Humanics Ergonomics

Ergonomics for elders

EVALUATING ELDER DESIGN

Rani Lueder, MSIE, CPE

Then swiftly, neatly, with the grace of the young man
on the flying trapeze, he was gone from his body...

For an eternal moment, he was all things at once:
the bird, the fish, the rodent, the reptile and man…

William Saroyan (1934)
The Daring Young Man on the Flying Trapeze

Saroyan’s writing haunted me as a teenager, hinting at quite different paths to attaining insight. It returned to me while teaching a human factors class over the last couple of years to industrial design students at Art Center College of Design (2).

My design students experience many of the same barriers to learning that I witnessed when evaluating my and others’ ergonomics training programs as a consultant.

As in business environments, the learning process endgame requires that the student successfully negotiate a series of steps:

They must actively listen.

They must correctly understand message content.

They must process and re-interpret its content in a way that becomes personally meaningful.

They must ultimately apply their newfound understanding to change intended behaviors.

Such demands frequently undermine effectiveness of training. Even highly rated training programs often fail to achieve behavioral change.

1 Rani Lueder, MSIE CPE is principal of Humanics Ergonomics Inc.

2 Art Center College of Design is an international industrial design school located in Pasadena, California. Their website is www.artcenter.edu.

Figure 1. The reductionist nature of scientific inquiry contrasts with the holistic experience of users with a range of functional limitations.

It became apparent that such barriers similarly affected students. Industrial design students expressed frustration with the demands required to make the conceptual leap necessary to translate research to design solutions that apply to a broad range of users.

Over successive terms, my weekly lectures became increasingly specific while attempting to identify objective anchors that might help ground students in the research.

For example, in their review, Norris et al (1997) demonstrated that the elderly seem to be able to exert about the same amount of torque as children in the 5 – 9 year old age group (Figure 2). I encouraged students to seek opportunities to interact with children to consider corresponding age/strength implications for design.

In tandem with such changing perspectives regarding the nature of disability is the growing recognition that focusing on accommodating people with special needs isolates them and emphasizes their differences.

Universal Design is the design of places and products to fit the broadest range of people and applications (Table 1; Center for Universal Design, 1997), thereby enabling us all. A ramped curb may enable wheelchair users to cross a street intersection, but also helps mothers with baby strollers, travelers rolling their luggage and shoppers with vision obstructed by grocery bags.

As such, it is crucial that designers refine their design language to empower all of its users.

Rethinking disability

The World Health Organization (WHO) redefined the nature of disability in its International Classification of Functioning, Disability and Health (ICF)

The ICF puts the notions of ‘health’ and ‘disability’ in a new light...every human being can experience a decrement in health and thereby experience some degree of disability.

Disability is not something that only happens to a minority of humanity. The ICF thus ‘mainstreams’ the experience of disability and recognizes it as a universal human experience….

Furthermore, ICF takes into account the social aspects of disability and does not see disability only as a ’medical’ or ’biological’ dysfunction.

By including Contextual Factors, in which environmental factors are listed, ICF allows one to record the impact of the environment on the person’s functioning.

Table 1. Comparison of published strength data and age
Age group	Age (years)	Source of data	Cap diameter (mm)	Method	Mean torque (Nm)
Children	4	Rohles 1983	27 & 29	cap only	0.58 – 0.63
	5-9	Norris 1997	29	movable bottle	1.51
	10-14	Norris 1997	29	movable bottle	2.43
Elderly	60-97	Imrhan 1986	31	vertical fixed bottle	1.62
	62-92	Rohles 1983	27 & 29	cap only	0.92 – 2.04
	60-86	Norris 1997	29	movable bottle	1.53
Teen-agers	students	Konz 1989	28	cap only	2.44
	15-19	Norris 1997	29	movable bottle	2.86
Adults	20-70+	Berns 81	28	movable bottle	1.18
	20-39	Norris 1997	29	movable bottle	3.12
	40-59	Norris 1997	29	movable bottle	2.59
Figure 2 Comparison of published strength data and age (Norris et al, 1997).

