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This report is a review of themes and issues drawn from selected literature on the subject of game design for senior citizens. The objective of this report is to understand the many faceted issues surrounding designing games for the elderly population. The review of the articles has brought the attention of individual-related, environment-related, industry-related, and society-related issues shaping the field of game design for senior citizens.
1 - Introduction and Overview
Designing games for senior citizens is not a straightforward affair. The market is dominated by games not for this age group but for the younger generation who are also the creators of most digital and computer games. It is thus not surprising as well that there is not much research done in the field. In the making of this report, articles that dealt with the issue were quite rare. Research relating to the topic of elderly digital games is also multi-disciplinary. Issues of mobility predominate as well as the social and psychological aspect surrounding ageing.
In this report, four articles were selected and their main issues and findings are discussed consecutively. Common themes could be observed from observations and studies done on this group in our society. Generally, in the design of games for the elderly population, one has to be cognizant of individual-related, environment-related, industry-related, and society-related issues pertaining to the elderly population. They are different from, for the most part, from the issues that the younger generation may face or are aware of and thus the tendency to be forgotten in the process of designing such games.
2 - Reasons for Low Take-Up Rate of Digital Games by the Elderly Population
It has been said that computer games are often designed by gamers for other gamers. As most gamers tend to be young males, games are often designed with them in mind . Thus games that cater to non-traditional player groups are few and far between . The elderly are one such group of non-traditional players who have been ignored by the gaming industry. The article review of "Digital Game Design for Elderly Users" by Ijsselsteijn, W., et al.  discusses game design with the aim of creating games whose contents are engaging and interfaces are user-friendly for senior citizens.
Senior citizens play digital games to a lesser degree than young people, which leads to the misconception that senior citizens are technology adverse due to a lack of openness or interest. However, although interacting with computers can be challenging for them, the literature suggests they are generally quite receptive. Usability and motivation are two factors that keep senior citizens from playing computers games more.
2.1 - The Usability Factor
Old age is generally associated with well-documented changes in vision, hearing and motor abilities and cognitive processes :
ï‚· Poorer vision - loss of sensitivity to colour and contrast, susceptible to glare from computer screens
ï‚· Poorer hearing - unable to hear high frequency tones, difficulty locating sounds and understanding synthetic speech [because it is often somewhat distorted]
ï‚· Poorer motor skills - slower response times, loss of coordination, balance as well as flexibility
ï‚· Poorer cognitive processes - working memory not as good as before, slower in terms of problem solving and reasoning, apparently easy computer tasks may also confuse them
As a result many games are simply not enjoyable or unsuitable for them because the interface (e.g., small size of the objects on the screen, rapid movements or reactions required).
Furthermore, senior citizens have not been exposed to computers as much as the current younger generation. This lack of exposure may result in seniors having an inaccurate mental model of how computers work. As they do not understand computers, using one makes them feel uneasy. Improving usability will remove their mental block towards using computers or at least alleviate their "computer anxiety". This will make them more receptive towards playing computer games in the future.
The following suggestions help improve the usability of game interfaces for the elderly:
ï‚· Usage of high-contrast color combinations e.g. black type against a white background should be used
ï‚· Usage of legible fonts (size 12- or 14-point) and allowing users to adjust font size as they wish. At any moment in time, users able to directly undo the adjustments - design so that corrections are possible 
ï‚· Providing additional space around clickable icons to allow for difficulty moving the cursor.
ï‚· Avoiding small icons and moving interface elements which pose difficulty for senior citizens 
ï‚· Providing clear instructions (minimize jargon and technical terms) in concise numbered steps
2.2 - The Encouragement and Motivation Factor
Motivation is also important in getting senior citizens to play computer games. In fact motivation might be a bigger pull factor in getting them to play digital games than usability. Studies have shown that many elderly users were interested in playing digital games when made aware that doing so could potentially improve their lives especially in terms of their mental and physical well-being, social connectedness  and as a way of passing time constructively .
