Using virtual reality to improve apathy in residential aged care

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Background and Objectives: Apathy is a common symptom in neurological disorders including dementia and is associated with a faster rate of cognitive decline, reduced quality of life and high carer burden. A lack of effective pharmacological treatments for apathy has placed an emphasis on non-pharmacological interventions. Virtual reality (VR) using head-mounted displays (HMD) has been successfully used in exposure and distraction-based therapies, however, there is limited research in using HMDs for symptoms of neurological disorders. This feasibility study assessed if VR using HMDs could be used to deliver tailored reminiscence therapy. Willingness to participate; response rates to measures; time taken to create tailored content; and technical problems were examined.Methods: A mixed methods study was conducted in a sample of older adults residing in aged care, 17 participants were recruited. Apathy was measured using the Apathy Evaluation Scale, verbal fluency was used as a proxy measure of improvements in apathy and debriefing interviews assessed feedback from participants. Side effects that can occur from using HMDs were also measured. Results: Those with higher levels of apathy demonstrated the greatest cognitive improvements after a VR reminiscence experience. All participants enjoyed the experience despite 35% of participants experiencing temporary side effects.Implications: There is a need to closely monitor side effects from HMD use in older adults. This study provides initial evidence that it is feasible to use VR with HMDs for therapy to treat symptoms of apathy in older adults in residential aged care.

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... Virtual Reality (VR) technology creates a novel interaction paradigm that immerses users into three-dimensional environments generated by computers and delivers a sense of presence [53]. It has received increasing attention as an intervention to improve the well-being of older people living in aged care homes [4,7,9,51]. ...
... Their study also raised the possibility of using VR as a reminiscence tool for aged care residents. Saredakis et al. [51] conducted a similar study to explore the feasibility of using VR to deliver customized reminiscence therapy. Their results showed that residents with higher levels of apathy demonstrated signifcant cognitive improvements after VR reminiscence sessions. ...
... Simulator sickness is one of the most common side efects of using VR. Participants in several studies reported diferent forms of sickness feeling, including the feeling of 'giddy' [7], dizziness feeling [51] and nauseous feeling [49]. The Simulator Sickness Questionnaire (SSQ) is used for measuring users' level of sickness symptoms and has been widely adopted in VR research [33]. ...
Conference Paper
While VR has shown benefits such as improving alertness, recalling memories and cognitive training for older adults, it is challenging to deploy it in aged care settings due to the complexity of social care, physical and healthcare needs of the residents. This paper presents a two-phase study that aims to explore the challenges of deploying VR technology in aged care settings. Phase one involved a thematic analysis of video recordings of 14 VR sessions, during which five residents of an aged care facility were invited to experience and interact with VR systems. Phase two aimed to explore the challenges further by analyzing semi-structured interviews with 11 staff members who had experience in coordinating VR activities in aged care homes. The results revealed a range of issues that need to be considered when deploying VR systems in aged care settings, including: usability issues related to VR systems; barriers caused by residents’ mobility constraints; physical discomfort; and challenges in providing guidance and support for residents using VR.
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