Behavioral and psychological symptoms of dementia (BPSD) are complex, costly, and result in poor health outcomes. Up to 75% of patients admitted to an acute-care inpatient unit have BPSD. Virtual reality (VR) technology provides a unique opportunity to expose individuals who are otherwise confined indoors to a variety of simulated natural and social environments that can be calming and engaging.
Researchers assessed thefeasibility of using immersive VR therapy for people living with dementia during acute-care hospitalization and explored its potential to manage BPSD. They found that the use of VR therapy is feasible and safe for older adults with various degrees of dementia. Patients also tolerated the VR equipment and content well, with limited side effects. The study was presented at the 13th Clinical Trials on Alzheimer’s Disease Congress 2020.
The prospective, longitudinal pilot study was conducted at a community teaching hospital in Toronto and included 10 patients (eight female) aged older than 65 years (average age, 86.5 years) with dementia ranging from mild to advanced.
Twenty percent of participants displayed violent behavior, and 30% required a sitter/patient care assistant/personal support worker at the bedside for monitoring purposes. Participants also had chemical (40%) or physical (30%) restraints administered during their hospital stay.
Participants viewed a sequence of five short 360° video clips (one to three minutes each) depicting various nature scenes (rocky lakeshore, sunny forest, dense forest, floating icebergs, and sunny beach) displayed on Samsung Gear-VR head-mounted-display for a maximum of 20 minutes.
A total of 18 VR sessions were conducted, with an average exposure of six minutes per viewing. The majority of participants (n=7) reported that they found the headset comfortable; one patient found the VR headset to be too heavy. No participants reported feeling pressure on their nose from the head-mounted-display.
One patient experienced negative side effects of self-limiting dizziness with mild nausea from the VR session. There were no reports of interference between the VR equipment and medical devices worn by participants, such as hearing aids.
During the majority of sessions (78%), participants made conversation and vocalizations. Many simply described what they saw, and one patient expressed interest and desire to engage with their surroundings. In 56% of the VR-therapy sessions, the researcher noted the expression of enjoyment by the participant, as deduced from the participant’s active looking around and movements that suggested interaction (e.g., reaching out with hands or legs, pointing, waving, and wiggling toes), as well as from laughter and verbal feedback.
In 61% of sessions, the researcher noted participant relaxation from VR, as perceived through deep, slow, and steady breathing; relaxed grip of the caregiver’s hand; and caregivers noting that the participant looks relaxed or “calmer than usual.” The majority of participants (n=7) opted for additional VR therapy sessions during their hospital stay.
“These findings support conducting large-scale randomized, controlled trials to investigate immersive VR therapy as a non-pharmacological intervention to manage BPSD in acute-care hospitals,” the researcher concluded.
Presentation: P084: Administering Virtual Reality Therapy to Manage Behavioural and Psychological Symptoms in Patients with Dementia Admitted to an Acute-care Hospital: Results of a Pilot Study. Presented at the 13th Clinical Trials on Alzheimer’s Disease Congress 2020, Nov. 4-7, 2020.