The social and therapeutic benefits of virtual reality in nursing homes

More than 30 years of clinical research have highlighted the social and therapeutic benefits of virtual reality. It is high time to allow nursing homes to benefit from this new non-drug approach.

The social benefits of virtual reality in nursing homes

You are 90 years old and you live in a nursing home. Unfortunately, you have lost a lot of mobility and your physical condition no longer allows you to walk very far. What if, without moving from your armchair, you could visit the pyramids of Egypt, go to the museum, go on a safari in Africa or explore the beauties of nature? What if, in addition to that, you could share these experiences with the other residents of your nursing home to create shared memories and exchange your feelings?

Immersive escapes improve well-being

Seniors who experience virtual reality in nursing homes have an almost instant feeling of escape and well-being. Here are some reactions in images that are worth much more than words.

A France 3 report in a nursing home using our virtual reality solution.

And this feeling of change of scenery does not lessen over time. Residents are looking for new destinations to continue exploring and discovering. Here are their testimonies:

In addition, clinical trials have shown the impact of virtual reality on the well-being of elderly people in nursing homes. Thus, after a virtual reality session, residents experience more positive emotional states such as relaxed, happy, adventurous states, etc. (Appel et al., 2020).

Shared immersions promote social ties

Social isolation and depression are real scourges in nursing homes. To combat this problem and promote exchanges and social ties, facilitators and caregivers in institutions use various mediators. Virtual reality adds a new string to their bow, provided it is simple and adapted. Thus, we simplified its use to allow staff to easily organize group workshops. From a tablet application, it becomes possible to control and synchronize several headsets remotely to offer shared experiences.

Immersion then becomes a mediator that allows supervisors to provoke and fuel dialogue before, during and after the videos. For example, before “teleporting” residents off the Red Sea with dozens of dolphins in the wild, you can have them talk about dolphins by giving them fun information. Thus, at Lumeen, we support each of our experiences with mediation content directly integrated into the tablet application. During the immersions you even have visual feedback of what the participants see and indications to guide them through the experience.

This content allows people to express themselves, remember, and share life memories. Facilitators and health professionals also tell us that residents continue to talk about it after sessions and during meals. It brings a bit of happiness and life into their daily lives.

Making art and culture accessible to prevented audiences

Dependent people are often isolated and lose access to art and culture. Virtual reality offers them a door to the world and allows them to visit museums and monuments; and to attend music shows and concerts.

So, at Lumeen, we want to offer a wide range of cultural content. In particular, we collaborated with the Atelier des Lumières in Paris to make Gustav Klimt's immersive digital exhibition accessible to disadvantaged audiences. This project was very successful with seniors and put stars in their eyes.

Facilitating intergenerational links

Virtual reality also makes it possible to strengthen the link with families. In many establishments, animators set up intergenerational activities in which they invite the families of the residents to participate. However, it's not always easy to find activities that generations can share. Virtual reality has the advantage of being entertaining for young and old and allows families to continue to have experiences together.

Whether for vacation or work, the new generations are traveling more and more. When the residents' loved ones leave far away, virtual reality allows residents to immerse themselves in the countries and customs that their families visit and to tell them about them when they return!

The therapeutic benefits of virtual reality in nursing homes

With the aging of the population, taking care of the physiological and psychological disorders from which the elderly suffer is becoming a real public health issue. According to the Médéric Alzheimer Foundation, 57% of residents in nursing homes have moderate to severe cognitive disorders. Neurodegenerative disorders progressively deprive the person of their autonomy and social life; which prove to be essential to well-being and health. Often, dementia patients show signs of confusion, disorientation, irritability, or aggression as their ability to understand the world decreases.

Cognitive disorders cause psychological and behavioral disorders in the elderly. These are relatively frequent and make up the daily life of teams in nursing homes. Among them, we can mention euphoria, anxiety, restlessness, restlessness, aggression, disinhibition, apathy, irritability, depression, sleep disorders, etc.

In nursing homes, healthcare teams support people at different stages of these diseases. Thus, the virtual reality solutions designed for them must be flexible to integrate into their care practices and adapt to patients and their pathologies.

