virtual reality transports seniors living with dementia to other worlds
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caregivers can also go along for the virtual ride via a secondary device, such as a tablet that mirrors what the person wearing the headset is seeing.
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drop by the dogwood lodge in vancouver on any given day and you’re likely to find residents regaling each other with stories about their day climbing mt. everest, swimming with dolphins, or hang-gliding over the grand canyon.
is this a youth hostel filled with high-energy adrenalin junkies? nope. it’s a long-term care home populated by older adults, many with dementia, who left an active lifestyle behind decades ago. but that doesn’t mean they don’t still want to seek out new adventures, explore foreign locales, or take a leap and try skydiving.
with virtual reality, they do it every day without ever leaving the comfort and safety of the lodge.
“a lot of times it’s hard for these patients, who have different disabilities, to go places they want to visit. we thought we could take them where they want to go,” says vancouver coastal health researcher dr. lillian hung, who co-leads the virtual reality program in long-term care project out of ubc’s idealab (innovation in dementia and aging lab).
and by simply placing a lightweight 360-degree vr headset on participating residents, they are transported from the confines of their care home to the wide-open world.
“the reaction is so positive. it brings such joy,” hung says of the 50 to 60 participants who, while wearing the headsets, laugh and point and wave their arms around in whatever immersive experience they’ve chosen that day.
“originally we assumed residents would only wear the headset for so long because they would feel uncomfortable,” says joey wong, research project manager at the idealab. “we ask them if they want to continue watching and they will say yes. some wear it as long as 45 minutes. they enjoy it that much.”
she says the technology of six years ago, when they initially launched the project to engage individuals with dementia, their families and caregivers, was just not good enough, so they paused the project. then, two years ago, they partnered with rendever, a massachusetts-based company that designs virtual reality experiences specifically for senior living communities, and which has vastly improved the technology, making it faster, more powerful and realistic. they have now implemented the program in two other vancouver-area long-term care homes with the same positive results.
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introducing virtual reality to a new generation
virtual reality has been in commercial use for years, most notably for younger generations who use it to play video games. repurposing the old gaming goggles so older adults living with dementia or others with mobility challenges can experience relaxing walks along the beach or cross-country skiing, however, is a relatively new idea.
lora appel, associate professor, faculty of health, york university, and affiliate scientist at toronto’s university health network, had been researching how to mimic sensory stimuli when she came upon studies that showed long-term physiological benefits — lowered heart rate and blood pressure, feelings of well-being — for people when outside in nature.
but there are populations who can’t get outside to experience those rewards. so, about 10 years ago, she shifted her focus to testing the use of vr to potentially benefit older, isolated adults, especially those living with dementia, in long-term care.
with grants from the centre for aging and brain health innovation, appel and her team purchased several meta quest vr headsets and augmented their accompanying software, recruited over 300 participants across a variety of studies, and began exposing them to a multitude of virtual environments, including customized images, with overwhelmingly positive results, similar to those of the ubc project.
“in one hospital trial, there was an individual of french background who had been non-communicative with his family for years,” appel says. “we put themes from paris in the headset and when he saw them he started speaking in french. his family [filmed him] on their phones to send it to their family in france.”
she relays another example of a participant who had scuba-dived once in her life but, as an older woman, was too frail to do it again. “we put her in a scuba diving film and she was moving all over the place, tearing up from happiness, from being able to experience something that she can no longer do.”
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using virtual reality to address loneliness in seniors
a recent report from the national institute on ageing showed that 58 per cent of canadians 50 and older have experienced loneliness. according to the canadian coalition for seniors’ mental health, social isolation and loneliness among older adults have been linked to:
- 32 per cent increased risk for stroke;
- 29 per cent increased risk for coronary heart disease;
- 50 per cent increased risk in dementia;
- 25 per cent increased risk of cancer;
- 45 per cent increased risk of premature death — worse than smoking 15 cigarettes a day.
while a cool headset won’t replace the warm human connection we get from friends and family, vr has shown to improve mood, decrease agitation and encourage social engagement among residents of long-term care homes, which can reduce loneliness.
the objective behind ubc’s project is to implement vr in long-term care settings and study the experiences of not only residents, but their families and staff. when a resident or patient is virtually gliding over the alps or surfing in hawaii, caregivers can take a much-needed break for themselves. those caregivers can also go along for the ride via a secondary device, such as a tablet that mirrors what the person wearing the headset is seeing.
“that also makes it possible for group sessions where one person can be in vr and the rest of the group can be involved. it’s an opportunity to also make it a social experience,” says appel.
in addition to virtual strolls through the forest or among animals in a zoo, the team is incorporating more customized environments. by uploading photos or videos from family members, for example, the team can compile personalized experiences and memories, such as a childhood home, photos of pets or videos of grandkids.
appel even plans to incorporate live streaming using 360-degree cameras. “i want a person in a long-term care home to effectively be having dinner with their family in their home.”
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hung and wong’s partnership with vancouver coastal health and support by the mitacs accelerate grant and the alzheimer society of canada will help them scout more personalized images as well.
“people are telling us they want more personalization,” says hung. “they want to look at more local videos, they want to go to coffee shops, watch fireworks on the beach and be among the crowds.”
virtual reality is not for everyone
as thrilling — or comforting — as it is for patients and residents to immerse themselves in environments beyond their four walls, virtual reality is not for everyone. some people living with dementia, for example, don’t always recognize the people or places around them. fitting them with a vr headset featuring a variety of images could confuse them even more. the accompanying sound and movement could also be disorienting or cause dizziness or motion sickness, especially if they’re on certain medications.
“we work with patient and family partners, so we have older adults living with dementia on the research team,” hung says. “we meet once a week to talk about these issues. safety often comes up. sometimes people will get really excited, they will move their arms around, they’ll try to reach for an animal or point at things. so we have guidelines to ensure the person is seated and is always supervised. they never use it alone.”
for those who may not be able to tolerate the headset, or grapple with motion sickness, hung and wong are testing other immersive experiences using projectors that cast images on walls such as sea turtles underwater or flowers blooming that participants can walk through.
the future of virtual reality in long-term care homes
it’s unclear how many canadian long-term care facilities have adopted vr for their residents, but one estimate noted 19 such facilities in just one health region in b.c. have implemented the technology, initially to combat isolation during the pandemic. when residents embraced the program with such enthusiasm, they continued it.
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barriers to broader use include limited staff training, financial resources to purchase the technology, ease of use of equipment, and perceived benefits.
“a lot of people think older people don’t like having something on their face that they won’t be able to understand, or think virtual reality is only for young people and people with dementia won’t benefit from these technologies,” hung says. “it turns out that’s not true. people with dementia can not only benefit from this technology, they have lots of fun. these videos are very short, usually about five minutes. but some of the residents will watch one after another, up to 45 minutes.”
with more videos and images regularly added to libraries of virtual experiences, generic and personal, users will be able to take a variety of trips with their friends and family or visit old neighbourhoods where they grew up, thanks to google streetview. they may even attend a wedding or reunion virtually, which allows them to reconnect in a meaningful way with relatives they might not have seen in a while.
and the effects can be long-lasting. participants who experienced a tour as a group discuss what they’ve seen with each other, share their thoughts and relive memories, which helps build and cement relationships.
“as you age, you’re robbed of autonomy, independence, an element of surprise,” appel says. “for [older] individuals, this isn’t necessarily the end of their life. they might have things they want to do that they haven’t done. also, there’s a lot of talk about equity in health. vr is an equalizer of sorts. you aren’t held back by physical ailments, your financial situation, or living in a cold country. you can choose to try something new from the safety and comfort of your home.”
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