We present the participatory design and evaluation of an orientation aid for individuals who have anterograde amnesia. Our design team included six amnesics who have extreme difficulty storing new memories. We describe the methods we used to enable the participation of individuals with such severe cognitive impairments. Through this process, we have conceived, designed, and developed the OrientingTool, a software application for Personal Digital Assistants that can be used by amnesics to orient themselves when feeling lost or disoriented. Two complementary studies were conducted to evaluate the effectiveness of this tool in ecologically valid contexts. Our findings suggest that the OrientingTool can improve an amnesic's independence and confidence in managing situations when disoriented, and that participatory design may be productively used with participants who have significant cognitive disabilities.