Can Virtual Reality Simulation Improve the Attitudes for People with Dementia in Informal Caregivers?

Background: As the number of people with dementia increases, the well-being of informal caregivers has received increasing research attention because informal caregivers play an important role in taking care of people with dementia. Studies have shown that informal caregivers are vulnerable to psychological distress, such as depression and anxiety (Lethin et al., 2017). Studies also suggested that higher empathy levels of informal caregivers can lead to better subjective well-being (Jütten et al., 2019). Traditionally, many caregiving programs tend to improve caregivers’ empathy through educational workshops. However, these workshops require significant staff and user time and are space and ability restrictive. To overcome these barriers, some programs have used virtual reality (VR) simulation in dementia care education in order to improve caregivers’ understanding and empathy for people with dementia (Hirt & Beer, 2020). The current study explored the acceptability and effectiveness of a VR simulation program.

Methods: The current study conducted a mixed-methods design investigating the acceptability and effectiveness of the program through the qualitative and quantitative data from a nonprofit organization that provides multi-faceted services for informal caregivers. This organization developed a program that employed VR technology for dementia caregiver education by simulating the experience of the early, middle, and late stages of people with Alzheimer’s disease in order to improve dementia caregivers’ attitudes towards dementia. The study included qualitative interviews with 6 informal caregivers using a semi-structured interview guide. The study also used a pretest/posttest design to measure their changed perceptions toward dementia using the Approaches towards Dementia Questionnaire (ADQ) (Woods, 2000) which was administered to 21 informal caregivers before and after using the VR simulation. Qualitative data were analyzed to understand the acceptability of the VR simulation among informal caregivers. Paired t-tests were conducted to compare the change of attitudes after the VR simulation intervention.

Results: The qualitative results indicated that the VR simulation was a feasible and acceptable intervention to improve caregivers’ attitudes and empathy for people with dementia. While quantitative results showed the mean posttest ADQ score was 0.4 higher than the pretest after the completion of the VR simulation, the change was not statistically significant in this sample (p >0.05).

Discussion: In this pilot study, the acceptability and effectiveness of VR simulation intervention for informal caregivers were evaluated. While the findings showed that the VR simulation is a user-friendly intervention and can help informal caregivers better understand the experience of people with dementia, quantitative findings did not support the VR simulation as an effective intervention to improve informal caregivers’ attitudes. This could be due to several factors, such as the small sample size of the study, the sensitivity of the measurement tool, and the ceiling effect. As aging service providers are increasingly using VR simulations, we need to conduct further studies with larger sample sizes to evaluate if and how these simulations can best be used as an intervention.