Since 2020, the palliative care department at Hôpital Lyon Sud des Hospices Civils de Lyon (HCL) has been using Lumeen virtual reality headsets and the feedback has been excellent. The objective of this service is to relieve physical pain and to take into account psychological, social and spiritual suffering. Lumeen then finds all its usefulness there. Dorothé Decrept, Health Framework explains to us:”The result is immediate! They tell you right away if they liked it or not and for 95% of patients, it's a real satisfaction”. So, what are the therapeutic and social benefits of virtual reality in palliative care?

‍

‍

1) The comprehensive approach to palliative care

‍

Palliative care is active care delivered in a comprehensive approach to the person suffering from a serious, progressive or terminal illness. The objective of palliative care is to relieve physical pain and other symptoms, but also to take into account psychological, social and spiritual suffering. Far from the image of dying that many may have, they are often a transitional service for patients before returning home. The palliative approach is not limited to the end of life. On the contrary, it is all the more effective since it is implemented as soon as a serious illness is announced that we know will not cure or when a severe complication occurs. “In the department, we regularly see patients again during various stays. There is a patient that we have been following for almost 10 years! , underlines Professor Elise Perceau-Chambard, head of the department. Palliative care units are centers of expertise and resources in many situations, especially for stubborn symptoms and in the first place, pain. It's knowing how to find treatments that will relieve patients and for that we have to be fast and effective, because our patients cannot wait.”

‍

‍

2) The therapeutic benefits of virtual reality in palliative care

‍

In recent years, virtual reality has been used in palliative care around the world and, as several clinical studies demonstrate, several therapeutic benefits are emerging from it. Of the 18 studies published between 2007 and 2018, 12 (including 9 randomized controlled trials with recognized methodological quality) showed a statistically significant reduction in pain thanks to the use of virtual reality during care, either associated with an analgesic and compared to the painkiller alone, or used as the sole pain management and compared to another distraction such as telephone games or television (Meta-analysis by Smith et al., (2020). In addition, in 2019, researchers from Osaka University in Japan conducted a study on 20 elderly patients with terminal cancer in palliative care and demonstrated that virtual reality immersion with Google Earth VR reduced pain by 51% and anxiety by 69% *.

‍

Tom Muselet, nursing assistant at the Palliative Care Unit at Hôpital Lyon-Sud, explains to us:”We use Lumeen a lot during painful or anxiety-provoking treatments for the patient and we really find a quick effect. Patients often don't even remember the treatment”. In addition, virtual reality can act as a non-drug therapy or as a complement to anxiolytic or analgesic treatments in order to reduce the consumption of medications that sometimes have unwanted side effects. For Audrey Ringot, project manager at the Cancer Coordination at Lyon-Sud Hospital:”Using headphones as an adjunct to opioids is more beneficial than using an opioid alone. It is very effective during painful treatments.” .

‍

‍

3) The social benefits of virtual reality in palliative care

‍

Virtual reality allows patients to escape the context of illness and the hospital room. It offers them moments of dreams, of sharing, which have a beneficial influence on socio-cultural factors (daily management, pending social and professional life, personal image) and spiritual (the future) factors related to illness and the end of life. For Rémi, a patient using virtual reality headsets, it's a breath of fresh air:”Whichever movie you choose, it's the power to escape. We push the walls of the room we are in”. The Lumeen escape module provides extraordinary moments and promotes well-being. These are videos in complete immersion, on the theme of nature, culture, travel: you can swim with dolphins, admire the Northern Lights in Alaska, or even visit the Grand Canyon. “It's a timeless break. ”, confides Mr. D, 58 years old;”I forgot for a moment that I was in palliative care”.

‍

On top of that, virtual reality revives good memories and strengthens the bond with loved ones. Hospice patients often ask to revisit places they loved, such as the location of their vacation or wedding. “It reminds me of the trips I made with my husband.” testifies Jeannine Frot after her getaway to Japan. The Lumeen Reminiscence program makes it possible to meet this need by transporting these people anywhere in the world thanks to Google Map. “We also use Lumeen to allow our patients to share travel memories, for example, or experiences with members of their family and friends during visits,” explains Dorothée Decrept, the service manager. These precious memories are calming and comforting. As mentioned earlier, the Japanese study from Osaka University also showed a significant improvement in well-being (51%) after a virtual reality session with Google Earth VR.

‍

‍

4) Conclusion

‍

In palliative care, virtual reality undeniably improves the care pathway. Easy to use, it can be deployed in less than a minute and offers real benefits to patients. In addition, it helps to bring life to life and to fight against preconceived ideas: the objective of palliative care is not to help the patient die, but rather to help him live in the most comfortable and caring way possible.

‍

We are delighted with the feedback from the palliative care team at Hôpital Lyon Sud with a clinical study project being written. So keep an eye on that.

‍

Resources:

‍

“Niki, Kazuyuki, Yoshiaki Okamoto, Isseki Maeda, Isseki Maeda, Ichiro Mori, Ryouhei Ishii, Yoshinobu Matsuda, Tatsuya Takagi, and Etsuko Uejima. “A novel palliative care approach using virtual reality for improving various symptoms of terminal cancer patients: a preliminary prospective, multicenter study.” Journal of palliative medicine 22, no. 6 (2019): 702-707.”

Niki, Kazuyuki, Megumi Yahara, Michiya Inagaki, Michiya Inagaki, Nana Takahashi, Akira Watanabe, Takeshi Okuda, Mikiko Ueda, Daisuke Iwai, Daisuke Iwai, Daisuke Iwai, Kosuke Sato, and Toshinori Ito. “Immersive virtual reality remembrance reduces anxiety in the oldest-old without causing serious side effects: a single-center, pilot, and randomized crossover study.” Frontiers in Human Neuroscience (2021): 595.

‍

Smith, V., Warty, R.R., Sursas, J.A., Sursas, J.A., J.A., Payne, O., Nair, A., A., Krishnan, S.,...,... & Vollenhoven, B. (2020). The effectiveness of virtual reality in managing acute pain and anxiety for medical patients: systematic review. Journal of Medical Internet Research, 22(11), e17980.

‍

https://www.parlons-fin-de-vie.fr/la-fin-de-vie-en-pratique/les-soins-palliatifs/ 

‍

https://www.sfap.org/rubrique/definition-et-organisation-des-soins-palliatifs-en-france

‍

https://www.chu-lyon.fr/soins-palliatifs-une-demarche-qui-ne-se-limite-pas-la-fin-de-vie

‍