InnoTech Systems offers an "accessible" Universal Remote Control - Accenda.

The Accenda Remote Control combines Voice Activation and Voice Feedback to enable visually impaired consumers control their devices easier. The Remote also features sculpted large buttons for better tactile feedback. In general universal remotes are too complicated for most people, innovation in this area is important.
The Accenda Universal Remote sells for $79.99 at Dynamic-Living

Features:

• Hands-free voice or hand-held push-button operation
• Sculpted buttons make it easy to find the right button just by touch
• Voice prompts to talk users through set-up & operation.
• Voice Memo recorder — no more fumbling for pen and paper!
• Flip-down keypad to hide infrequently used keys
• Smart Source, which eliminates the usual need to push the TV, VCR, Cable/Satellite button etc.
• Menu Key Lockout to prevent the accidental operation of menu and setup keys