Improving well-being in people with advanced dementia is a challenge that the health system faces daily. Virtual reality (VR) is a technology that offers opportunities to develop new ways of intervention, and that is gaining a boom in recent times in its application with people with dementia. A recent review on the subject indicates that RV has generally been used for cognitive evaluation and/or rehabilitation and therapeutic activities. However, from the person-centered attention, it is central to create personalized interventions, based on life history, whose objective is to improve the well-being of the person.
The Spanish Journal of Geriatrics and Gerontology echoes a recent study that aimed to make an approximation, qualitatively, and with a small group of people, about the effects of displaying personalized content presented with VR glasses, in well-being and involvement observed in four people with advanced cognitive impairment.
To carry out this study, four people with advanced dementia were selected, with whom the RV system had previously been tested, and it was proven that it was accepted and did not create any adverse effects on them. For each of them, customized VR content was created, based on some relevant aspects of their life history. All VR contents were created by the Oroi company ( www.oroi.info), and the “Oculus Go” VR glasses were used.
Four experimental conditions were created to study the effect on each participant of the customized VR content versus other stimulation options. The experimental conditions that all participants went through were:
- Baseline situation: without stimulation.
- Stimulation with classical music heard with headphones: listen to The Blue Danube by Strauss. The same music for the 4 participants.
- Visualization of neutral RV content: natural landscapes. The same for the 4 participants.
- Visualization of personalized VR content: each person visualizes the content that has been created for them based on their life history, tastes, and preferences.
Each experimental condition lasted 30 minutes in total, segmented into 3 sections of 10 minutes (pre-exposure-post) and was repeated morning and afternoon of the same day in the same conditions, to compensate for effects of the level of activation of the person that may depend on other factors (environment, light, sleep, medication). Finally, each person collected observational data for 4 hours (1 hour/day). During the 30 minutes of each observation, people were sitting in an armchair in a quiet area of the unit in which they live. All the measures were collected by the same researcher, who made the records and placed the virtual reality devices to the participants. Behaviors were observed throughout the period that each experimental condition lasted.
- List of indicators of well-being (LIBE): evaluates behaviors considered indicators of well-being in people with dementia. It considers elements of well-being that the person has an adequate interaction with the environment, with other people with whom they live, that has the possibility of making choices, and that this is shown in their state.
- Engagement / Engagement Record (RIE): composed of 15 observation categories, based on the topographic description of the behavior, with incidence record (presence/absence) and not exclusive. Collect behaviors of involvement and deimplication.
Participants increased their involvement (orienting their attention, responding to the stimuli or talking about them) regardless of the type of activity to which they were exposed concerning the baseline situation. Half of the sample also showed indicators of well-being (facial and verbal expression of well-being, satisfaction, joy, and acceptance or search for physical contact) in the situation of personalized RV. None of the participants showed adverse effects of the use of RV.
In short, the personalization of the intervention adjusted to the characteristics of the life history of each person is the differential factor between the involvement with an activity and the expression of well-being.
The novelty and uniqueness of this study lie, on the one hand, in the use of RV with people with advanced dementia, and on the other, in that it has its objective in improving the well-being of these people, unlike most found studies, which apply this technique for the stimulation of cognitive abilities.
The inclusion of any type of sensory stimulation increases the indicators of well-being and involvement of people with dementia participating in the study. Also, in people with more advanced impairments, the RV, specifically the personalized one, has a greater effect.
It is important to note that, although it is a study of 4 cases with methodological limitations, the experience of stimulation in people with advanced dementia to increase their indicators of emotional well-being and involvement with the environment, has shown encouraging results to continue working in this line. The rapid advance of technology allows a greater proliferation of the use of virtual environments in the field of dementia. However, it is necessary to carry out more controlled studies with which to scientifically demonstrate the benefit that can be obtained from its use.