We have worked with things like this before for people with disabilities. Take a look at www.ablenetinc.com
, the have things like what they call JellyBean buttons which can be used ir or contact. Also look at their TV/VCR button which is a single button and can learn ir. We have been able to use some of these buttons to perform sequences (with hardware in the background). One push, turn on tv and cablebox, next push scroll through favorite channels etc.