Ask HN: Best Video Call Solution for Elderly | Hacker News Reader

Ask HN: Best Video Call Solution for Elderly

57 pointsnoodlesUK63 comments

Hi HN, I’m looking for a device that I can give to my grandmother that she can use to video call me and other family members from her care home. It needs to either be completely remotely manageable by me, or it needs to not have any real settings that can be changed accidentally (and can be pre-provisioned). Ideally it would be able to connect to the internet over 4g, so it wouldn’t be at the mercy of whether her nursing home has WiFi. Basically what I want is an office phone with a video screen that can connect to a 4g network. Does any such thing exist? If not, does anyone have any suggestions?

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When people make suggestions for this they underestimate how complicated their suggestion can be from a UX perspective.

Sometimes your user is someone who can't text, longs for the days when a telephone rang and the UX was to simply grip the receiver and put it to their ear.

Even a traditional tablet can be a pain because the user has to spend time finding the wake button when it's sometimes styled identically to the volume buttons. And they can't rely on location for memory as the tablet can be oriented different ways.

"Ohh that's not a real problem" you think.

Well, maybe not to you, but what if your eyesight is fading and you have arthritis in your hands? Then, even a touchscreen is a pain, I've watched folks use them where every tap happens three times to get it to "register"

I think an appropriate video device for OP's gran needs to have physical buttons (and not many of them aside from up/down answer(ring)/hangup, and have only one screen orientation.

Even when someone makes such devices they can't help but throw in the kitchen sink by letting it make phone calls as well. Great, now your UX is modal depending on whether you're making an audio or video call.

You’re quite right. I tried to give my grandparents an iPad, but a few months ago I spent two or three hours trying to get them to reboot it and logged into FaceTime (over the phone). About half of that was literally trying to get them to reboot the iPad. They just couldn’t find and then hold down the power button. They were struggling to see it, and then struggled to hold down the button for long enough without releasing it. It was really really hard for them. I eventually gave up, and they were very frustrated with the iPad and themselves.

FWIW, this can also be done with Settings -> General -> Shut Down.

I'd like to buy you a beer. Where are you located?

Ireland, but I appreciate the offer.

I agree about physical buttons. I add that sliding is an unfamiliar concept (unlock or answer by sliding is novel) vs tapping (an entire life of pushing buttons.) And flat interfaces are very bad, they don't have any previous experience of things actively trying to hide controls for the sake of... well, I never understood the goal myself but I use them. Anyway, I spent hours explaining to my parents which button does what, if it's press or slide, how to activate the speakers, the camera etc. Every single app has its kwn share of problems. Probably the right device is a pair of old 3G phones with video call and a keyboard. Unfortunately those video calls were quite expensive.

I keep having this argument with family who keep trying to get my grandmother to move to a smart-phone or tablet.

It's the whole mental model of mapping down all the various functionality that makes this impossible for her.

Just some of the issues that we encountered:

- Holding this small thin device means touching at least part of the glass front. This registers as a touch, and/or activates some kind of other unintended functionality when shifting grips.

- Inconsistent UI - things appear and disappear depending on context. 'Pull down from the top/bottom/etc' just makes no sense.

- Inconsistent response times - a variety of applications require polling some server on the internet, which means waiting for dodgy wifi on crummy DSL to then connect to a server that's the best part of 16,000KM away (Sydney to US-East coast). Too many app developers test only against a server that's either on their machine, or on some close-by staging environment and never bother to see how their app responds (or doesn't) on anything less than an ideal connection.

- Single tap vs long tap vs double tap... They all do different things, and because not every application responds at a consistent rate, she gets frustrated and presses it again, harder (not knowing if it just failed to register the previous touch). Worse, because some apps now 'play' the second tap once the new screen has finished rendering ... well we've now clicked in some other random part of the application.

- Often things are delivered as webpages (or partly so) - and again, with content being loaded asynchronously, the page jumps around, often for quite a while.

- Two fingers pressing against the screen / palm rejection... she'll be tapping with the pointer finger, but the knuckles of another finger, or the palm or wrist will touch the screen... causing all sorts of bizzare behavior. Leads to frustration, leads to tapping repeatedly, see above.

Then there's the issue that every 12-18 months, the UI changes, functionality moves, changes, etc.

At least with some devices, you have a home button that's easily locatable, but then that seems to be dying in favour of soft buttons everywhere too, which means that it's yet another thing that you just have to know it's there, and when it's not.

All these smart devices that only have a touch-screen are a major usability problem.

I don't think it's necessarily fair to assume she "needs" that without further context.

