Before joining the hackday prize dream team, I had already built a simple Universal TV remote to assist those with limited dexterity.

You can read all about it here: https://rubenfixit.com/2016/08/20/megabutton-universal-remote-mk-ii/

Essentially I created a custom box with recessed arcade buttons and wired it up to an existing universal remote. While this works, it has it's limitations and the current version can no longer be programed because the Logitech universal remote that was used is end-of-life.