A Day to Remember

Penn State College of Nursing's Nikki Hill wants to improve the lives of people living with memory loss. An app she's developing with the College of Engineering's John Hannan might offer a solution.

From time to time, forgetting to pay a bill, misplacing car keys, or searching for reading glasses (while you’re wearing them) can be an irritating, yet normal, part of life. But for people over the age of 60, memory loss that encroaches into daily living—like habitually forgetting to take medications or missing appointments, for example—might have more serious consequences.

Nikki Hill, a postdoctoral fellow in Penn State’s College of Nursing who works with older adults, wants to improve the lives of people living with memory loss. She’s developing an app that might offer a solution. 

"Even some level of memory loss or cognitive impairment can have a big impact on a person's life."—Nikki Hill

For the two million people over the age of 65 living in Pennsylvania—a state that boasts the fourth highest percentage of older adults in the nation—this could be a real brain boost. 

The iOS app My Day, which will soon undergo preliminary usability testing for a clinical trial, is designed to be a way for adults over 60 to remember and keep track of important tasks. Its calendar, to-do list, and journal features are designed to be easy to use for those with memory loss who, from day to day, might also have trouble remembering how to use the app itself. 

“Even some level of memory loss or cognitive impairment—I’m not talking about dementia at this point—can have a big impact on a person’s life,” Hill says. “Changes in memory can impact the way an individual is able to complete important tasks and how independent he or she can be. On an emotional and psychological level, people begin to perceive and internalize these symptoms, which can cause fear, anxiety, and even depression.”

A screenshot of the My Day app that demonstrates the calendar function

My Day app screenshot

The My Day app's calendar helps users keep track of medications, appointments, and more. The app is designed to be a way for adults over the age of 60 to remember and keep track of important tasks. 

Image: Penn State

As part of the study, Hill will work with each participant to create a personalized plan for how to use the app based on a goal he or she would like to accomplish. Many participants need help with health management, while others have more social needs. Whatever the goal, Hill’s hope is that the app will help them maintain their independence and quality of life. 

Each day, participants have access to a new to-do list, calendar page, and journal entry, which displays information about what they need to do that day. They can review the calendar, get alerts about upcoming medical appointments, or check off to-do items for taking medication or paying bills. 

For some participants, remembering the names of individuals in their social groups is challenging. So, to alleviate anxiety before going out with friends, they can use the app’s journal feature to review information they’ve previously added about their friends, including names and notes coupled with photographs. 

Though paper-based agenda programs have proven useful in the past, Hill wanted to use technology because of the interactive capabilities it can offer. 

"[G]iving people an easy way to feel more in control of their symptoms and helping them maximize their functional abilities now might have long-term implications on their cognitive health."—Nikki Hill

In addition to digital photos, the app can send audible alerts and notifications—something a traditional paper-based planner cannot. Someday soon, Hill would also like to make it possible for a participant’s spouse, child, or caregiver to share access to the app, if needed, to check in on completed to-do items and add appointments to the calendar. 

“We know older adults who have memory loss are at a greater risk for developing dementia later on,” Hill says. “So giving people an easy way to feel more in control of their symptoms and helping them maximize their functional abilities now might have long-term implications on their cognitive health.” 

John Hannan, an associate professor of computer science and engineering in the College of Engineering, helped turn Hill’s vision into a reality. 

Since My Day isn’t the average calendar or to-do list app available for download at the iTunes App Store, Hannan has designed and developed it specifically for people who are not only experiencing issues with memory, but who also have varying degrees of technological know-how to begin with.

“Some individuals in the study have their own iPads, while others have never even held one or used an app,” says Hannan, who has also helped build such Penn State apps as Dining@PSU and the Engineering Penn State Newsstand app. “Again and again, we asked ourselves, ‘How do we design this so it’s going to be accessible to this population?’” 

Hill and Hannan had to carefully choose each font, color, and page layout to make the app easy to read and navigate. 

“What seems normal to the tech savvy could potentially cause a big problem for someone who hasn’t used this type of technology before,” says Hill. 

For these reasons, scrolling is limited, fonts are large, and each screen is color-coded and free of visual clutter. Actions like swipes and pulls that are intuitive for daily tech users aren’t so obvious for many older adults. And if a participant is idle on a screen for too long, on-screen prompts can guide them through what they should do next—like choose a date or pick a time. 

My Day app screenshot

My Day app screenshot

Participants can use the journal to review photos and information about friends and family.

Image: Penn State

So far, it’s been a rewarding experience for Hannan, who admires the strides apps have been making to address the needs of a diverse mix of people, including the visually impaired. 

“It’s nice to develop an app that can potentially have a real impact on bettering people’s lives,” he says. “And this particular project is also a great learning experience that I am able to extend to my students.” 

In the upcoming first round of testing, which is funded by the National Hartford Center of Gerontological Nursing Excellence, Hill will collect data about how easy the app is for people to use and if it helps them meet their goals. If all goes well, she’ll pursue a pilot and clinical trial in the years to come. 

"Again and again, we asked ourselves, 'How do we design this so it's going to be accessible to this population?'"—John Hannan

As a gerontological nurse and researcher, it might seem unusual that Hill has turned to app development, but for her, it’s just a new way of helping people. 

“John [Hannan] and I see the possibilities for using technology more and more to improve the lives of older adults,” she says. “We’re always asking ourselves how we can integrate tech into their lives in a way that is meaningful and that really addresses a need they have.”