My parents (late 70s; mother has severe arthritis) have an iPad that they use for video calling and they have been able to pick it up without issues. The only other thing they use it for is looking at photos we share to them on Google Photos.

They were actually fairly tech illiterate (if anything weird happened to the TV or VCR they would phone me), but maybe 5 years ago I setup a Linux PC for my father to send emails to relatives. I should note that this was the first time he ever used a computer or anything remotely technical (his career was as a carpenter). I expected him to get frustrated and never use it again after the first few times, but he has learnt and managed to pick it up fairly well.

I agree some things did take a while (e.g. explaining right clicking), but he persisted which was the main thing. The first few video calls usually resulted in me not seeing anything as they held their fingers over the camera, but they learnt how to do it. He has even started an online shop buying and selling Lego pieces (much to the detriment of my mother, as she barely sees him now).

Obviously, OP can give a better answer as it's closer to home.

I'm glad that your folks have taken to it quite well, but I'm just speaking from my own experience.

The thing is, if I can come up with design constraints for folks that struggle in my own experience, chances are, it's probably an easier interface for everyone.

A solution for physical buttons was less of a comment on OP's grandmother's situation, and more as plus point for the fact that physical interfaces trump touchscreens when the amount of total actions you wish to take are limited. It's the same reason I prefer physical knobs and switches when I'm driving as opposed to touchscreens.

I'm pretty tech literate, I work in the industry, and if this screen gives me pause to work out what the heck I want to press on it:

https://imgur.com/hTnnOmB

then it's a no go as a general solution for everyone.

very valid points, even my siblings (in their 50s and 60s I might add) struggle immensely with even already aging tech, if i want to facetime my sister, I must first make a costly international telephone call to alert her to the incoming almost free video call, mostly so she can turn on the device (an iPad)! If she hands that device to my father, in his 90's, then it's a real struggle, as he doesn't relate the voice chat to the video chat, and to be honest he gets so little experience of it, he never will. My Uk resident siblings are a little slow on modern tech, and quite comically to me, believe they are up to the minute.... My brother for the longest time found it easier to send me a "linkedin" message than add my email address to his address book!!!! never mind use the WhatsApp he had all along! Slowly they're catching on....

as for Skype, well they missed that completely I think, yet I use it almost every time I make an international call....

oh yes, one more important thing, as my parents aged, we tried to get them to use a handphone (mobile phone), again, a huge problem, as they would never leave it turned on, and again, never knowing when the batteries had drained, so my father would take it cycling, if he needed help, turn it on (or try to) then try to use it, as far as i am aware, it sat its entire life beside a few similar hand me downs on the living room window sill, next to the coiled up charger, waiting for that time when it may be useful (if only it were charged), I am certain that none were ever used. I suggested an Ipad some years ago when they first appeared, my sibling simply cried that they were too complex, it seems even for them, never mind the parents!

Somewhat related but I just wanted to brag on my dad:

My dad is a pastor that runs Sunday mornings at a relatively large church. Roughly 600 people on a Sunday morning over a few services; not mega-church, but definitely bigger than the vast majority of Methodist churches. Over time he's become the "technology guy". He's not (or at least wasn't) particularly more competent than most, but wasn't afraid to learn and get his hands dirty, so to speak. Now I would call him plenty sav.

One of his passions is bringing the church to people who can't come to the building. A lot of personal visits to shut ins and hospitals, and recently this meant live streaming. We already had a two camera broadcasting set up, so it was pretty simple to plug it in to the internet (some sort of turn key "send audio and video to this box with an ethernet cable and we"ll stream to everywhere elsed" kinda deals) and off we go.

As an even more aside, I just want to shout out that since the epidemic started he basically started producing 3-4 hours of video each week to live stream.

Anywho, this lead to him asking me how eldery-proof we could make in-home streaming for folks who can't always leave the house, or maybe want to watch VODs if they miss a week or something. I mused that the turn key solution he was using made a few TV streaming options (apps on Fire TV, Roku, Android, etc.) and you could probably set one of those up to start automagically on boot or something.

About two weeks later he calls me up and, to my genuine amazement, has actually come up with a solution. He set up a Roku with a remote that custom app buttons, set up the streaming app (again, this is an app specifically for streaming our church) on one of those buttons, and set the app up in such a way that the first button hops onto the live stream. He even set up pretty good UX studies with a bunch of elderly folks to make sure his instructions were clear!

He ended up getting sponsored for about a hundred of them from a few generous folks around the church and personally set them up in folks homes.

It occurs to me that a combination of Amazon products might yield a similar outcome by way of the Alexa skills system, albeit at the price of asking someone to talk to their Alexa or TV remote. Your solution sounds a little more straightforward for people unsure of technology.

