Re: It sucks to be old.
Apple have done some work. I was talking to a lad this month who was actually used as a guinea pig by them back when he was about ten. Long story short, a UK Apple employee had a child who's blind - and so they used him and his friends as convenient test subjects for a bit - they even had online meetings with Tim Cook. The lad started at Oxford this year, and is Mum's pride and joy as he was in the last group she taught the year she retired.
But even he, who's grown up with the things, admitted that the iPhone isn't that easy to use. And that he has to do it by remembering where the controls are on the screen and being very precise where he puts his fingers.
You can solve the orientation problem by using a phone case. Though I very much doubt that you can set one up yourself without help from someone to get the thing into accessibility mode.
I remember when I first got the original iPad testing it with him, and we came to the conclusion that it wasn't going to work. Here, the smaller screen of the iPhone probably helps, because although you've got smaller controls - and so have to be more precise - you've also get less distance to move your fingers from the sides of the screen to find the UI elements.
On iOS 4 the screen reader was laughably crap. We'd press a button on the keyboard and it would tell us, "capital A". Not because shift was selected - but because the Apple keyboard was all in CAPS, like a typewriter - and so because the software hadn't been specifically written it told you for each letter that it was a capital, whether hitting it would get you one or not.
I give Apple credit for having made quite a bit of effort, at a time when Google weren't even bothering with Android. But if you're totally blind you've got to have amazing memory and dexterity to use a smartphone - and physical buttons are going to be much easier.