JMIR Publications

ABSTRACT

Background:

Technology is increasingly being used and is evolving in the dementia care landscape. Once such technology that has gained traction in the last decade is virtual reality (VR). VR is being applied to many areas of dementia care including cognitive assessment and training, reminiscence therapy, music therapy and other recreational VR applications. Despite the plethora of applications, they are often not shaped by the experiences and perceptions of older adults living with dementia. There is currently no qualitative evidence synthesis which explores this area. This review aims to provide qualitative evidence to support existing systematic reviews in this area.

Objective:

The aim of this qualitative evidence synthesis is to explore key stakeholders’ experiences and perceptions of VR for older adults living with dementia. It aims to explore the barriers and facilitators to VR use and provide recommendations for future design and implementation.

Methods:

Qualitative evidence synthesis was used which involved a systematic search of six databases to identify studies which qualitatively explored key stakeholders’ experiences and perceptions of VR for older adults living with dementia. Thematic synthesis was used to integrate the findings from 14 studies (from 15 reports).The Critical Appraisal Skills Programme (CASP) tool was used to assess the methodological quality of the included studies. The confidence placed in the review findings was assessed using GRADE Confidence in the Evidence from Reviews of Qualitative research (CERQual).

Results:

15 reports of 14 studies were included in the review consisting of a range of levels of VR immersion, stages of dementia and care contexts. Three analytical themes were generated: stepping into virtuality, a virtual world and returning to reality. The results indicate the importance of sensitively designing and introducing VR to this population as often, older adults living with dementia have no prior experience using this technology. VR can be a positive experience for older adults living with dementia and can provide meaningful experiences such as enhancing connections, positive expressions and long-term impacts on everyday functioning. However, it should be acknowledged that there are negative associations which need to be accounted for prior, during and after use.

Conclusions:

This review highlights the positive implications as well as negative associations of VR use. It emphasizes the need for VR design and implementation that is driven by the needs and views of older adults living with dementia and other key stakeholders. Future research needs to explore the vital role older adults living with dementia play in the design process and how they can be empowered to meaningfully design and use this technology.