Making Technology More Supportive for People With Cognitive Changes

For aging adults and people experiencing memory changes, everyday technology can be confusing, frustrating, and difficult to navigate.

Angela Cearns is the founder and CEO of AsKevin,  which offers workshops and digital coaching to help older adults and those with cognitive challenges — including Alzheimer’s, dementia, and Parkinson’s disease — better understand and use technology. In this conversation with Being Patient’s Mark Niu, Cearns identifies three core struggles facing people with cognitive challenges in the digital world: the constant distraction of notifications that makes it hard to keep track of information, the self-doubt caused by frequent software updates that change familiar interfaces, and the shame that comes from needing to ask family members for help. 

Cearns, a former head of product management at Amazon Prime and chief e-commerce officer at Pizza Hut International, shares practical strategies for simplifying devices, turning off unnecessary notifications, cleaning up contact lists and focusing on tools that keep people connected. She also highlights the growing threat of multistep scams targeting older adults. While technology can bring risks, Cearns emphasizes that it can also be a lifeline — helping people stay engaged with loved ones, health care, and the wider world.

Being Patient: Tell us, how did you come up with this idea for AsKevin?

Angela Cearns: During the pandemic, so many people were asking for my help. And I’m sure you have a lot of people calling you saying, “How do I do Zoom? How do I talk to people? How do I see my doctors?” And there was a wake-up call for me.

I spent my life helping companies to transform digitally to the modern day. And who is helping the digital transformations of seniors and older individuals? At the time I looked around, seniors and individuals really had two options. 

One is tech support like Geek Squad, which really focuses on fixing broken phones and computers. And the reality is that nowadays all your devices are working, but they’re just not working together for you. 

Or the second option that seniors have is the Apple Genius Bar, but they’re not going to help you with a Microsoft Outlook issue on their MacBook or Google Docs issues. And every time a senior needs help, you have to call a different help desk, and people are getting frustrated. And I just thought there has to be a better way, a modernized way to help people with technologies in a holistic manner.

Being Patient: What does the research say about how all this personal tech that we’re being bombarded by, is affecting our brains and memory?

Cearns: Research is very clear that general tech usage definitely decreases the risk against cognitive decline. General tech usage actually really helps your cognitive decline. Now it is not my opinion, there are scientists who really are focusing on this area and looking into the research. The latest research last year was published by Dr. Jared Benge and Dr. Michael Scullin. 

They made the conclusion that general tech use really helps protect people against cognitive decline.

Being Patient: How is it affecting our memories?

Cearns: What happens is that you have to look at how a person’s memory often declines as you age. There are three big factors. Age is the biggest predictor of decline and dementia, and you and I can’t stop aging even though I really want to. And the second factor is genetics, because genetics appears to be related to the decline, and I can’t change the genetics, and you can’t change the genetics. And the third thing that is important, that can help or have an impact on people’s memory and cognitive functions as we age, is building reserves. Building reserves is something that you and I and everybody can control. 

The key important thing is to improve the controllables. Building reserves means that there are different aspects of your life — like, for example, the easiest to think about is physical activities. If you’re strong and fit, you’re building a reserve to have muscle strength. So as you decline, you are starting at a higher point. You have more to lose, so to speak. And everything in our lives, you can look at it that way. Your knowledge base, your experiences, your health.

The interesting thing is that medical communities often talk about the physical, the experiences, the knowledge base and health, but nobody really talks about building a digital or technological reserve. That is an area that’s often missed.

Being Patient: You’re helping all kinds of people with issues, and among those are people who are neurocognitively challenged, some with Alzheimer’s. What are some of the key problems you’re seeing? 

Cearns: There are definitely the stereotypical problems that everybody can think of. Like, my printer is not printing, password issues, huge cyber issues, a big emphasis on getting scammed, clicking on scam links. But I actually want to focus on our experience working with seniors and older adults, one-on-one. 

I would say there are three main issues, specifically for the neurocognitively challenged population. The first one I’m going to call the “where is my stuff” problem. “Where’s my stuff” is finding and locating a specific piece of information like emails, texts. I remember somebody called, I have to respond, but did it come from a text or did it come from an email, or was it a call, or was it a document? 

It’s increasing a lot of anxiety because people don’t know where their stuff is in the world. And you’re really only talking about a small device like a phone. It is because our device is designed in a way that distracts you. You have endless pop-ups, notifications, everything is fighting for your attention. 