Here is an overview of the most important therapeutic benefits that virtual reality can provide in nursing homes:

Relieve anxiety and pain

Virtual reality makes it possible to divert patients' attention from their anxiety and pain. One of the most studied virtual environments is “Snow-World.” In 1996, Hunter Hoffman, PhD, and colleagues at the University of Washington developed an immersive experience that produced the illusion of flying through an icy canyon. As they navigate this fresh and serene world, patients can throw snowballs at penguins, mammoths, and other snowmen.

SnowWorld was designed for people who struggle with chronic pain. In particular, immersive play is used to divert the attention of burn victims during painful treatments. And the results are there. The 11 patients included in one study reported a 35% to 50% reduction in pain during the Snow World experience (Hoffman et al, 2011).

Since Snow World, virtual reality has evolved a lot and numerous studies have highlighted its effects on anxiety or pain. Jones et al. (2016) show that among the 30 participants in their study with chronic pain, 100% experienced a relative decrease in pain during a virtual reality experience, 33% of whom experienced complete pain relief. The analgesic effects of virtual reality would last beyond exposure since an average decrease of 33% in pain perception persists after exposure.

For these reasons, virtual reality is now used in hundreds of hospitals around the world. The most popular solutions combine calm environments with music therapy and inductions based on the principles of medical hypnosis in order to amplify patient calm. These therefore allow for a reduction in pain-relieving medication. Virtual reality is therefore now considered to be a non-drug alternative in some cases.

Immersive trips that revive memories

The places we have known and loved are full of memories. Imagine an elderly person who could return to visit the neighborhood where they grew up or where they proposed? Virtual reality stimulates emotional memory and revives buried memories. It comes into its own during recollection therapy sessions, especially since the sensation of immersion thanks to the 360-degree view seems to amplify the recollection. The study by Benoit et al. (2015) shows that virtual reality significantly stimulates autobiographical memory.

At the end of life, returning to the places you loved is a source of peace and happiness. It's in these memories that residents can often find a comforting connection to themselves.

Stimulate cognitive functions

In the form of serious interactive games, virtual reality makes it possible to stimulate specific cognitive functions in a fun way. Attention, it is not a question of creating virtual versions of activities that can be carried out with common objects such as a card game or a ball. It is much more relevant to focus on the new activities that virtual reality can offer. In three dimensions, we can create space and move around in it. This opens up the field of possibilities for orientation and spatial memory exercises that are difficult to carry out in a real environment, with in particular the risk of people falling. On another level, being able to visualize environments at 360 degrees makes it possible to imagine more successful visio-spatial tracking activities.

Flexible, these games can adapt to patients' level of dependency and can be fully integrated into the practice of neuropsychologists, psychomotricians, occupational therapists, and other caregivers. Several studies involving a total of 564 individuals with mild cognitive impairment, stroke or Alzheimer's disease have shown that the use of VR improves their cognitive abilities such as memory and visual attention (Moreno et al, 2019).

Finally, it should be noted that the fun and ecological side of technology makes it possible to increase the motivation and ownership of patients. A study including 66 elderly people showed that they are more motivated after a VR experience. 76% of them also wanted to repeat the experience (Appel et al, 2020).

Fighting depression and apathy

Unfortunately, depression and apathy are very common in nursing homes. According to the Department of Research, Studies, Evaluation and Statistics (DREES) (2020), between 20% and 33% of nursing home residents would suffer from depression. Apathy, which results in a loss of motivation, social withdrawal, a feeling of lack of energy, and emotional dullness, is one of the most common behavioral disorders encountered in Alzheimer's disease. As indicated by the Alzheimer Foundation, 60% of elderly people with this condition are affected. The study by Geraets et al. (2019) shows that the use of virtual reality improves generalized anxiety states and associated depressive symptoms.