I have couple of friends who use Facebook Portal for their non-tech savvy grandparents. Seems like the lack of features (compared to other tablets) make it easier for them to use it. Another thing, it integrates with WhatsApp (a big plus for many!)

https://portal.facebook.com/

I use the portal and I like it a lot. I can see why older people would love it too. The UI is simple - large buttons to call each contact and once you're in the call, a red button to end the call. There is a hardware button to disable audio and camera, if necessary. Elderly users don't need to worry about charging because it's plugged in. They don't need to worry about focussing the camera to their face because it does it automatically.

Side note - camera quality is good. I've had multiple friends comment about how my video is much better than the other folks in the call.

My grandparents are in their early 80s or late 70s and aren't very open to learn new technologies.

For the past 7 years they used and iPad (one of the early models 2nd or 3rd generations) and it served them well. I've introduced the the family contacts, put FaceTime and Photo library on the first screen and it seems ok for them. I've also annotated what volume button do and teach them that if they have a problem with it to press the big button (home button).

The only problem with the iPad is that recently there are some connectivity issues (it seems it doesn't always stay connected to Wi-Fi and they don't receive my FaceTime calls). I think this may be due to the old iOS it's using (v10 or v9). So, considering to buy them a newer version.

This is a problem I’ve experienced as well. As apple devices get much older, you run into things like password nags much more frequently. This is extremely off putting for someone who isn’t familiar with tech. Eventually some apps just stop working at all. Then you try to give them a new device, and it’s just similar enough to be extra confusing.

GrandPad. Ninety four year old grandmother uses it and loves it. Easy to use tablet, great customer support that only works with seniors and their app for other family managers is surprisingly good. It’s literally made for this purpose.

I've had a rough time with GrandPad. Tried to set it up for a family to use during covid, the mother is in her 60s and pretty competent with tech - they use iPads, Kindles etc just fine. We tried to change the registration of the GrandPad from her billing and they said they needed to ship us a whole new device. Then they said they could just ship a new sim. So anyway she's gotten the new sim in the mail and has had such a frustrating time with it & can't get it to do video calls. She's wanting me to take it back.

The whole idea was that it would be simple enough that her son with Down Syndrome could use it to keep in touch with friends. He's smart, he can use gmail, but he can't use this thing.

Honestly my perspective on them has been that it's a cheap thing, UX is a real mixed bag, customer service not great, & I deeply regret losing the time we've spent trying to work with it vs exploring other solutions. Ugh. I even don't want to go pick it up to try and deal with it from my side.

Glad you have had a better experience, but let's just say it's not universal!

My grandmother has an Ipad and an IPhone. We sometimes video call her on here phone using whatsapp. But this works around 50% of the time correctly and the other times we just call using a regular land line phone. She uses the Ipad only as a image viewer. We showed her multiple times how to google something but that is just to difficult for her. But she understands how to watch the photo's we put on the device, and she really likes to watch the old photo's of all our vacations together. So my recommendation would be use something that your grandmother is already comfortable with and start thinking from there. Introducing something new can be hard for her even if it is simpeler.

She’s unfortunately not a smartphone or tablet user at the moment, and I doubt that she has any desire (or ability) to learn how to use one... Basically I want a landline phone that can also do video

The feature on my iPad that utterly entranced my mother in law (in her 80s) was Google Street View - she was absolutely fascinated by being able to "visit" places she had been before.

I found it impossible to teach my elderly grandparents to properly use the swipe-based UI of modern iPads. They kept having issues properly timing it and had random things appear on screen. Even with enterprise lockdown it wasn't possible to disable all the features.

Even worse - you can't lock the iPad to only show FaceTime/Duo/whatever. It stops receiving calls if you put it into single app mode with a communication app.

I have helped both my mother and some elderly folks with their computers and have a few observations which may be of some help.

1) UI changes really bother them. A lot of that crew works on muscle memory -- an icon moves and they get lost. They don't easily re-parse a new UI for changes.

2) Click speed decreases, so double-clicks are much harder. A single deliberate click is fine, but the doubles seem to pose problems.

3) The iPad doesn't seem to work for some. When I found there was no easy cheat sheet available (the ones I found seemed either insufficient or were focused on trivia/new-hotness), I made a series of laminated sheets. One described the various screens, one pointed out the parts of an iPad (controls, mostly). The third showed the different "gestures" (the important ones, anyway). This just ... didn't take. She doesn't care for it. Possibly due to #1 -- I am considering getting a laptop and using Classic Shell to fake that it is XP just so she feels comfortable again.