You receive an email. You’re in the middle of answering the email, a text message pops up. And then it’s from, let’s just say, a notification from My Health Online, from your health care provider about your test results. It’s important. You look at it, you click on the link, the next thing you know, you’re in the health portal app. And then you’re lost. And then you’ll say, what was I doing? I was answering an email. The key issue is you often get lost in your own world and you just get lost in your phone. That is the numbr one thing.

The second problem — I’m going to call it the “am I losing it” problem. It’s this self-doubt created by the constant changes in our technology. And you know how to press the button, you know how to get access. I’ll give you an example. You go to Safari, you go to Chrome, you know how to find things. The search bar where you type in the information used to be on the top. You have spent 10 years typing in, you were looking at the top, and all of a sudden, it disappeared. It’s not on the top. You can’t see it, you don’t know where it is. And for you and me, not challenged by cognitive issues, we’ll look around and then we’ll say, “Oh my God, they just moved it to the bottom.” So you find it on the bottom. 

For those who are neurocognitively challenged, they’re not going to look. They’re going to be like, “Oh my God, what happened? I remember this.” And they’re just going to fixate on this and say, “It’s my memory — I don’t remember. Am I being that forgetful? How did I do it?” This constant change of our technology is creating a lot of self-doubt. 

Part of my job is really to help my clients build up their confidence and say, “It’s really not you. It’s the technology changing. You’re not losing it.” And that is the second biggest problem in terms of that population, the neurocognitively challenged population and technology.

The third and last one, I’m going to call it the “My dad is driving me crazy” problem. And that is the problem where you don’t know, you can’t find a search bar, you ask your son, and your son just gets frustrated, or you ask your daughter. There’s a lot of shame built into that interaction. There’s a lot of conflict between family members from helping my dad or helping my grandmother with the technologies, and it creates a lot of shame in the person. I would say those are the three main issues that you don’t hear about if you don’t work with seniors on technology on a day-to-day basis.

Being Patient: That shame, I know you’ve mentioned that. You’re working with people that have really high-end educations, people that have worked for Apple before, and still the technology is confusing them when their mind is affected and as they get older, too.

Cearns:  Especially — you and I are in Silicon Valley. We’re in the middle of tech. A lot of my clients, CFOs, CTOs of tech companies, are not tech-unsavvy. As a matter of fact, they are tech experts. Used to be tech experts, top of the field, leading the technology evolution of the country. And all of a sudden they got diagnosed with Alzheimer’s, early dementia, Parkinson’s, and they can’t use the device anymore, or they are having difficulties. 

They’re looking for empathy from the family members, or tech support people, not just family members, from anybody. And yet often what they get is invalidation of their expertise or their knowledge — who they are as a person.

Being Patient: Let’s talk about some of the issues that you’re helping to solve for people out there. First of all, let’s take a look at the iPhone, for example. What issues are we having here? I know I deal with a lot of issues, but what are you seeing in the top ones?

Cearns: The top one is, like I said, “where’s my stuff?” They’re constantly getting distracted. You need a lot of short-term memory to hold on to: OK, I’m checking my email, OK, then there’s text messages, now I am checking my blood test result in the health portal.. You need to remember to go back to the original email. That is a big thing. One of the key things that I tell my clients to do is to turn off notifications. And it’s also difficult, but they say, I want to know, I want to know that a text message is coming. That is a huge issue, that constant distraction on the iPhone.

“This constant change of our technology is creating a lot of self-doubt.”

Being Patient: What about the design of, say, for example, the iPhone? Is it getting better for those with neurocognitive challenges and the elderly?

Cearns: I would say a lot of concepts are great, but they don’t quite work in the real world, especially for older adults. I will give you an example. Our phone is currently designed to be a more powerful computer than what you and I were using probably in the ’90s. And everything is customizable. 

And to older adults, they want to have some stability in this world and in their devices. Which is a very fair ask — for it to not have 50 applications that they did not choose to download, that just kind of come with the phone. And everything is movable. Sometimes they press the icon a little bit too long, and then all of a sudden everything starts jiggling. It’s that instability. 

Our technology is designed to be changeable, customizable. And [for] older adults it’s important to have that stability — everything just stays the same so they can use it.

Being Patient: How about facial recognition and fingerprint recognition technology?

Cearns: Face recognition technology works really well, I have to say. Fingerprint technology is absolutely lousy for older adults. Unfortunately, MacBook doesn’t have face recognition technology yet, and they do have touch technology. 

As people get older, their skin conductivity changes. And also there are more folds, and devices often cannot recognize the fingerprint. And it’s not just fingerprints. The whole touchscreen design does not work well for older adults.

