Skip to main content

Geri Tech: It's the little things


There's a lot of interest in using technology to improve the lives of seniors, especially here in the Bay Area. This Christmas my grandmother received as a gift this little gadget which to me so beautifully captured both the promise and pitfalls of such tech.

It's a headlight. For a walker! Brilliant. Maybe.

If you want to help seniors, first you need to identify a problem. Falls are a big problem. Many falls occur at night, when a person gets out of bed to use the bathroom in the dark.

Next you need to conceptualize effective solutions. We have many imperfect tools and strategies to help prevent falls at night, ranging from bedside commodes to reducing nighttime fluid intake to leaving lights on. The solution here is a light that attaches to the walker.

There's a lot to like. It's small, lightweight, and unobtrusive, yet has a strong LED light and long-lasting battery. The soft, stretchable plastic housing wraps simply but securely around the walker's horizontal brace. You just push the button to turn it on.

I push the button. It starts strobing like a Berlin disco. Dizzily, I push it again, and it relaxes to a slow blink. Once more and finally it's steady like a normal light. Fourth push to turn it off. Why does it have three modes? Why is the only obviously useful mode, the normal light, the third? Why does it strobe at all? Did they envision that the primary use of this light would be to alert oncoming motorists when elders walked their walkers along highway shoulders in the dark? Maybe they weren't thinking of the problem I thought they were thinking of.

My grandma tries to turn it on. She pushes and pushes but nothing happens. Maybe she's pushing in the wrong spot. Can she find the button? It's the same blue color as the rest of the device (in the photo above we had already painted it with nail polish to make it stand out). With no color contrast, the only hint that it's a button are some tiny ridges in the plastic. Alas, she can't feel the ridges - peripheral neuropathy has rendered her fingers mostly numb. And you actually need to push pretty firmly right in the center. She can't push hard enough with her finger. She finally gets it by pressing in the middle of our paint job with her fingernail. She seems undeterred by the strobe, but it still takes her a while (and quite a bit of concentration) to cycle through to the "steady light" mode. She wonders aloud if she should keep a screwdriver in her walker pouch to help turn it on.

I'm imagining someone with poor vision, numb fingers, and urgency desperately trying to get this darn thing to turn on in the middle of the night while their bladder holds out. My grandma, fortunately, has a bladder of steel. She took the gadget home to try anyway. I advised against the screwdriver.

So much about this gadget is right. It's cheap, simple, and might effectively help with a real problem. But it's done in by the little things. It should have a big, raised, brightly contrasting button that doesn't require much force to push. Maybe even have the button glow in the dark. And it should have two modes: on and off. My grandma could have told them as much. I can't help thinking that the manufacturer never had anyone over 40 try to actually use it. Yet it is specifically marketed as a "mobility light" for "mobility aids".

What are the lessons for tech mavens striving to fix our elders? Keep it simple. Test your product with the same elders you think might use it. If you're making a product for a walker, test it with elders who use walkers. Account for weakness, tremors, and sensory impairments. Good intentions and even good ideas are not enough - it's the little things that really count.

by: John Newman

Comments

I am 5'2"
Two days ago in the podiatrist's office, I sat far too long on poor therapy chairs. Pain. The water therapy basin left my legs dangling - nothing to rest feet on to save short legs from pain.

Yesterday, when I was told to come in an discuss some side effects of therapy, I got the new, expensive chair. It is so wide that I coudn't rest my arm on both sides at once. A BARIATRIC CHAIR.

There is no chair in that office that allows my feet to rest on the floor as Mayo Clinic recommends. But there is an amazingly expensive BARIATRIC CHAIR.

Would someone with GeriPal's audience please fight for adjustable chairs for people whose legs are not long (we also need less chair depth when our legs are not long above the knee.

If it's vital to have heathy chairs at work, Why isn't is vital to have them in doctor's offices. (And why not in senior facilities, too?)
Linda Jacobson said…
Great post, fun to read. I'm in the Bay Area too, where there is general enlightenment about the importance of good user-interface design. I agree with your lesson for the tech mavens: keep it simple -- and to that I would add, design teams should include social scientists or interface designers. Or at least managers who've read Don Norman's books or "100 Things Every Designer Needs to Know About People."
Daniyal Khatri said…
Very interesting blog. Alot of blogs I see these days don't really provide anything that I'm interested in, but I'm most definately interested in this one. Just thought that I would post and let you know. ipad covers

Popular posts from this blog

Practical Advice for the End of Life: A Podcast with BJ Miller

This week we talk with BJ Miller, hospice and palliative care physician, public speaker, and now author with Shoshana Berger of the book "A Beginner's Guide to the End."

As we note on the podcast, BJ is about as close as we get to a celebrity in Hospice and Palliative Care.  His TED Talk "What Really Matters at the End of Life" has been viewed more than 9 million times.  As we discuss on the Podcast, this has changed BJ's life, and he spends most of his working time engaged in public speaking, being the public "face" of the hospice and palliative care movement.

The book he and Berger wrote is filled to the brim with practical advice.  I mean, nuts and bolts practical advice.  Things like:
How to clean out not only your emotional house but your physical house (turns out there are services for that!)Posting about your illness on social media (should you post to Facebook)What is the difference between a funeral home and mortuaryCan I afford to die?  …

Improving Advance Care Planning for Latinos with Cancer: A Podcast with Fischer and Fink

In this week's GeriPal podcast we talk with Stacy Fischer, MD and Regina Fink, RN, PhD, both from the University of Colorado, about a lay health navigator intervention to improve advance care planning with Latinos with advanced cancer.  The issue of lay health navigators raises several issues that we discuss, including:
What is a lay health navigator?What do they do?  How are they trained?What do lay health navigators offer that specialized palliative care doesn't?  Are they replacing us?What makes the health navigator intervention particularly appropriate for Latinos and rural individuals?  For advance care planning? Eric and I had fun singing in French (yes French, not Spanish, listen to the podcast to learn why).
Enjoy! -@AlexSmithMD




You can also find us onYoutube!



Listen to GeriPal Podcasts on:
iTunes Google Play MusicSoundcloudStitcher

Transcript

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: And Alex, I'm really excited about toda…

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …