There are currently more than 353,800 Australians living with dementia, according to Australian Institute of Health and Welfare statistics. It's a figure that's expected to increase to 400,000 in less than five years, and without a breakthrough, it could be as high as 900,000 by 2050.
The Australian Bureau of Statistics cites it as the second leading cause of death in Australia. Depending on the type of dementia, various treatments are used to help with symptoms, but most do not slow down the condition's progression. Until a cure is found, the kind of care and support patients receive from carers, family, and friends to improve the quality of life is key. This is where virtual reality can help.
Virtual reality (VR) is already being used in certain areas of healthcare for robotic surgery, medical personnel training, phobia treatment, and as a diagnostics tool. For people living with dementia, VR can offer relief by triggering memories and positive emotions, even for those in the later stages who are often responsive to very little.
Build VR, a Victoria-based company that specialises in VR, virtual tours, and 360-degree video and photography, recently released their Solis VR unit, a Gear VR handset for care homes that marks a big step forward in the quality of care for those living with dementia in Australia.
Marc Pascal, co-founder of Build VR, told TechRepublic that the company's work in aged-care was a result of his and fellow co-founder Sally Darling's personal experiences of the difficulties of having a family member who needs professional care.
"Her father passed away some months before her and I met. We'd been to these facilities, especially the one where her father was staying, so she had a lot of personal insight. It's traumatic for everyone in the family. These facilities — they're kind of out of sight, out of mind. They're beautiful facilities but the residents are bored."
The company was touring facilities with their VR demonstrations, before eventually leading to plans to develop a unit that was more specifically for people living with dementia.
"Our first demonstration was about 18 months ago," Pascal said. "We went to a facility, we had a dozen residents try it and most of them had dementia — we didn't know that before we arrived. So everyone was a bit apprehensive as to what the reaction would be, but the reaction was amazing. All the staff loved it and it pretty much became a hit, because we have all these residents now communicating with each other, talking about what they're seeing and even sharing some stories.
"We went to a number of facilities across Victoria, often the same trial, the same demo, to get the feedback based on what content they would like, what they don't like ... we went through over a hundred VR experiences and then we settled on five."
Those five VR experiences now form the five categories of video scenarios that the handset offers users: Travel, adventure, animals, aquatic, and relaxation. The user starts in a computer generated atrium in front of a wall with five paintings, each one reflecting a VR experience. When the user looks at a painting, a 360-degree video begins, which could be of anything ranging from scuba diving, canoeing, or a trip to Bali.
"Another thing we did was figure out how to sync a tablet with the headset, so a staff member can actually see what the resident is experiencing in real-time — that's proven very popular too, they can help guide them and see what they like and what they don't like."
Pascal said that one of the many positive effects of the handset is offering a distraction if dementia patients are experiencing boredom or displaying repetitive behaviour.
"In terms of dementia residents it's more about how they're behaving before they try it," he said. "There's one woman in particular I remember: She had been making a repetitive moan every few seconds and was really not reacting to anything. We got her to try Solis and within about 10 seconds she just stopped, she was just fixated with what was she was experiencing, which was a canoe trip. She didn't [make the noise] again until I left. And she was in high-care."
It can also affect users in some quite profound ways. Pascal shared a story where an elderly Italian gentleman cried when they removed the goggles from him. When asked why he was so emotional, he said that he had given up ever returning to Venice, and he had felt like he was there in a gondola.
"Words like 'beautiful', 'paradise', 'Garden of Eden' continue to be used in every presentation. The other thing they really like about it is that it's the newest technology; they feel special. I say, '15-year-olds would love to have this technology and you get to have it' — and they love that too.
"And the response from carers is emotional. They want so much to be able to provide more for their residents."
In terms of the uptake of Solis VR, some facilities are initially wary of new tech such as virtual reality that could be possibly seen by some as gimmicky or irrelevant.
"There are a lot of technophobes in this world and a lot of them are carers," Pascal said. "When they first see the tech they're a bit intimidated, and once they get used to it, they love it. There are some [companies] that just sell [their products to the facilities]; try and make quick cash and leave, but we didn't want to do that. We're about the long-term to help."
Alzheimer's Australia, which estimates that 1.2 million people are involved in the care of a person with dementia, has taken a slightly different route to improve dementia care through the use of VR. Rather than an experience tailored to the person with the condition, Alzheimer's Australia Vic last month released a free app in collaboration with Deakin University that allows anyone with a smartphone and Google Cardboard to see through the eyes and experience the challenges of a person living with dementia.
The app, Educational Dementia Immersive Experience (EDIE) provides an experience from the point of view of EDIE (Eddie), who has dementia. The user gets a first-hand experience of how a seemingly simple task like going to the bathroom in the middle of the night can be affected by the diagnosis. The intended result is an increased sense of awareness and empathy towards what dementia actually means, and what it's like to live with it.
Like Build VR, Alziemier's Australia had previously conducted demonstrations and training workshops before rolling out something that was both more accessible and more mobile.
Tanya Petrovich, manager for Business Development at Alzheimer's Australia Vic, told TechRepublic the organisation was looking to update their training after doing much the same thing over the last 30 years.
"Our first foray into virtual reality was with our virtual dementia experience, which we have here in Parkville. We projected the game onto the wall and people can come into the room and experience what it might be like to live with dementia, and we used that in a workshop scenario," Petrovich said.
"We wanted to make it more widely available, so we were looking round at mobile platforms. One of the first ones we looked at was actually Oculus Rift, which is a fabulous platform, but it's a bit clunky in terms of mobility. So we started looking at Google Cardboard and Gear VR.
"The Cardboard obviously is really affordable platform; we've gone with that for getting the message out to as broad an audience as we possibly can."
VR gave Alzheimer's Australia Vic the opportunity to show, rather than tell, what dementia is. Petrovich stressed the idea of empathy and a shift in perspective was the big focus.
"We had [the app] evaluated by Swinburne [University] — we did the same workshop with the VR and without the VR; everything was the same apart from the VR elements. And we found that with VR, there was a threefold increase in empathy developed by the participants, so there was a greater understanding of a person living with dementia. When they were interviewed, they spoke from the point of view from the person living with dementia. Whereas in the other workshop without the VR, they spoke more from the point of view of the carer, so there was a shift in perspective, and that's really what we're after."
Next year, Alzheimer's Australia Vic's 'Enabling EDIE' workshops will introduce more scenarios with Gear VR. The headset user will be able to experience more scenarios and navigate around EDIE's house while receiving instructions from EDIE's wife. From there, the organisation will evaluate all feedback before looking at a possible second version of the smartphone app.
"It's been really successful; VR certainly has great potential in getting people to understand perspective of the person living with the disease," Petrovich said. "There's lots of things we can change in the environment and supports we can put in place to make it a lot easier for the person [with dementia].
"The potential for it I think is huge. I do see lots of other uses for it and I do hope that, particularly healthcare, people use it more so."
For Build VR, customisation and interaction is the big focus for the future. Pascal envisions an interactive profile for each dementia patient as part of their very own CG atrium. More personalised video content, such as a grandchild's birthday party, could be uploaded on the same day it happened, allowing less active patients to experience the event as if they're there.
"You could have, potentially, in the near future, an old man connecting with his grandson and doing a trip through his hometown together," he said. "In terms of dementia, it's really being about doing everything we can to bring back those memories.
"Now you're not just sitting and experiencing; you're interacting. And your actions will have a reaction, which will have another reaction. And that's really what virtual reality should be and that's where it's going. The desktop PC version of VR can do that; mobile just needs to catch up. And it will, I see in the next 12 months you'll be able to do that."
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