Through experiences of recollection, discovery, relaxation or games, virtual reality offers strong emotions to the elderly, which bring back passions and motivation. This even makes it possible to renew the dialogue with some residents. The study by Saredakis et al. (2020) shows that virtual reality used in recollection therapy has a positive effect on the cognition and apathetic condition of elderly people. Thus, immersive experiences have a positive impact on people who are depressed and apathetic.

The risks to take into account

Of course, it is important to identify the risks of using virtual reality for sick people. For example, how could this technology impact a person who has delusions and hallucinations? Could that worsen his condition? We don't have all the answers yet, but we have a responsibility to conduct clinical trials that will help define clear and secure therapeutic indications and protocols.

The benefits for healthcare teams and institutions

We were surprised the first time we learned that caregivers were using our tool to offer escape sessions to their nursing home staff. But in retrospect, it makes sense! Caring for dependent elderly people is a difficult and exhausting job, which results in a high rate of absenteeism and frequent team rotation. By offering moments of escape and relaxation to staff, virtual reality makes it possible to improve well-being at work in nursing homes.

In addition, virtual reality contributes to increasing the attractiveness of jobs in a sector that is struggling to recruit. Indeed, cutting-edge solutions reflect an innovative image that attracts talent.

Conclusion

The benefits of virtual reality in nursing homes are numerous. It makes it possible to improve the well-being and care of residents, the relationship with families, the brand image of establishments, working conditions and the attractiveness of elderly professions.

We hope that virtual reality will find its place in nursing homes and will contribute to enriching the quality of life of dependent elderly people and maintaining their mental health for as long as possible.


References

Appel L, Appel E, Bogler O, Wiseman M, Wiseman M, Cohen L, Cohen L, Ein L, Ein N, Abrams HB and Campos JL (2020) Older Adults With Cognitive and/or Physical Impairments Can Benefit From Immersive Virtual Reality Experiences: A Feasibility Study. Forehead. Med. 6:329. doi: 10.3389/fmed.2019.00329

Benoit, M., Guerchouche, R., Petit, P. D., Petit, P. D., P. D., Chapoulie, E., Manera, V., Chaurasia, G., G., Drettakis, G., G., & Robert, P., & Robert, P., & Robert, P. (2015). Is it possible to use highly realistic virtual reality in the elderly? A feasibility study with image-based rendering. Neuropsychiatric disease and treatment, 11, 557—563. https://doi.org/10.2147/NDT.S73179

Saredakis, D., Keage, H.A., H.A., Corlis, M., & Loetscher, T. (2020). Using Virtual Reality to Improve Apathy in Residential Aged Care: Mixed Methods Study. Journal of Medical Internet Research, 22(6), e17632. https://doi.org/10.2196/17632

Shirine Abdoul-Carime (DREES), 2020, “A third of elderly people living in institutions are in a degraded psychological state”, Studies and Results, No. 1141, Drees, January.

https://www.fondation-alzheimer.org/lapathie-le-symptome-oublie-de-la-maladie-dalzheimer/

https://www.fondation-mederic-alzheimer.org/les-chiffres-cles

Hoffman, H.G., Chambers, G.T., Meyer, W.J., Meyer, W.J., 3rd, Arceneaux, L.L., 3rd, Arceneaux, L.L., Meyer, W.J., Meyer, W.J., 3rd, Arceneaux, L.L., 3rd, Arceneaux, L.L., Russell, W.J., Seibel, E.J., Richards, T.L., Richards, T.L.,,, Sharar, S.R. Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Annals of behavioral medicine: a publication of the Society of Behavioral Medicine, 41 (2), 183—191. https://academic.oup.com/abm/article-abstract/41/2/183/4569537

Moreno, A., Wall, K.J., Thangavelu, K., Thangavelu, K., K,, K,, K, K., K., K., J., Thangavelu, K., K, Craven, L., Ward, E., and Dissanayaka, N.N. (2019). A systematic review of the use of virtual reality and its effects on cognition in individuals with neurocognitive disorders. Alzheimer's & Dementia: Translational Research & Clinical Interventions 5, 834—850. doi: https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1016/j.trci.2019.09.016

 Report of the French Society of Gériatrie and Gerontology (SFGG) on depression in nursing homes.