4) Visual acuity varies widely but you're probably on top of that.

5) Plugging things in can be problematic, so some kind of easy docking station or wireless charging might be better if available.

I have been watching this post with interest.

I’m using an echo show for this use case. My granddad has dementia and lives at home on his own. I set up some blink cameras in his house to watch for falls and setup an echo show so family could speak with him during lockdown. The big advantage I found about the echo show is the “drop in” feature which allows starting a video call with no interaction from his side.

How do you feel about “drop in”? It feels a little invasive. Do you have the option to have the device ring rather than just dropping in, whilst still maintaining the option in an emergency?

There’s no doubt that the cameras and drop in features are an invasion of his privacy. Unfortunately his dementia is advanced enough that we couldn’t ask him if this was ok before we put it in. His son has power of attorney over him (allows him to make legal decisions on his behalf) and as I am the only person who has access to these features and the intent is to help protect/care for him, we felt it was a fair trade off.

You can limit the people who can “drop in” on the device, so I guess you could let most friends and family use the call feature and save the drop in feature for certain trusted family members to use in an emergency.

Take a look at KOMP: https://www.noisolation.com/uk/komp/?

Heared some good stories about them in a podcast I recently listened. Not cheap, but the UI/UX should be very good.

Video chat and elderly relatives was a pain point in my life for a few years. I spent quite a lot of time finding a solution (spoiler: it's FaceTime and 4G iPads).

Things I tried:

- Initially, I tried Skype on a Windows laptop (around 2011). This was a nightmare for everyone. There were too many points of failure (wifi would disconnect and require a support phone call, Windows would update and require a phonecall to log back in, Skype would require an update and trigger a support call, etc).

- Around 2013, I tried an Android tablet with the Skype App over wifi. This was just as bad as a laptop (the app was also pretty unstable.

- I switched to Google Hangouts. The UI was an issue and was also unstable.

- In 2014/2015, I gifted an old Macbook Air. I set this up with Facetime and also Skype. My relatives preferred Skype initially (since they had experience with the app), but I showed them how to make and answer FaceTime calls over a Christmas weekend and they picked it up in less than an hour. The MacBook setup was great, but it died in 2016.

- In 2016, I gifted them an iPad with 4G. We continued communicating with FaceTime (and iMessage). This has been flawless for the past 4 years. I update the iPad each year over Christmas. I've only had one support call to install Snapchat (so my grandparents can keep in contact with a great-grandchild).

If the iPad dies anytime soon, I would consider Facebook Portal as an alternative.

I'm also looking for something like this - I tried using an iPad but the experience on newer iOS is just too confusing and error prone for elder users. It also doesn't really support locking to single task well.

I've been looking at Skype desk phones but those were discontinued as well. Google Home smart devices are nice for video calls, but you can't disable Assistant functionality. Happy to hear any other recommendations.

I was thinking Google home devices might work. Is assistant actually a problem? I wondered if it would be actually useful for some people.

I FULLY recommend the Claris Companion: https://www.clariscompanion.com/. It keeps things as simple as possible, and they provide tech support. I've used them for over a year now I think and I've been very satisfied. My grandfather is in his 90s and is able to use it in his care home.

The UI takes over the normal android UI to make things very simple. It also provides an email/messaging system which blocks out communication from anyone but the approved contacts, so there's no need to worry about email scams etc.

I'm not sure if they ship to the UK but they have a 4G version. But if you can get a 4G device, you could still use their app.

The key thing is absolute simplicity of interface and use, and this service is great for that.

Sorry this sounds like an ad, but it's seriously provided so much value to me in being able to keep in touch with and see my grandfather from 1000s of kms away.

Tablet with Kid/Kiosk mode to only allow one app? E.g. iPad with Facetime?

Or PineTab with a browser in kiosk mode (Surf?) pointing to a meet.jit.si room :)

It's a breeze to set up with NixOS as long as you're not afraid of the command line, and easy to remotely manage with SSH and fully reproducible configuration. Hit me up for a free sample VM :)

This sounds like a great setup. Never heard of PineTab before - is the CPU powerful enough for live video encoding?

May be a little too underpowered actually.

There was a recent forum thread with users claiming the Pinebook Pro is somewhat usable with Jitsi Meet; and the Pinebook Pro has a more powerful CPU in it than the Pinebook which has the same chip as the Pinetab.

Maybe going with a refurbished Surface or similar would be a better option; talking to an elderly relative is an use case that hardly calls for open hardware.

