Developing dementia-friendly phone app with How Do I?

This page is about how people with dementia, and carers have influenced development of app technology with How Do I? 

Person with dementia testing phone app with How Do I?

The Purpose

How Do I? wanted to involve people with dementia, and carers, at all stages of its app development, as part of Alzheimer's Society's Accelerator programme.  Their app is intended to help people live independently for longer, enabling them to do tasks of daily living, to make and treasure memories.


Initially a group session was arranged. Then, micro-involvement opportunities enabled people with a wide range of dementias and levels of ability, to have their say to inform the app development too. 

Several people who took part asked to stay involved. Some took part in further activity as a result.

What happened

Participants were welcomed and invited to carry out one or more practical activities. This was done as a mix of 121 semi-structured interviews, and small group activities (usually with people in the room at the same time but working in parallel rather than in plenary discussion). Facilitators gathered feedback from a mix of verbal responses and observation of what people did. People were asked to reflect on how they felt about doing each activity. The facilitators asked about their observations to check their perceptions directly with the participant.

Trying out some simple steps within the app

Completing practical tests, such as holding up a phone to a sticker to prompt a video to play, led to learning about how people with dementia, and carers, would be able to follow instructions in the app.

Icons testing

How easy do you find it to understand the icons (images) you see on smart phones, ipads and computers? With or without dementia, our brains interpret images in lots of ways, so it’s important to get lots of people’s feedback about what particular images mean to them. 

Nobody was expected to be an expert on using technology.  Nobody could 'get an answer wrong'. The question was 'what does this image mean to you?'.

Completed icons testing forms

In the group session, icons testing was one small activity, among others.

  • The icons were presented on laminated A4 pages which could be written on with appropriate marker pen, photographed or otherwise recorded, wiped clean and re-used. 
  • To help find any confusion about what the images are intended to represent, they appeared without words next to them. This sought to replicate how someone who finds reading words difficult or impossible, might experience the images. 

When used as a micro-involvement activity - a talking point at information stands and as ice-breaker for groups - A5 pages icons were used (adapting the selection to those for which feedback was needed as saturation point enabled decisions to be made about others as work progressed).

  • People were able to speak their answers and have them noted, or to take the page with them and return it later during the event where they needed more time or support to complete the activity. This enabled a lot of people, including those unable to take part in a longer, group, activity, to have their say.

The results were immediate, interesting and informative!

  • Overall older people tended to suggest meanings relating to older types of technology or pre-digital lifestyles. Younger people's suggestions sometimes also reflected their visual experiences of the world. For example
    • an image intended to show a video camera, doesn't really reflect the mobile phone devices most people use to make videos these days. One older person identified it as a 'flashlight', while a younger carer identified it as a 'goldfish'. 
    • an image intended to represent a reel of film, was often identified as a 'cotton reel'.
    • an image intended to represent 'download', was found confusing, with suggestions being 'this way up' and 'getting into a bath'.

It became clear very quickly that some images were much easier to understand than others. 

Ranking colour preferences 

This used a simple process with post-it notes numbered 1 to 6 to rank preferred colours from 1st to 6th place.  In the photograph the participant has placed brighter and more contrasting colours, ahead of others.

Ranking colour preferences for use in the phone app

The Results

Lots of useful learning to influence the app development!

Tom Casson celebrating a great morning of app testing in Peterborough

What changed for people with dementia

Between the first and second group sessions, the learning from people with dementia, and carers, led to changes that made it easier for people with dementia to carry out key tasks.

How Do I? received enough feedback to make decisions about some icons for the app.

'I really enjoy these opportunities like testing Alexa and the phone app to help make life easier for people with dementia.  It’s important people listen to us and this is helping us to get heard.' Valerie Howes, living with dementia.

Learning points

Initially one of the challenges to recruit people with dementia was that many people did not realise they were using smart phones and did not see themselves as people who would ever use smart phones or apps. It was much easier to involve people when opportunities were introduced with the emphasis on simple, quick and fun, and conversations asked about using a 'phone' rather than a 'smart phone' or 'iphone'.

Key contacts to find out more

Tom Casson, Co-Founder at How Do I? Email: [email protected] 

Useful links

Alzheimer's Society Accelerator Programme

How do I?

How do I? Blogpost - September 2019