Improving accessibility for people with dementia: web content and research

The Internet can provide a means of communication, searching for information, support groups and entertainment, amongst other services, and as a technology, can help to promote independence for people with dementia. However, the effectiveness of this technology relies on the users’ ability to use it. Web content, websites and online services need to be designed to meet the abilities and needs of people with dementia, and thus the difficulties that these users encounter must be explored and understood.

The primary aim of this thesis is to investigate web content accessibility for People with Dementia and develop recommendations for improving current guidelines based on accessibility needs. The secondary aim is to support people with dementia having a voice within research through development of accessible ethical processes.

Qualitative data were collected with a scoping study using questionnaires about everyday technology use (people with dementia and older adults without dementia); and in-depth interviews to explore difficulties and web accessibility issues. A document analysis was conducted on Web Content Accessibility Guidelines (ISO/IEC40500:2012) for inclusion of the needs of people with dementia followed by review of Web Usability Guidance (ISO9241-151:2008) to consider how gaps relating to the unmet accessibility needs for people with dementia could be met.

The scoping study found that both people with dementia and older adults without dementia use everyday ICT to access the Web. Both groups described difficulties with web interface interactions, which refined the research scope to web content accessibility.

The interview data with people with dementia (n=16) and older adults without dementia (n=9) were analysed using Grounded Theory techniques. It was found that both user groups experienced the same types of difficulties using the Web, but that dementia symptoms could exacerbate the difficulties from usability issues (older adults without dementia) into accessibility issues for people with dementia. Navigation was a key issue for both groups, with a range of web content design elements contributing to accessibility issues with navigation for people with dementia.

The document analysis found that the accessibility guidance did not address all the accessibility issues encountered by people with dementia. However, the usability guidance did address many of the accessibility issues for web content navigation experienced by people with dementia.

The research provides recommendations for improvements to web content accessibility guidelines including content from usability guidelines, and amendments to current guidelines and success criteria. A new ethical recruitment/consent process was developed and tested as part of the research process and is recommended for use in future research to support engagement of people with dementia.