Giving Call Bell Technology a Facelift using Skeuomorphic Design Concepts

I’d like to bring together two of my previous blog articles. I’ve written previously on mobile apps and their applications to older adults with dementia here, and I’ve written about a nifty, potential way of addressing wait times for patients receiving help in long term care, here.

The problem with getting older adults to use mobile app technology remains that of cohort effects. Essentially, even though contemporary polling data (such as the Pew Center’s regular polling on this subject) suggests that while the fastest-growing adopters of Information Technology, or IT, is older adults and baby boomers – older adults, particularly those in their 70s and up, are still behind everyone else in terms of their use, familiarity, and comfort with IT. In other words, growth in IT use in older adults is growing faster than any other age group, but it’s growing from a much smaller base.

So, any attempt to introduce technology in the long-term-care environment, such as cognitive orthotics, will be running up against potential issues with possible hostility to technology, or technophobia (fear of technology), lack of familiarity, et cetera.

Before I go further, I wanted to introduce a couple of user interface / user design concepts that I’ve run into over the past year or so. The first one is the concept of skeuomorphs, which is defined as: “a derivative object that retains ornamental design cues from structures that were necessary in the original.” Many of you reading this blog use Macintoshes (I do). Apple is notorious for use of skeuomorphic design, such as in the design of it’s Address Book app found on the iOS operating system (e.g., iPhones, etc):


The idea behind skeumorphs, I think, is to (at least in part) capitalize on another, related design concept I’d like to mention, the principle of least astonishment (POLA, for those of you that like acronyms). From Wikipedia: “If a necessary feature has a high astonishment factor, it may be necessary to redesign the feature.”

So why am I bringing up skeumorphs and POLA? Let’s get back to this:

Hospital call bell

Say hello again to the oh-so-analog, getting-rather-long-in-the-tooth, but almost universally recognizable hospital call bell. As I mentioned in my post last week, the call bell hasn’t really changed that much in terms of functionality since patients in hospitals literally had bells in their rooms for the purposes of calling in nursing staff – while over the years there have been some minor feature upgrades to call bells (e.g., addition of analog technology, a flashing light above patients rooms, addition of a 2-way intercom system, etc.); generally, overwhelmingly, hospital call bell technology hasn’t changed much over the last 50 years.

Here’s the rub though – call bells are very, very familiar, very unsurprising and un-astonishing, it’s a highly expected feature of the hospital and nursing home environment. I’m quite certain that very large proportions of us – from the very young to the very old, knows what a hospital call bell is, and what it looks like, and what it does. Conversely, only a small (albeit rapidly growing) proportion of my nursing home residents are familiar or comfortable with smartphones and tablet computers.

So, it hit on me the other day – the call bell is probably an almost ideal skeumorphic vehicle for the introduction of mobile app technology within the long term care and hospital environment! Capitalizing on POLA by making deliberate use of skeumorphic design concepts to shift call bell design to a digital, mobile-app based platform will allow for much more easy introduction of the potential array of useful features available in the mobile app development platform (such as cognitive orthotics, medication reminders, more flexible forms of communication between staff and patients, etc). In other words, while many older adults today may recoil if you try to get them to start using iPhones or Droid tablets (how many times have you heard an older adult friend or family member of yours exclaim, “I’ll never use one of those things!” when presented with a smartphone or tablet computer?), it’s a far easier sell to get older adults in long term care to use an upgraded, digital version of a call bell – since they’re all already using call buttons, and many have been using them for many years already.

What would a mobile app-based call bell look like? That’s a question for the design geeks to answer.