It's hard to know who relies on the telephone more, teenagers or the very elderly. The elderly are certainly right up there, as for so many who become increasingly home bound the telephone is their lifeline to the outside world. But as eyesight and dexterity decline, and arthritis and forgetfulness increase, many of the telephones we choose for our seniors become increasingly difficult for them to use.

As a group, we "youngsters" tend to like cell phones and portable phones. Both these designs allow us to roam around while we talk. For the elderly, however, both designs tend to have more disadvantages than advantages.

Cell phones are tiny. When you have poor eyesight and clumsy fingers, it's hard to use the buttons. The "talk" and "end" buttons are hard to see and hard to remember. For a senior who no longer goes out alone, a cell phone is usually much too difficult to use. Because of their small size they are also very easy to lose, and you have to remember to plug them in regularly. These are all BIG disadvantages to cell phones for the old elderly. We don't recommend them.

If you still feel that a cell phone would be a workable second phone for a senior, the Jitterbug is probably the best choice. It is the largest and easiest to use of the larger cellular products available. They still have to be re-charged - there's no way around that.

Portable phones for the home have the advantage of being portable, that's true. However, even the larger portable phones tend to be rather difficult for seniors with sensory or memory deficits to use. Although the buttons are larger than on most cell phones, they still tend to be fairly small. In order to talk, you have to push a button when you answer. Many seniors we know routinely forget which button is which. They push the "end call" button when they answer and immediately disconnect. Because they are portable these phones tend to be left in odd places, which makes them difficult to find. Remembering to put them back on the charging stand can be an issue, as well.

We don't recommend that a frail senior have only a portable phone, even if you provide a two-phone set. All too often both phones end up lost somewhere in the house, drained of power, or both, and the senior ends up with no working phone until someone visits to put things straight.

If a portable phone is dropped or knocked off a table it can be difficult to reach, which can create a very real risk of a fall, especially at night. If the handset is knocked off a corded phone it can usually be retrieved simply by pulling it back up by the cord.

For those with dementia, portable phones are also often confused with television remote units, which adds to the fun.

As a supplement to a corded phone, portable phones are handy for carrying around in walker baskets or pockets as long as they are turned off after use so that the line is clear. If you believe that your elder would be safer with a portable phone to carry about the house, look for an easy-to-read portable phone with big buttons that has a simple way to start and finish a call. Making sure that the unit gets back to the charging station will still be a potential problem, which is why we strongly recommend that every senior's home have at least one corded telephone that stays put and doesn't need to be charged.

One corded phone on a table by the most commonly used chair, and one at the bedside is an ideal arrangement for the very elderly. Corded phones are not expensive, and many come with large buttons and volume control for those with vision or hearing loss. Some even have a flashing light to supplement the ringer alert for incoming calls. A full-size handset is almost always easier for a senior to use than the long, fat portable phone. It is certainly easier to hold and use than a cell phone.

Remembering how to work the keypad to dial commonly-called numbers becomes more difficult for the elderly with memory and cognition problems. Corded big button picture phones programmed to automatically dial a frequently-called person almost always greatly increase the length of time that someone with dementia will be able to use a simple big button phone independently.