Administering Virtual Reality Therapy to Manage Behavioral and Psychological Symptoms in Patients With Dementia Admitted to an Acute Care Hospital: Results of a Pilot Study

Lora Appel, Erika Kisonas, Eva Appel, Jennifer Klein, Deanna Bartlett, Jarred Rosenberg, Christopher Nc Smith, Lora Appel, Erika Kisonas, Eva Appel, Jennifer Klein, Deanna Bartlett, Jarred Rosenberg, Christopher Nc Smith

Abstract

Background: As virtual reality (VR) technologies become increasingly accessible and affordable, clinicians are eager to try VR therapy as a novel means to manage behavioral and psychological symptoms of dementia, which are exacerbated during acute care hospitalization, with the goal of reducing the use of antipsychotics, sedatives, and physical restraints associated with negative adverse effects, increased length of stay, and caregiver burden. To date, no evaluations of immersive VR therapy have been reported for patients with dementia in acute care hospitals.

Objective: This study aimed to determine the feasibility (acceptance, comfort, and safety) of using immersive VR therapy for people living with dementia (mild, moderate, and advanced) during acute care hospitalization and explore its potential to manage behavioral and psychological symptoms of dementia.

Methods: A prospective, longitudinal pilot study was conducted at a community teaching hospital in Toronto. The study was nonrandomized and unblinded. A total of 10 patients aged >65 years (mean 86.5, SD 5.7) diagnosed with dementia participated in one or more research coordinator-facilitated sessions of viewing immersive 360° VR footage of nature scenes displayed on a Samsung Gear VR head-mounted display. This mixed-methods study included review of patient charts, standardized observations during the intervention, and pre- and postintervention semistructured interviews about the VR experience.

Results: All recruited participants (N=10) completed the study. Of the 10 participants, 7 (70%) displayed enjoyment or relaxation during the VR session, which averaged 6 minutes per view, and 1 (10%) experienced dizziness. No interference between the VR equipment and hearing aids or medical devices was reported.

Conclusions: It is feasible to expose older people with dementia of various degrees admitted to an acute care hospital to immersive VR therapy. VR therapy was found to be acceptable to and comfortable by most participants. This pilot study provides the basis for conducting the first randomized controlled trial to evaluate the impact of VR therapy on managing behavioral and psychological symptoms of dementia in acute care hospitals.

Keywords: aged; behavioral symptoms; dementia; hospitalization; hospitals, community; hospitals, general; humans; mobile phone; nature; sensory art therapies; virtual reality; wearable electronic devices.

Conflict of interest statement

Conflicts of Interest: None declared.

©Lora Appel, Erika Kisonas, Eva Appel, Jennifer Klein, Deanna Bartlett, Jarred Rosenberg, Christopher NC Smith. Originally published in JMIR Formative Research (http://formative.jmir.org), 03.02.2021.

Figures

Figure 1
Figure 1
2D screen capture of 2 of the 5 virtual reality scenes (scene 2: open field with foliage and scene 5: Aquamarine beach).
Figure 2
Figure 2
Participant tries the virtual reality experience. Written informed consent was obtained from the individual for the publication of this image.

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