Being Patient: We got a question here from Luke. He’s asking, “Are there apps that you would recommend for daily use? For example, calendar, to-do list, contacts, etc. Or is there a singular app that has calendar, to-do list, contacts, etc.,” which kind of goes with your theme of not having too many things, being bombarded by too many things.

Cearns: This is where I would say that I always focus, number 1, on one app or two apps that help with connecting the person to the family members. You have to think about texting and phone calls. Ultimately,  your phone is for you to call your friends, to pick up the phone when your family calls you. That’s number 1. And how do you use that? Using voice is important. It depends on the person’s disability. And texting is important. Photos are important, because you can see family members.

I would prioritize the applications that help a person connect to their friends and family members first. Everything else comes second.

Being Patient: I helped my mom and we definitely took off any banking or apps first. Anything that can connect to financial information. I wrote an article about putting it in a gray mode where, as long as I remember that password I can put it in and even the Apple ID is whited out. So nobody, if they steal the phone and get into it, can do that.

Cearns: The other thing I was thinking about is what are the applications that are useful for seniors. But I think a lot of the time when we help seniors, we have to think about what access you, as a helper, need. 

For the person, for the older adults, it’s the texting — it’s maybe not the email —— it’s the phone calls and texting. That’s the most important. And then you talk about the calendar. Yes, the calendar is really important because it can tell the older adults, “Hey, Johnny is coming to visit you today.” Or, “You have a doctor appointment, remember to go,” or “Someone is going to pick you up to see Dr. Johnson today.” 

But the calendar app is less about teaching the older adults with cognitive issues how to use it, how to put in a calendar event. You as the helper, as the family member, almost need to look at yourself as the executive assistant for the older adults. You are the one who should have access to that calendar. You manage the calendar and all your grandmother or your father does is look at it. 

You teach them to look at it, but they don’t do anything. They don’t accept, they don’t decline, they don’t propose new times. If they need a new event to remember, they tell you. You have to look at those applications from that perspective, instead of saying, well, let me teach you how to use the calendar.

Being Patient: Tell me about scamming, which is a very important issue. I faced it myself with my own mother. I’m getting calls, seeing her phone about to give information away. Have you had scenarios where people have really been scammed or about to be scammed? 

Cearns: Yes, we have helped a lot of our clients, all ages actually, from 21 years old to 94. My oldest client is 104. Scamming is a huge issue. The key thing is, yes, you can go to a class, and AsKevin offers a lot of cybersecurity classes or internet security classes, or just gives tech talks on the subject. 

But I want to tell you, one of the important things is it’s a cat-and-mouse game. Scammers will always outsmart any defense that we put in place. As soon as they learn that people know not to give away two-factor codes, they will figure out another way. And especially for the population who is cognitively declining or changing. And the memory — it’s impossible to remember. I often say that you have to help them develop that gut feeling that something is off. 

In my cybersecurity talk, I will give them techniques and say, “Remember this, remember, don’t click on the link.” But modern scams are very elaborate. It’s an elaborate story. It often involves multiple people over many days, or sometimes weeks and hours, to work the person. 

The biggest thing that I tell them is, “I’m going to help you develop that gut feeling that something is off. You may not be able to verbalize what is off, but I want you to feel that if you’re interacting with someone and you feel being pressured or something is off, you don’t need to know why. You don’t need to remember someone taught you certain techniques. You just need to understand that, ‘Hey, I remember sometime, somewhere, there was this lady who told me that I can hang up my phone.’”

Because the scamming doesn’t start with a click of the link. That’s only step one. You can make the mistake in step one, but the actual scam will come in step three and step four. And steps three and four are for you to hang up the phone, ignore the emails, don’t pick up the phone, and talk to your family members.

“Our technology is designed to be changeable, customizable. And [for] older adults it’s important to have that stability…”

Being Patient: Everybody gets these spam calls. Sometimes there’s nobody there. Tell us what’s going on with this strategy sometimes.

Cearns: They will send you a text message or email. You click on the link, and let’s just say they say, “Hey, you have spent $5,000 buying this piece of furniture. If it is not you, click on this link or call us.” And that’s a scam email. You click on the link and say, well, please take the charges off, thinking that it is actually from your bank. That is really step one of the whole story. 

They’re not going to be the person who asks you to give them the $10,000. So let’s just say they’re going after your bank account. That person’s job, the scammer’s, is to gain your trust, and then they will pass you on to somebody. They may say, “Hey, you should call your credit card. We’re going to invalidate this charge, you should call your bank. Or you should call this person, or you should call the police,” and they’re going to give you a second number. 

And then you go call that person. And then you’re thinking that they are your bank or the police, and then they will ask you to log into your bank account. 