I tried doing that for my family and iOS has this wierd restriction where it drops all incoming calls automatically when you use Kiosk/SingleApp mode. Even if FaceTime is open in foreground.

You could also limit the iPad to running Facetime only in Apple Configurator.

That's exactly the case where iPad starts dropping calls.

Oh. Kinda makes sense, but bad restriction in this case.

An Echo Show device matches most of your requirements: low configuration, remotely manageable, plus it's voice-managed. Sadly there are no 4G versions, but you could solve it with a small plugged 4G router.

I’m leaning towards this, at least from a hardware standpoint it sounds like an echo show is a good bet (assuming there is WiFi or a hotspot). Can one be set up without a mobile phone number though? I’m reading about them, and that sounds like it might be a sticking point.

I think the Amazon account does need a phone number, but it could be any phone number you have access to, or the phone number used by the hotspot.

A Chromebook with a sim, and a USB receiver. Chrome books can be managed, I'm not sure if they have Sim slots. Possibly not, in which case a 4G USB device or 4G wifi might have to do.

There are LTE Chromebooks by Dell and Samsung

I use a combination of a conventional phone with FaceTime on an iPad with my 90 years old mother. I call her on the phone (which works much better with her hearing aid), and then I connect through FaceTime for the video. If there are any technical issues, I can walk her through them. We have been doing this every evening for the past three months without any insurmountable problems. Having the iPad on a dock helps, as it keeps the orientation constant.

I use a combination of Nextcloud Talk (for 1-on-1 conversations) and Jitsi Meet (for larger groups) with my 82yo mother, she has NC Talk and Jitsi on her phone and tablet and access to both through the browser on her laptop. We use Telegram to schedule meetings through Jitsi Meet or for those cases where NC Talk doesn't notify the called party that someone is calling. It works fine, we use it for ~30 minutes per day, every day.

An basic iPad/iPhone could work well - even when he was too young to unlock and use it much, my son was able to voice dial with 'Hey Siri, call Dad on Facetime' etc, and it was easy to make it to work from the lock screen. He didn't even need to touch it - turning on auto answer in the accessibility settings helped too.

Hi. I am actually working on a solution for this. My grandma has a bit of dementia combined with hearing loss and a language barrier. This led me a solution of a remotely managed box with video camera hooked up to a TV. I'd love to chat with you and get to know your use case more. Feel free to e-mail me.

Sadly these ipad/iphone/facetime combos only work if everyone in your family is on Apply. In the ROTW, that's not so common...

My mum, who's got dementia, can just about work her portal to make and receive calls.

I've heard giving them an android tablet with Skype app set to auto-answer may be the most foolproof x-platform way.

iPad and FaceTime. Keep it simple. Bonus - others in the facility will have the same, including staff.

I'm thinking about on-premise solution for my family, but that would involve a point-to-point calls only and LAN stretched thru all my family networks connected with VPN devices. But that is a bit overkill for Your scenario I guess...

If you prep their phone with Jitsi Meet then it's very simple to use. My elderly mother even managed to follow the Jitsi link I sent her in a text message, to the Play store, install the app and connect.

This requires them to have a phone and know how to use it... She does not.

Seriously, iPad. If they can’t handle the old navigation, setup an MDM and put it in single app mode with managed contacts.

I have a client who uses this as a quick and dirty reception system in 3-4 offices.

This is probably relevant to your search for good UX

https://news.ycombinator.com/item?id=23589798

I think Amazon Echo Show line has video call auto-answer with a time window to refuse, so once configured the remote side don’t have to be able to understand how to stop ringtone and start talking.

the mother of my gf has problems keeping devices loaded. mostly because she has alzheimer, but dont forget about that aspect.

also, how are you calling, is it always on, is the speaker loud enough and microphone good and lastly is her privacy not compromised?

a solution to easily start a video chat without user registration is whereby.com , but thats mostly good if you already have a remote device, but no control over it.

elderly people are not stupid, they have different experiences and interests. if they want to learn how to use a device, they are likely able to do so.

Perhaps some sort of telepresence system is what would work best, but I don't know if there are any such systems available for non-enterprise uses?

My grandpa loves his iPad. Best computer for old people.

I'm not understanding why a smartphone, with parental controls enabled to prevent her accidentally changing settings, would not work?

A Kindle Fire HD with Telegram would be really good and easy to use.

Telegram doesn't support video calling yet

I have experimental evidence that a Kindle Fire wouldn't, for an elderly father losing his faculties, after my sister and nephew insisted he should have one and use skype. Just getting the on/off switch is bad enough, along with other problems mentioned here. The whole thing was bad enough for me as a hacker used to android, specifically interacting with skype.

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