JMIR Publications

ABSTRACT

Background:

Dementia is a global public health concern, with prevalence projected to reach 78 million individuals by 2030 and 139 million by 2050. Most persons living with dementia (PLwD) reside in community settings and are supported by family caregivers. As caregiving demands grow, caregivers experience significant psychosocial, emotional, and financial burden, including high rates of stress, social isolation, and depressive symptoms. Access to effective support services remains limited, highlighting the urgent need for innovative and accessible caregiver interventions.

Objective:

This pilot study first aims to assess the feasibility, acceptability and tolerability of VR-SIM Carers, a virtual reality (VR)-based psychoeducational training program for family caregivers/care partners of PLwD. Secondly, it will provide a preliminary evaluation of potential impact on caregiver outcomes, including caregiver competence, stress, resilience, empathy, and quality of life.

Methods:

A mixed-methods design will be used with a sample of 30 family caregivers of PLwD. Participants will complete three immersive, self-paced VR caregiving scenarios - Managing Apathy, Crisis Response, and Refusal of Care - receiving real-time feedback from simulated characters, including clinician and PLwD avatars. Primary outcomes (Feasibility and educational impact): Recruitment, retention, adherence, usability, acceptability and tolerability; caregiver competence (Pearlin’s Caregiving Competence Scale), perceived stress (Cohen’s Perceived Stress Scale), resilience (Connor-Davidson Resilience Scale), empathy (Empathy Assessment Scale). Secondary outcomes (Preliminary efficacy): Caregiver quality of life (AC-QoL), caregiver burden (Burden Questionnaire) and behavioral symptoms (Neuropsychiatric Inventory, CES-D Short Form) assessed at baseline, post-intervention, and one-month follow-up. Feasibility and user engagement will be evaluated via the Guess-18, Igroup Presence Questionnaire, qualitative interviews, reflection notes, and open-ended feedback. Quantitative data will be analyzed using repeated-measures ANOVA and paired t-tests, while qualitative data will be analyzed using an inductive thematic coding framework.

Results:

Findings from this study will inform the feasibility, acceptability, and educational value of immersive VR for caregiver training, while offering preliminary efficacy of VR-SIM Carers as a training tool to improve psychoeducation outcomes for family caregivers of PLwD and reduce caregiving burden.

Conclusions:

VR-SIM Carers represents an innovative, scalable intervention designed to enhance caregiver preparedness, psychosocial outcomes, and sustainable community-based dementia care. This pilot study will provide critical evidence to guide further development and implementation of VR-based caregiver support programs.