Table 2. United Nations Principles for Older Persons (Abbreviated)
Independence	Older persons should be able to live in environments that are safe and adaptable to personal preferences and changing capacities. Older persons should have access to the educational, cultural, spiritual and recreational resources of society.
Participation	Older persons should remain integrated in society, participate actively in …policies that directly affect their well-being and share their knowledge and skills with younger generations.
Care	Older persons should be able to enjoy human rights and fundamental freedoms when residing in any shelter, care or treatment facility.
Self-fulfillment	Older persons should be able to enjoy human rights and fundamental freedoms when residing in any shelter, care or treatment facility.
Dignity	Older persons should be able to live in dignity and security and be free of exploitation.
World Health Organization www.who.int 2nd World Assembly on Ageing, 2002 www.un.org/esa/socdev/ageing

Table 3. Principles of Universal Design. (CUD, 1997)
Principles	Reason
Principle #1: Equitable use	The design is useful and marketable to people with diverse abilities.
Principle #2: Flexibility in use	The design accommodates a wide range of individual preferences and abilities.
Principle #3: Simple and intuitive use	Use of the design is easy to understand, regardless of the user’s experience, knowledge, language skills or current concentration level.
Principle #4: Perceptible information	The design communicates necessary information effectively to the user, regardless of ambient conditions or the user’s sensory abilities.
Principle #5: Tolerance for error	The design minimizes hazards and the adverse consequences of accidental or unintended actions.
Principle #6: Low physical effort	The design can be used efficiently and comfortably with a minimum of fatigue.
Principle #7: Size and space for approach and use	Appropriate size and space is provided for approach, reach, manipulation and use regardless of user’s body size, posture or mobility.
Permission of ©1997 NC State University, The Center for Universal Design. With permission. www.design.ncsu.edu/cud
Figure 4. An important surprise for students was the extent that the functional limitations in hearing, sight, mobility, etc. interacted. While evaluating a Laundromat (above), the team noted that visual and hearing impairments worsened existing symptoms by aggravating postures. They had difficulty reading instructions, hearing when the ring of the machine on its completion, manipulating the large laundry container and stooping to load the laundry. (Courtesy of Eunji Park, Mei-Hua Chen and Mayu Tsukada)
Rethinking our users As an attempt to help students expand their notion of the users they must accommodate with design, the midterm and final projects became simulated aging experiences (Table 2). Class projects emphasized simulations of the functional limitations of elders aged 80+ years to evaluate the design implication of anthropometric, cognitive / psychosocial, physical / motor coordination, visual, hearing and kinesthetic dimensions. Some students tried creative approaches such as restricting joints with bandages to simulate arthritis; adding bulky layers to simulate obesity; developing contraptions that limited their peripheral field of view. The aim of this simulation was to help the students develop a visceral response through direct experiences that resemble those of elders. The hope was that this sense memory would continue to stay with them over their career and enable them to continue to expand their understanding of the broad range of user considerations. This approach is not new. Healthcare professionals have often described the use of simulated aging as a learning tool, particularly in geriatrics (e.g., Henry et al, 2007; Lorraine et al, 1998; Marte, 1988; Pacala et al, 2006; Robinson & Rosher, 2001; Wood, 2002). Lorraine et al (1998) simulated specific diagnosed disabilities. Wood (2002) described its objectives as follows: The aging simulation exercise individualizes the effects of physiological aging by forcing students to experience functional losses. By doing so, it brings home the meaning of functional impairments to healthy, young undergraduate students in a much more effective way.	Figure 7 Raj Rihal evaluates entry into different vehicles while restricting his range of motion by strapping a metal bar to his back to simulate physical restrictions associated with back injuries. (Raj Rihal, Nina Hermsdorf & Ruth Fang)
Figure 5. Many students developed a greater appreciation for opportunities to rest and recover from day to day challenges with functional limitations. Christine (above) described the difficulty of sitting on low theater benches, given her painful and stiff knees. (Courtesy of Yamchi Hung, Christine Park & Mun Kim)