The number one motivation is the social component, i.e., "being able to play with friends". In a recent study, researchers and senior citizens brainstormed together and converted resulting ideas into game concepts. One senior citizen listed "Tai Chi" as her passion but on further explanation it came to be understood that she actually liked the time she spent with her friends as a result of the sport . The social interaction in games is thus a crucial motivator to engage in digital gaming. Digital games may also connect different age groups together while enjoying a common activity e.g. encouraging interaction and bonding between grandparents and grandchildren while gaming together .
Games can also be played with the aim of keeping one's mind sharp. Challenging puzzles and quizzes help stimulate memory and cognitive processes - which slow down the onset of Alzheimer's. Moreover, the sense of accomplishment after mastering a certain game or obtaining a respectable game score  can provide a significant boost to one's self-esteem . Nintendo has capitalized on these aspects and for the Nintendo DS platform they introduced "Dr Kawashima's Brain Training: How Old Is Your Brain". This a software which puts players through a series of number games, word puzzles and reading exercises to test their "brain age" - an indication of mental capability with respect to age .
Games can also be played as a form of exercise. With new interaction technologies available on the market these days, digital games now offer new ways of interaction that engage the whole body effectively. A good example of such an embodied interaction device would be the Nintendo Wii. Using motion-sensing technology to capture the players' physical actions and translate these actions into game commands, the set up allows for physically active way of interacting with the game content. Playing such interactive games thus provide a fun alternative way of exercising. With this aim of keeping fit in mind, Nintendo Wii has been introduced in some homes for the elderly where they are used to keep the senior citizens fit as well as socially engaged with one another through group gaming sessions.
3 - Research Techniques in Designing Games for the Elderly
In this section, the findings and concepts raised in the article "Introducing Human-Centered Research to Game Design: Designing Games Concepts for and with Senior Citizens" by Abeele and Rompaey will be presented .
McGuire, F.A said in Khoo, E. T report that (Age Invaders) playing video games can contribute to an individual's pleasure, dominance and changing behavior. Weisman (1983) mentioned that even though computers and video games have become common tool in our society, there was no concern for whether the elderly can get benefit from these games. His suggestion was that the elderly need to have the opportunities to get some experiences while playing games.
In this article review, we will discuss the methodology for designing games for senior citizens based on "ethnographic principles and participatory design". The researcher observed and investigated the "natural habitat" of elderly people in their daily life. Seniors and researchers brought forth ideas into game design concepts. As a result, this methodology provides game concepts, directly embedded to the passions and desires of the elderly. Also more important than actual game concepts is to understand the features that are fundamental to understanding the concept of "meaningful play" in elderly life.
3.1 - Types and Features of Research Techniques in Games Design
3.1.1 - User-Centered Game Design
The user-centered design achieved rapid success with strong prominence on user evaluation and testing of a game. But these design techniques are used in the later part of the design life cycle because most of the decisions were already made by game designers. It is essential to bring these user-centered design techniques upfront in the design life cycle. To understand the user, to find the desires and needs, one needs to investigate the user in their natural settings, often referred to as contextual design.
3.1.2 - Human-Centered Game Design
Human-centered design is essential to innovate game play for senior citizens. In this article, the research is divided into two different steps. The first is an ethnographic study of senior citizens. And the next one is taking out ideas from seniors and researchers by brainstorming and adapting the selected ideas into game concepts.
220.127.116.11 - Ethnographic Inquiries Stage
Firstly, researchers explained to the senior citizens about the project. During ethnographic inquiries, they were observed and interviewed at their homes. The senior citizens were asked to take note of all their interests and to post it on a passion logbook. The researchers reviewed these notes and used these as inputs for the discussion. During the final stage of ethnographic inquiries, researchers analyzed these notes to get a better understanding.
Figure1. One page out of passion logbook (left) and a heart shaped post-it note on a newspaper (right)
18.104.22.168 - Participatory Design Stage
After the stage of ethnographic inquiries, design teams involving one senior citizen and one researcher were formed. An interaction designer and a social designer conducted the design process for moderating and facilitating purposes. Seniors and researchers were encouraged to get possible ideas by brainstorming. After the generation of these ideas, the teams evaluated them based on their attractiveness and designed them into game concepts.
4 - Preferences of the Elderly Population
Nowadays, the rapid development of technology has made the digital devices more widely used by the elderly. There are activities that can be the source of entertainment and fun for elderly people used to improve their physical and psychological health. One instance of these activities is gaming which require physical play in social settings. There have been some games developed for the elderly, for example digital games . The article "Towards Designing a Mobile Game for Elderly's Social Engagement" by Mubin, O., Shahid, S. and Mahmud, A.A. , on which this section is based, highlights some issues pertaining designing mobile games for the elderly in relation to their social engagement needs.
Most of existing games are intended for young adults and not elderly people. Moreover, the environments of the games are non-social settings, which lead to social isolation and frustration on the part of the elderly. Mubin O mentioned Games that stimulate the memory, entertain and socialize can have a positive impact on the elderly if they were redesigned according to the real needs of the user group . To motivate the elderly to play games, new games are designed as a part of the real environments and centered on their everyday activities.
4.1 - Design Considerations Identified From Study
As an initial investigation for a user-centered game design for senior citizens, the conducting of requirement analysis based on a focus group of 9 or 10 elderly people found the need for a simple game design, one that is pleasurable, and one that is socially entertaining when designing elderly-oriented games. The elderly was found to prefer playing games, which is displayed on various television screens. Most of the elderly enjoyed playing games with their grandchildren because they believed that their grandchildren could assist them in understanding the rules involved in playing the games. They appreciate games with simplified rules and advanced technologies and which were more interesting and exciting. They do not have the confidence to remember game instructions and rules if the game requires too many controls or options and games, which are fast and swift.
Based on the result of requirement analysis, it was suggested that the following design principles be integrated into design consideration.
Game design should involve supplements for existing conventional games by integrating advanced technologies.
Game design process should have not only simple rules but also provide more enjoyable.
Game design should recommend both active and passive involvement for senior citizens.
Game design should support the need for senior citizens to interact each other during playing games.
4.2 - Implications for Future Game Design
From the point of this article review, the following points can be valuable to include in game design for the senior citizens.
The game should make an effort to involve many players as possible which can affect to improve social engagements for senior citizens. The game should have both active and passive participation for elderly because some of them can have physical and cognitive problems to play games.
The game should have "Minimum Rules and Maximum Fun" target for elderly people.
The playing game experience of elderly can be improved by playing conventional games with advanced technology and new rules, etc. Moreover, conventional games become more enjoyable, interesting and fun.
The game should attract not only male but also female elderly users. For example, females don't like to play some games such as billiard.
The game environment for elderly need to be customizable to change the opinions of their experience upon playing games and to motivate them to play games.
5 - Inter-Generational Games: Findings from the Game Age Invaders
The game Age Invaders is an example of a game designed with the needs of the elderly population in mind. The following are findings and issues raised from the article "A Social and Physical Inter-Generational Computer Game for the Elderly and Children: Age Invaders" by Cheok et al. on this game . This game is intergenerational - to be played by several age groups - and as such concerns for the elderly is one component of the various issues raised.
5.1 - Factors Considered in the Design of Age Invaders
Age Invaders is a game that is designed to address four major areas where the needs of the elderly are concerned: their social, physical, cognitive and psychological needs. However, as the game is meant to be played with other members of a family (the parents of their grandchildren and the grandchildren themselves) the needs of this younger group is also essential. Also of importance noted in this game example is that the problems that the elderly face does not emanate from the elderly alone but is also a complex result of preferences and needs of the younger generation.
5.1.1 - Social, Physical, Cognitive, and Psychological Issues Associated with the Elderly Population
Most of the issues related to the elderly population as identified by this article repeat the findings and propositions mentioned in the earlier articles. This article identified that as the population ages, there is the need to enhance the relationships between the younger members of a family, the children and parents, with the more elderly members of a family, identified as the grandparents. The elderly is identified to be a potential resource in imparting various skills and knowledge to the younger generation. This includes family history and values that are beneficial to the younger generation.
The elderly population was identified to have the propensity to face many social problems including social isolation thus loneliness. This can be due to other members of society's preoccupation with other matters. Their adult children may not live with them, are away most of the day or prolonged periods at work outside of town as well while the younger generation is constantly connected to the Internet.
The elderly is agreed to be in need of physical exercise and outward forms of expression. This is no different from the needs of young people, which are seemingly also neglected today.
The cognitive aspect refers to the need for stimulating one's mind and mental state also identified in the first section earlier. The brain needs constant stimulation in order to function properly. It is a common understanding that elderly persons' mental capacities are not as strong as they were in their younger days and may deteriorate rapidly.
As for psychological well being, the elderly is identified as needing to feel useful and connected to those around them and being able to contribute and partake in various activities with other members of their family. Only when they feel as such would they be in the correct psychological frame of mind. Interactive gaming can support this role.
5.2 - Age Invasion, Factoring in the Needs of the Elderly and Younger Generations in One Game
Age Invasion was designed to overcome and/or incorporate many of the issues identified above. The game involves the participation of all family members, grandparents, parents, and children. Location wise, the grandparents and children will need to be in a common physical space. The parents can have the option of participating off-site through the Internet.
It was noted by the author that the elderly seems to prefer certain types of games, such as chess or fishing, a finding not unlike those mentioned earlier. These are however not the preferences of the younger generation and thus there was a need to also produce something that is attractive to both the young and old. A puzzle-game element is incorporated into Age Invaders to allow grandparent and child to work together to solve them for example.
The game requires physical motions by grandparent and child, to satisfy the need for physical exercise. Technology such as RFID is used to facilitate these movements. The motions for the elderly are slowed down given their slower mobility. These are adjustable nonetheless to cater to different needs. This was identified as necessary to sustain interest for both the elderly and the young to the game, similar to earlier findings.
5.3 - Limitations and Other Issues from this Game
The following are some issues not covered by the article. The nature of the game seems directed only for senior citizens with families. However, the adjustable features of the game could perhaps allow an all-adult-participants situation for locations such as hospices and retirement homes/villages.
The physical mobility aspect of the game also means that the game is perhaps more suitable for elderly persons who are still physically able. There is the option of participating over the Internet however for cases of less physically-abled persons. The game is also quite equipment dependent, motion detector screens and such and thus could be possibly rather expensive.
This article brings up the difficulty of trying to create games, which are attractive to both the elderly and younger generation as both generations have their different needs and limitations.
6 - Concluding Remarks
Digital games have the potential to benefit elderly users. They allow elderly people, to bond socially, either online or with those around them, thereby enhancing their social connectedness and potentially enlarging their social circle. However, senior citizens are at present underrepresented as consumers of digital games. They can be considered a significant market opportunity that has yet to be tapped to date and in the future given the expected ageing society that is anticipated.
A step towards tapping this market would be to focus on making games more elderly-friendly. This would make games more accessible to them and not a cause for anxiety instead.
Acknowledging that "meaningful play" is a form of motivation for playing digital games for them , game designers also need to make sure that there are perceived benefits for elderly users in gaming - not just in terms of entertainment value but substantial therapeutic value as well. When the elderly are motivated to play computer games, they will embrace such technology more willingly and whole-heartedly.
Current research may not be sufficient or totally relevant for the future however. It was noted that the current older generation were introduced generally late to computers as compared to the younger generation. When the current younger generation become part of the elderly population themselves in the future, their needs and expectations may differ given their lifetime exposure to high technology products. Perhaps physical-related concerns may remain but social and industry context and practices may evolve.