You’re dealing with two or three people. That’s what I meant by it’s a very elaborate scheme. And every step of the way, they’re trying to gain your trust. And that’s why all these texts coming through are really the first step. They are trying to get you to engage. 

The purpose of those texts with a link, an email link, is a ploy to get you to engage. And that engagement will be an elaborate, multistep process so that you can trust them, with the ultimate goal of getting into your bank account for transfer. They’re going after everything in your bank, basically.

Being Patient: What are you recommending for phones to prevent those calls from coming? What do you recommend?

Cearns:  What I recommend is don’t pick it up unless it is someone that you know.

Being Patient: But sometimes they don’t have the cognitive ability to know. Is there a further step we can take?

Cearns: I would say that for this particular population, I do clean out their contacts with their family members. It’s very important to clean out the contacts to the ones that the person actually needs, whether it’s the doctors or you. And really reinforce the concept that if the contact name doesn’t show up, you don’t talk to them. You don’t pick up the phone.

Being Patient: Do you go a step further sometimes and just completely whitelist or blacklist and just not even allow anybody?

Cearns: I don’t recommend that because it is very important for the older adults and people who need to be able to reach their family members and ask for help or just talk to them. It’s that social engagement. I may recommend that solution in terms of just no phone calls and blocking every single phone call and putting the call in silence if they are very good with texting or have another means to talk to you, because social interaction is part of those reserves that is extremely important to the elderly as well as those who have neurocognitive challenges.

Being Patient: Can you talk about some of the more dramatic cases that you faced where some of your clients were almost tricked, so that we know to avoid some of these things.

Cearns: Remember I said that the most important thing that the scammers are trying to get at is not just getting information from your phone or getting information from your computer? Somewhere along the line, they are going to ask you to check your bank account. And they will be on the phone with you. It is very important that you never check your bank account when someone calls you unless you are physically with someone you trust, and I’d much rather use another device.

If somebody calls the person and says, “Oh my God, can you check your bank account or can you check your credit card?” You don’t. You just say, “My son has access to my bank account. My daughter has access to my bank account, and I will ask them to check it.” 

What I would actually recommend is give that as a script to your grandmother or your father. Give it as a script, because just like everything else, you prepare — because sometimes when you’re caught in the moment, you don’t know what to say. 

Being Patient: Are there any particular technologies that you recommend?

Cearns: I know often people want to look at technology as a solution. I think technology oftentimes is a solution and also is the problem. If you are talking about phones and scammers in this situation, the solution often isn’t about the technology. On a computer, there are some technologies that I will ask people to install. 

One of the things is called an ad blocker. There are a lot of pop-ups on the computer, and a lot of these pop-ups, they by themselves may not be scams, but you click on the pop-ups and it takes you to another, let’s just say, legitimate location that has a lot of ads, and then it brings in a lot of pop-ups. That is a behavior that will ultimately lead them to a malicious site, because one of these pop-ups is a malicious site.

Being Patient: You’re also helping people with Parkinson’s. Tell us some of the issues that they’re facing using tech and how you address them.

Cearns: I think one of the misperceptions of Parkinson’s is that Parkinson’s is really just a motor skill issue. And it is not. The manifestations of that illness are different for everybody and the progression is also different. 

What is not being talked about outside of the Parkinson’s community is that at later stages, cognitive issues are a huge thing. In helping my Parkinson’s clients, I often want to make sure that I get to help them early on during the illness, to build muscle memory before the cognitive issues start. 

Often when a person gets diagnosed with Parkinson’s, they’re overwhelmed. Technology is not that big of an issue for them just yet. Yes, they have tremors and they may have a hard time pressing the buttons. Then I will work with them to really figure out how voice commands — like, “Hey Siri, or “Hey, Google” — can help them and simplify their technologies and then reinforce those activities as the cognitive decline happens.

Being Patient: Any final words on technology solutions and advice? I want to leave you with the last word, but overall, do you think tech is presenting a solution to improve the lives of the neurocognitively challenged, or making it more of a danger?

Cearns: I would say tech has its dangers, but tech is a lifeline to older adults in general and specifically related to those who have cognitive issues. Because as your world gets smaller, and often you reach the state where you are homebound, technology is your lifeline to the world. Whether you can interact with your friends, whether you can talk to your friends, or for those who can even play games, watch the news or listen to the news, the only way to do it is through tech. 

It is absolutely important, but we often think, “If I can just have this one tech, then it can cover everything.” I think it is really important to think about how you use the least tech to help you connect to the world and to those you love. And there’s never tech only for the person who is suffering neurocognitive challenges, but it’s tech for the family. How does the family use this technology to help that person?