Moderator’s note: Isabelle Fetherston, a reference librarian in central Florida, writes the valuable Senior Friendly Libraries Blog.D.R.


Could e-books someday be the new large “print” for older people in the U.S. and elsewhere?

As a reference librarian, I speak with many who must struggle with regular print books, magazines and newspapers. Consider the ironies. The eyes of millions of retirees are failing just when these seniors finally have the time for leisure reading.

Frustratingly, too, arthritis might prevent them from holding the heavier large-print editions. And those are far from the only problems here—the reason why e-books might be the solution in many cases with appropriate devices and titles available.

With the right e-book standard in use, moreover, just about every book could be the equivalent of a large-print book. Readers could easily adjust the font size.

Granted, many elderly people love audio books. But others understandably prefer text so they can enjoy books in the usual way.

Arthritis as a challenge

Yes, arthritis is a major challenge for the elderly. The National Center for Chronic Disease Prevention and Health Promotion says that “In 2003–2005, 50 percent of adults 65 years and over reported an arthritis diagnosis.” Moreover, “By 2030, an estimated 67 million of Americans aged 18 years or older are projected to have doctor-diagnosed arthritis.”

Unfortunately, large-print books tend to be too heavy and unwieldy for many older people with arthritis to hold. Many library patrons tell me that they cannot use large-print books because of their arthritis. So they are stuck—they can hold paperbacks, weighing less, but they can’t read the smaller print! I really sympathize with people in this predicament. I want to be able to provide them with the books they want to read.

A shortage of large-print titles

Unfortunately, I have just a limited selection of large-print titles that I could recommend to them even if they could hold the books.

What are the numbers? Researching this essay, I looked at the Bowker’s Books in Print professional database and found that only two percent of the books printed from 2000 – 2007 were published in large print. Just one-tenth of mysteries, one of the most popular genres for the elderly, appeared in large print in 2006. Many older adults have told me that they can’t continue reading their favorite mystery series, since large-print editions do not exist. I have also spoken with older men who are looking for Westerns in large print.

So why don’t publishers print more large print? In a recent Publishers Weekly article, Bethanne Kelly Patrick wrote that the publishers have not succeeded in selling large-print books. Perhaps part of the problem is that they have more pages than regular editions and cost more. Also, publishers say some baby boomers feel that large print is only for the very old. Publishing houses are responding to this by marketing books as “larger print” and highlighting their use by people who like to read while exercising on a treadmill.

In addition, HarperLuxe sells a line of “larger-print” books with a font size of 14, whose front covers and spines do not even mention large print. This 14-point font is the bare minimum size to be considered large print—most large print titles use a font size of 16 or 18. I don’t like the trend since it will hurt the people who need larger font sizes.

How e-books could help

So could e-books come to the rescue? Should libraries and senior-citizen organizations such as the AARP promote the creation and use of suitable hardware for the elderly, as well as the availability of appropriate books for them? I most emphatically think so.

A small, lightweight e-book reader with large buttons would be easy for older adults to hold and manipulate. Ideally, such a reader would allow the reader to pick the most comfortable font size and be able to reflow the text for that font size. The screen of such a reader should provide a reading experience as close as possible to the clarity and the lack of glare found with print books.

Today most books exist as computer files anyway, and conversion houses are available, so the cost of digitizing new books is lower than before. And old titles can always be scanned. Ideally, then, publishers can put millions of books online while spending far less money per title than they once might have. Consider their opportunities to market to the “long tail” by eventually providing all their books online. It would be wonderful to have so many titles available for older adults and others with limited vision. Simplifying the task would be the right e-book standard. A good candidate might be .epub, a reflowable format developed by the International Digital Publishing Forum, the largest e-book-related trade group.

Other issues abound. Most e-books from large publishers use digital rights management, for example, which makes it difficult for some readers to enjoy books from more than one company and may limit choices of hardware and software for accessing specific titles. If publishers demand DRM, the IDPF ideally will come up with ways for protection systems from different companies to be interoperable.

Even without the complexities of DRM, many of the current e-book readers seem to be very complicated to use and may require lots of technical expertise to transfer e-books between formats. For e-books to become popular with older adults, we need to have an e-book reader that is easy to use and quick to learn. Many older adults will not consider an e-book device if they have to invest several hours or days to learn how to use it.

Of course, price is also a factor. The high price of e-book readers is an obstacle to many older adults, especially those on a fixed budget. Hopefully, libraries will consider loaning out e-book readers to their patrons when these devices become more reasonably priced. The library market could help seed the commercial one and encourage interest in appropriate hardware, making mass-production more practical and driving down prices. Ultimately, even low-income elderly people could own their readers, which in some cases might also be used for other purposes such as Web surfing or e-mail.

Vast need for senior-friendly E

I have no doubt of the need for senior-friendly digital books and the right devices to read them with. According to Lighthouse International, “approximately three percent of individuals age 6 and older, representing 7.9 million people, have difficulty seeing words and letters in ordinary newspaper print even when wearing glasses or contact lenses. This number increases to 12 percent among persons age 65 and older (3.9 million)” (McNeil, 2001 as cited by Lighthouse International).

As the oldest Baby Boomers become senior citizens in 2011, the population 65 and older is projected to grow faster than the total population in every state. The Census Bureau reported that 12.4 percent of the U.S. population was 65 and older in 2000. The bureau projects that this percentage will increase to 13% in 2010 and to 19.7% in 2030 (Table 5)! This is a dramatic change; 26 states are projected to double their 65 and older population between 2000 and 2030. Florida, for example, already has 17.6% of its population 65 and older—which should increase to an amazing 27.1% in 2030! (Table 5).

To sum up, although I’m excited about about the possibilities of e-books for young students, could it be that another age group needs them just as much? Their grandparents.

Moderator’s note: Also check out TeleRead and the elderly and An e-book guy sees promise in the $100 children’s laptop—and a new e-mail list is on the way for the gizmo’s users. The latter advocates a laptop/tablet specifically designed for the elderly, a suggestion that Wayan Vota of the unofficial OLPC News has also made. – D.R.

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