do with the glowing book in the corner, my grandfather got hours of enjoyment out of a piece of technology that he often described as being “like magic.”

But as he started to use it more and more without my guidance, the magic seemed to be interrupted by prolonged bouts of frustration and confusion. Things that have become second nature to you and I, like getting rid of a software update alert or navigating a website, gave him so much trouble that he often just gave up.

At first I just chalked it up to the steep learning curve of a new technology. But then something happened that made me think that maybe it wasn’t that my grandfather wasn’t capable of learning a new technology. Maybe the websites that he was trying to use just weren’t doing a good job catering to users like him. What happened was that I saw him try to search for information on a medical condition he’d recently been diagnosed with.

Observing my grandfather try to find information on a medical site was both painful and revealing.  There was a lot of squinting, unintentional clicks, confusion and a general inability to find anything if it wasn’t located prominently on the homepage of the site. As someone who works with healthcare providers to improve their online channels, the experience made me think about how we can improve usability and user experience for this important demographic.

Seniors on the Web

Seniors (ages 65+) are one of the fastest growing demographics on the web, with a growth rate of 16% per year so far this decade (source). By the year 2050, more than 1 in every 5 people throughout the world is projected to be aged 60 or over (source). And, as studies (and my grandfather) have shown, searching for health information is one of the most popular activities on the Internet for older adults.

This isn’t an audience that you can afford to disregard, especially if you’re in an industry like healthcare. So how do you design websites that are accessible and easy for seniors to use?  By identifying some of the reasons why seniors have trouble navigating the web, we can start to adjust our designs and interfaces to compensate for these limitations.

Physical Limitations

It’s no secret that as we age, our bodies undergo a lot of changes – most of them negative. Some of the most common physical changes associated with aging include vision impairment, loss of motor control, and diminished cognitive abilities such as memory loss (source). Because interacting with a computer requires the use of each of these abilities, these changes can cause major problems for seniors.

Here are some ways that web designers can help accommodate for these changes:

Vision:

In addition to the normal degeneration of the eye due to aging, there are a number of eye diseases and conditions that can significantly affect how seniors are able to view information online, including Cataracts, Glaucoma, Myopic Degeneration, and Macular Degeneration.

  • Use sans-serif typefaces like Arial or Helvetica, as the small trailing lines on serif fonts (like Times New Roman) can make it difficult to recognize characters.
  • Use medium or bold type weights. Reductions in the amount of light that reaches the retina can make it hard for seniors to read normal font weights.
  • Use a default font size of at least 12pt to ensure that older users can view the text. While allowing users the ability to adjust the font size is fine, most seniors won’t even know this is a possibility.
  • Use a high-contrast combination of text and background colors to ensure legibility and to reduce eye-strain.
  • Make line heights larger. Allowing for more whitespace between lines of text can improve readability and make it easier to click on hyperlinks in the text.
  • Left justify your text.

Motor Control:

Whether you’re using a keyboard, a mouse or a touchpad, motor control is extremely important for successfully interfacing with a computer. With arthritis affecting 50% of Americans over 65 (source), and the risk of Parkinson’s and Tremors increasing with age, the importance of designing interfaces that account for limited motor control is huge.

  • Make clickable elements large and allow for additional white space around them to avoid erroneous clicks.  Conditions like arthritis, Parkinson’s or Tremors can make it difficult for users to keep their cursor hovered over small elements. 
  • Avoid pull-down menus or other moving interface elements that require users to hold their mouse-clicks while navigating.
  • Only use single mouse-clicks, as double clicks can be hard for users with limited motor control to perform.
  • Minimize scrolling. Using click-and-drag scroll bars is often difficult for those with decreased motor control.  
  • Avoid click-and-drag elements. Having to hold down a click while also dragging an element (like adjusting the volume bar on a YouTube video) can be extremely difficult.

Cognitive Ability

In addition to well-known cognitive diseases such as Alzheimer’s and Dementia, most older adults will experience some sort of memory loss and cognitive impairment as a normal result of aging. This can often make it difficult for them to recall the paths that they took through a website or where they are in relationship to their desired destination.

  • Use prominent breadcrumbs so that users can tell how they got to the current page, and navigate back if necessary.
  • Make sure that visited and unvisited links are clearly distinguished using different colors.
  • Use a broad, shallow site structure that doesn’t require the user to click too many times to find important information.
  • Make navigation elements consistent and clear. Your navigation should clearly indicate what content they can expect to find in each section.
  • Break text into short paragraphs. Large blocks of text are harder for those with cognitive impairments to process and recall.
  • Include clear page headings and titles so that users know that the information they are looking for can be found on that page.

Lack of Computer Experience

Most people just assume that seniors are technophobes who don’t want to understand how computers and the Internet work. But that’s usually not the case (except for maybe my grandmother). In general, most Seniors want to know how these things work, they just don’t have the experience to grasp some of the concepts that more savvy Internet users take for granted.

In the limited time I’ve spent helping my grandfather navigate the web, I’ve noticed a number of seemingly simple concepts that he had a hard time understanding, including:

  • The difference between the computer’s home screen and a browser window
  • The difference between a search box and a status update box (on Facebook)
  • The difference between Google and the entire Internet
  • The first three links in a Google search result (and those in the right rail) are usually advertisements
  • The concept of switching between different “Tabs” on a browser

While a growing number of people have never known a world without computers, seniors have spent the majority of their lives without this technology. It’s understandable that they’d have a harder time learning its terminology, conventions and functionality. But that doesn’t mean there aren’t things we can do to help lessen the learning curve – and maybe even simplify it for the rest of us as well.

  • Avoid jargon or “clever” messaging. This includes body text, headings and even navigation elements.
  • Don’t assume that users will understand basic web design conventions. Things like clicking the company logo to return to the homepage or a speaker icon to adjust the volume aren’t readily apparent to most seniors.
  • Use prominent call-to-actions. Senior web users can get overwhelmed quickly and are often afraid of making a mistake. Make it easy for them to identify the main task the page is trying to help them perform.
  • Use descriptive text in hyperlinks. Instead of using “Click Here” as your anchor text, include text that lets the user know what they will get by clicking the link, like “Click here for more information on….”

Conclusion

As power users of technology and the Internet, those of us who create websites on a daily basis (as well as people in the organizations we work for) often have a tendency to design experiences based on our own needs and desires. But good user experience design is about having empathy for people who are different than you – and working to meet the needs of users, whoever they may be.

In the case of healthcare organizations, a large proportion of their audience is inevitably going to be elderly adults, so it only makes sense to keep their needs and limitations in mind. But with the Baby Boomer population reaching retirement and the amount of seniors online increasing rapidly, organizations in all industries are going to need to take into account this influential group of users.

After learning more about the unique needs of seniors and how interfaces can be designed to accommodate them, I’m definitely going to work harder to incorporate these recommendations into my own work. And as someone who understands the unique frustration of trying to help a grandparent fix a computer problem over the phone, I really hope that the rest of the design community does as well. 

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