Virtual Reality for Therapeutic Recreation in Dementia Hospice Care: A Feasibility Study

Am J Hosp Palliat Care. 2020 Oct;37(10):809-815. doi: 10.1177/1049909120901525. Epub 2020 Jan 24.


Objectives: To explore acceptability, tolerability, and subjective experience of virtual reality (VR) as therapeutic recreation for hospice patients living with dementia (hPLWD).

Design: Descriptive study setting.

Community hospice agency participants: A convenience sample of n = 25 hPLWD cared for by a local hospice agency.

Intervention: Participants viewed a beach scene using VR headset for ≤30 minutes.

Measurements: Tolerability was measured with Pain Assessment IN Advanced Dementia (PAINAD)scores at baseline, every 5 minutes during VR use, and 5 minutes after headset removal. Additionally, follow-up phone calls to caregivers several hours after the intervention were performed to inquire regarding any noted adverse effect after the intervention. The subjective experience was measured with qualitative semistructured interviews with the hPLWD regarding enjoyment for the VR. Descriptive statistics were performed on all collected data.

Results: The VR was stopped early in 2 of the participants due to a ≥2-point increase in PAINAD score. Baseline behavioral and psychological symptoms of dementia (BPSD) were reported to have worsened in 2 (8%) of the participants at follow-up. There was no significant difference between dementia type and usage time or dementia severity and usage time. Of the 25 participants, 14 (56%) reported enjoying VR and 12 (48%) would do it again.

Conclusion: Virtual reality use was generally safe and enjoyable in hPLWD. Virtual reality can provide meaningful activity and enhance quality of life for hPLWD at the end of life. In the future, VR may be a useful intervention for BPSD in hPLWD.

Keywords: advanced dementia; behavioral and psychological symptoms of dementia; caregiver; dementia; hospice; meaningful activity; recreation therapy; virtual reality.

MeSH terms

  • Dementia* / therapy
  • Feasibility Studies
  • Hospice Care*
  • Humans
  • Quality of Life
  • Recreation
  • Virtual Reality*