Human Factors Considerations for Medical Devices Used by Older Adults

By Tiffany Yang-Tran and OnKee Min

Landscape of older adults and healthcare technology

Older adults are amongst the many who are increasingly adopting healthcare technology into their lives, especially following the COVID-19 pandemic. Healthcare technologies might include mobile devices, wearable devices, telehealth, and personalized health-monitoring tools. Healthcare providers (HCPs), product designers, and human factors engineers (HFEs) can ensure a positive and effective experience for older adult users by creating digital health products that accommodate the unique abilities and natural impairments of an aging population.

Product design considerations for older adults

There are many factors to consider when designing for older adults compared to younger adults, including:

Cognitive factors. Older users might have experienced cognitive decline in their later years that have affected their ability to concentrate, remember and/or make decisions.
Mobility limitations. Mobility and dexterity can naturally decline with age and might affect various interactions with a mouse, keyboard and/or touchscreen.
Sensory impairments. Older adult users are more likely to have vision and hearing impairments that would affect their interactions with any visual (e.g., touchscreen) or auditory (e.g., notifications) components.
Technical literacy. Compared to younger generations who have grown up around technology, older users might be less familiar with various devices, UI elements, and terminology.

User interface (UI) related design suggestions

Below, we'd like to provide a few design suggestions to address these factors and considerations.

Design suggestion	Rationale
Large font size Text should be large for on-screen readability.	Ease of use generally increases with the text’s font size, up to 24 points at typical viewing distances. Larger font sizes with high text-to-background contrast are important for individuals with cognitive or visual impairments (e.g., for information processing and reading).
Large touch targets Large touch targets allow for higher accuracy.	Touch targets size should accommodate declining motor controls and other dexterity limitations, such as arthritis. Touch targets are recommended to have a height and width of at least 40 mm.
Label icons with text Icons (which might also be used on buttons) should be labelled with simple text that explicitly describes the function or information the icon represents.	Standalone icon meanings might not be obvious and intuitive. Icons might also require additional memorization and cognitive effort from the user to recall each icon’s meaning.
High color contrast Screen content (including text and images) should have sufficient color contrast for increased visibility and readability.	Users with vision impairments, such as low-vision due to age-related macular degeneration, might have difficulty reading and interpreting content with a lower color contrast.
Minimal gestures Use gestures (e.g., swipe, tap, pinch) that are common/simple and reduce the variety of gestures.	Gestures are typically a hidden functionality that require users to remember and recall various movements and actions. Touch gestures (e.g., pinching with two fingers to zoom in/out) might not be intuitive for older users. Older adult users might have limited dexterity and decreased motor controls to perform complex gestures and/or quick movements.
Extend timeout modals Extend session timeout periods to provide users more time to interact with the content.	Users with dexterity and/or cognitive limitations might require more time to process information and perform tasks on a screen.

Provide instructional resources for older adults

Even if we design a UI with all of the aforementioned design attributes, older users might require additional support and guidance when using the device. Below, we list considerations when providing instructional resources for older adult users.

Onboarding resources. Often, onboarding screens and tutorials are only available with first use of the product. This assumes that the user will know how to use the product with just one brief tutorial. Consider making onboarding screens and tutorials always available to reference (e.g., on the home screen).
Searchable reference materials. Consider the organization of reference materials and how users might find information on the product. Solutions might include an index in alphabetical order, troubleshooting articles categorized by commonly asked questions and/or an easily identifiable search bar. One or a combination of these methods might be more helpful when an older user is trying to solve a problem.
Troubleshooting information. Especially if troubleshooting might require a multi-step approach, having the troubleshooting information readily available to open and reference while performing the steps makes it easier on the memory and removes the need for toggling between screens.
Live helpline. Consider providing live support to users (e.g., via chat or phone call). Older adult users are more likely to be familiar and comfortable speaking with another person when trying to solve a problem.

Lifestyle compatibility

Before sending an older user home with a device or other piece of technology (e.g., mobile applications), it is up to HCPs, educators, family members, or whomever the support system is comprised of to equip older users with the appropriate tools and skills they need to succeed with their device. It is also important to consider how the device will fit within their lifestyle.

Older patients who might not be ready to use technology independently might benefit more from additional experimentation time, tutoring, caregiver support, and more. When developing the treatment plan, clinicians should be prepared to assess the factors which influence an older individual’s digital health readiness. These factors can include their personal preferences, access to technology, sociodemographic factors, health literacy and impairments.

Regarding access to technology, some devices require existing infrastructure, such as high-speed internet, smartphones and other Bluetooth-enabled devices. Consider whether the new device will fit in well with the user’s current technology/infrastructure and understanding of that technology and whether it will be a significant financial or cognitive burden.

Conclusion

There are many different human factors considerations when designing digital healthcare tools and devices for an older adult. Manufacturers must consider whether the device’s user interface elements can accommodate the unique needs and limitations of these users without posing undue burden on their capabilities or require an unrealistic learning curve. As with anything else, having a comprehensive understanding of the user’s needs and expectations earlier in the product development process can help ensure a successful device. Contact our team to learn more about how you can incorporate human factors to create a satisfying and effective design for different user groups.

Tiffany Yang-Tran is a Senior Human Factors Specialist and OnKee Min is a Human Factors Specialist at Emergo by UL.

Learn more about human factors engineering and usability for medical devices at Emergo by UL: