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Perhaps the most obvious difficulty in using the computer for an elder is the size of print on the display. Add to this the difficulty of seeing the computer display when wearing bifocals, and many elders find the computer uncomfortable to use.
The Microsoft Accessibility Wizard offers settings that accomplish some of the Elder Interface changes, but does not address all of the visual changes that are recommended.
(For younger readers, bifocals are designed so that when wearers look down at a desktop or book, they are looking through the "near vision" portion of the lens. When looking at eye-level, wearers are looking through the far-vision portion of the lens. But when looking at a computer screen which has been set up appropriately, the upper portion of the screen is viewed through the far-vision part of the lens, and the lower portion through the near-vision portion, with an annoying line across the middle of the screen. In order to view the computer screen, bifocal wearers often find themselves craning their necks to see the entire screen through the near-vision lens.)
The most effective method of accommodating bifocals is having the elder invest in "computer glasses." (These are the same thing as reading glasses, but sound fancier.) If the individual has vision in both eyes that is nearly the same, low cost reading glasses can be purchased at many pharmacies that will be adequate. If the individual has significant astigmatism or different levels of vision change in each eye, a custom prescription might be required. Depending on the degree of vision corrected, the cost of these glasses can be significant, but they can also be used for other "close work."
The Windows Operating system is delivered with a wide range of typefaces (called, inappropriately, "fonts") that can be used to make printed documents more "interesting." However, very few of them are designed to accommodate readers with limited vision.
The American Printing House, however, and designed a typeface, "APHont," specifically for individuals with limited vision which is highly readable. This typeface can be obtained and distributed at no cost.
APHont can be downloaded from the website of the APH at http://www.aph.org/products/aphont.html. Clicking the "Download APHont" link will advance the browser to a page asking for basic information about the intended user of APHont, who is the elder in question. This information is used by the American Printing House to track the use of the font, but does not result in any unsolicited email.
Once the font (typeface) file is on the computer to be adapted, it must be installed. The downloaded file is a "zip" compressed file, and can be opened directly in Windows. Double-clicking on the file should produce a window labeled "WinZip Self-Extractor-aphont.exe." Ordinarily, zipped files are expanded into a "temporary" folder, but we want these files to be available in the operating system immediately.
Click the "Browse..." button in the WinZip window to open a dialog box in which you will specify where the font files will be stored. In this dialog, folders that contain other locations have a small box with a "+" symbol if they are "closed," and a "-" symbol if they are "opened." If the "Local Disk (C:)" is closed, click the "+" symbol to open it. This will reveal a list of the folders on the computers hard drive.
Near the bottom of this list, locate the "Windows" folder, and click the "+" to the left of it to open that folder. In the resulting list, locate the "Fonts" folder, which will generally not be preceded by a "+" symbol. Click once on the "Fonts" folder to select it, then click the "OK" button at the bottom of the window. This will close the file dialog, and return control to the WinZip folder. Click the "Unzip" button at the top-right of this window to install APHont on the computer. After a moment, a small window should announce "5 files(s) unzipped successfully." Click "OK" to dismiss this window, then close the WinZip window to complete the installation. THere will be no obvious changes in the operation of the computer, but APHont will now be included on the font menus of all applications.
In the change from Windows 2000 to Windows XP, Microsoft took advantage of the enhanced abilities of displays to make more "attractive" icons and window borders. However, for individuals with limited visual acuity, these softer, rounder buttons, windows, and icons can be more difficult to identify than the older, blockier style. In addition, some portions of the text information provided within window components cannot be changed in the new style, but can in the older style of display.

Fortunately, Windows XP provides the option of returning to the older, less colorful display style, and making more of the interface easily accessible.
To revert to the older, more visible display, open the Display Properties control panel. This can be done by selecting Start>Control Panels, then double-clicking on the Display control. If the Display control is not visible, your display may be set to display in "categories." On the left, find the text to "Switch to Classic View," or click on "Appearance and Themes" to get to a display that shows the Display controls.
Alternatively, you may right-click on the desktop, and select "Properties" from the contextual menu that appears.
The exact appearance of the Display Properties window varies depending on the hardware that is present in your computer. At a minimum, the Display Properties window should show a row of tabs across the top which include Settings and Appearance. Click the Appearance tab.
In the resulting display, below the tabs you will see an area that shows foreground and background windows, and a Message Box. This area shows what the screen will look like with the current settings.
Just below this area is a set of three "drop-down" menus. The upper menu, labeled "Windows and buttons:," offers settings for "Windows XP style" and "Windows Classic Style." Select "Windows Classic Style" and then click "Apply" at the bottom of the screen. The screen should change to show blockier windows and graphical elements.
The middle menu offers a number of color schemes that can be applied to the Windows interface. These include high-contrast and lower contrast, as well as a range of colors and hues. When configuring for a particular individual, it may be worthwhile to explore the options of this menu to find a color scheme that the user finds restful to the eye.
The bottom menu allows selection, under Windows XP style, of Normal, Large, or Extra Large font sizes. Under the Windows Classic style, however, only "Normal" is offered. This is not an issue, because the we will be adjusting the settings in more ways that simply font size.
Once the Windows Classic Style and the desired color scheme are selected, you are ready to set the scale of the Elder Interface. Click the "Advanced" button of the Appearance tab to open the "Advanced Appearance" window.
This window, like the Appearance window, has an upper area showing the effect of selected settings. Below this area, on the left is a menu labeled "Item:" which is a list of the features that can be adjusted. To the right of this are controls for the size and the primary and secondary colors of the selected feature. Below these are settings for the font to be used in the feature, the font size, font color, and bold or italic display of font for that feature.
The Elder Interface involves changes to many of these features. Select the features listed in the table below, and adjust the settings as indicated. For each entry, select the feature from the "Item:" list. This will show the current settings in the other controls of the window. The settings for Font will not be active for those features (such as the window border) that do not display fonts. Similarly, the upper size control may not be active for a feature that only has font characteristics.
The recommended settings are those that we tested in the Elder Interface, and will be functional for most typically developing elders. For elders with visual anomalies that are not typical, other settings may be required.
Once all of these changes have been made, select "OK" to close the Advanced Appearances window, then OK to close the Display Properties window. After a few seconds, the menus, title bars and other windows features will adopt their new appearance. Important note: in many places within the Windows environment, clicking the "close" icon is the same as clicking "OK" or "Apply." That is not true here. Unless "OK" or "Apply" are clicked, all of the changes will be discarded.
Not all programs use the system settings fully. In Microsoft Word, for example, the program menus will use the new, larger font, but the embedded menus in tool bars will not. Some programs generate all menus and dialogs, and ignore system settings. Quicken, the home money management program, will allow the font size in the check register to be adjusted by the system preferences, but all menus, dialogs, and displays use fixed font sizes that cannot be adjusted by the user. In some versions of iTunes, the menu bar will ignore the larger font settings, but the menus themselves will be readable. These settings will not make all of Windows more readable, but will do much to improve usability by elders.