Figure 6. Some students recognized certain public environments that accommodated users with disabilities. One team lauded the store above for its use of large high contrast signs, large text on labeling, wide aisles, adjustable surfaces, multiple handle heights, convenient positioning of heavy items on shelves, smooth flooring and emphasis on security, wayfinding and other features. (Courtesy of Michael Churchill, Ben Grider & Shaun Smith )
Some lessons learned include: Students evaluated a broad range of products and environments, including Laundromats, grocery stores, subways, malls, movie theaters, bus terminals and other environments. Many students became enthusiastic over the projects. Repeatedly they told me that it permanently changed their understanding of design implications for this particularly vulnerable group of users. Invariably there were surprising and insightful discoveries. An important surprise for students was the impact of the combination of factors. It is one thing to recognize individual factors, quite another to simultaneously experience synergistic limitations in vision, hearing, mobility, and kinesthetic awareness. It was of course necessary to remind the class that they were not truly walking in the shoes of elders. Some student approaches, such as wearing their grandparent’s glasses for a day were sadly off the mark, since these visual changes did not in anyway reflect actual visional changes that accompany aging. It is very difficult to truly simulate symptoms such as rheumatoid arthritis. Over time, elders also develop coping mechanisms that enable them to manage in new ways. Even so, the simulations will hopefully help them to expand and supplement their design perspectives as they proceed in their career. ABOUT THE WRITER Rani Lueder, MSIE, CPE is President of Humanics Ergonomics Inc. an ergonomics consulting firm in Austin, Texas she established in 1982. She has consulted, performed research and served as an expert witness in occupational ergonomics, posture and the design and evaluation of products and places for adults, children and people with disabilities for more than two and a half decades. She recently edited her third book "Ergonomics for children: Designing products and places for toddlers to teens” (2008; Taylor and Francis, London and New York). Her website www.humanics-es.com contains extensive content in ergonomics. ACKNOWLEDGEMENTS My thanks to Art Center College of Design in Pasadena and my talented students for providing me with the opportunity to learn from them. There is insufficient space to describe the many other teams’ interesting efforts. REFERENCES Center for Universal Design (1997). The Principles of Universal Design. Version 2. ©NC State University. Center for Universal Design. www.design.ncsu.edu/cud Beverly Henry, Carolinda Douglass, and Irene Kostiwa, 2007, "Effects of participation in an aging game simulation activity on attitudes of allied health students towards older adults,” JAHSP: The Internet Journal of Allied Health Sciences and Practice, 5, 4, 1-9. V. Lorraine, S. Allen, S., A. Lockett, and C.M. Rutledge, 1998, "Sensitizing students to functional limitations in the elderly". Family Medicine, 30, 1, 15-18. A.L. Marte, 1988, "How does it feel to be old? Simulation game provides "Into aging" Experience," J Continuing Education Nursing, 19, 4, 166-168. Beverley Norris, Neil Hopkinson, Richard Cobb, and John R. Wilson, 1997. “Potential hazards from carbonated drinks bottles” Product Safety and Testing Group. Institute for Occupational Ergonomics, University of Nottingham, U.K. Beverley Norris, Neil Hopkinson, Richard Cobb, and John R. Wilson, 1999, Report URN 99/619 on elderly and childproof packaging. Product Safety and Testing Group, University of Nottingham. March. Commissioned by DTI / the Department of Trade & Industry, The Consumer Affairs Directorate, UK. Report URN 99/619. March 1999 www.dti.gov.uk James T. Pacala, Chad Boult, and Ken Hepburn, 2006, "Ten years’ experience conducting the aging game workshop: Was it worth it?" J Am Geriatrics Society, 54, 1, 144-149. Sherry B. Robinson, and Richard B. Rosher, 2001, “Effect of the ’Half-Full Aging Simulation Experience’ on Medical Students’ Attitudes." Gerontology & Geriatrics Education. 21, 3, 3-11. Monika Deppen Wood, 2002, "Experiential Learning for Undergraduates: A Simulation about Functional Change and Aging", Gerontology & Geriatrics Education, 23, 2, 37-48. Paul Thompson, "Democracy and Popular Power in Beijing," Radical America 22 (September-October 1988): 22.