A Deeper Perspective on Dementia

This VR simulation is perfect for use with our own nursing students here at Behrend, but this is a product that can be used by anyone wishing to gain a better understanding of what life may be like for a person living with dementia.

This VR simulation is perfect for use with our own nursing students here at Behrend, but this is a product that can be used by anyone wishing to gain a better understanding of what life may be like for a person living with dementia.

Credit: Penn State Behrend

Engineering students design virtual reality simulation for caregivers

Caring for a person with dementia can be challenging at best, overwhelming at worst. What would be basic tasks for most people—shutting off a running faucet, feeding a mewing cat, or watering a thirsty plant—can be major obstacles for a person with cognitive impairments and a source of aggravation for caregivers.

It has been said that the best way to develop empathy for another human being is to walk a mile in their shoes, but it’s hard to relate to something for which you have no frame of reference.

What would it be like if a caregiver could, for a brief time, understand what it’s like to have vision that blurs without warning, to lose minutes without any clue where they went, or to walk into one room only to find yourself in another and have no idea how you got there?

Dr. Omar Ashour, associate professor of industrial engineering, focuses his research on the use of engineering tools and methods to improve health-care delivery systems. In the summer of 2018, Ashour reached out to Dr. Dan Eaton, assistant teaching professor of nursing, to discuss a collaborative project. Eaton, whose research interests lie in mental health and older adults, suggested they investigate how a dementia simulation would affect caregiver empathy, awareness, and preparedness.

Ashour and Eaton started by collecting data using a current simulation tool called Dementia Live® that Ashour believed could be improved with Virtual Reality (VR) equipment.

“VR technology offers the ability to interact with virtual objects and creates a ‘first person’ experience by providing the feeling of presence,” Ashour said. “With VR, we can simulate many cognitive and sensory impairments that are experienced by people with dementia, such as visual hallucinations, tactile changes, and more.”

In the summer of 2019, Ashour and Eaton received an Engineering and Science Collaborative Research Initiative seed grant from Penn State Behrend to continue their work. Some of the grant funds were used to support a School of Engineering capstone project in which a team of Behrend students were tasked with developing the VR dementia simulation.

The students—Computer Science major Derek Furst and Software Engineering majors Anthony Pio and Tyler Concannon—worked with their capstone project adviser and project sponsors to understand the challenges dementia patients face and how they might recreate them in a VR simulation.

“It’s not just about forgetting things,” Pio said. “Individuals with dementia often have blurred vision, loss of fine motor control, reduced grip strength, tremors in their hands. It can be very disorienting.” So the students set out to create a disorienting experience that would allow caregivers to see what their patients are dealing with.

What the students couldn’t have predicted, however, is that they would find themselves out-of-sorts in their own way when they had to return home mid-semester and complete their final capstone project remotely, without any of the lab equipment they had been working with for months.

“We had to pivot to using Oculus Quest headsets as opposed to the Valve Index VR kit we had in Dr. Ashour’s lab,” Concannon said. “They are less expensive and easier to obtain, but they offer less optimization. It wasn’t ideal, but it was what we had to work with at that point.”

Fortunately, students had made significant headway on the project before COVID-19 disrupted the spring semester. It works like this: A user puts on the VR equipment and then must complete a series of tasks—turning off an alarm, putting on their glasses, making their bed, brushing their teeth, and more—in a virtual home within a certain amount of time. They must complete each task before they can move onto the next one.

It’s not as easy as it sounds. Challenges, resembling those experienced by persons with dementia, are programmed to have users face confusion, tremors, and other cognitive and sensory impairments.

The students met several times with Eaton to learn about the various impairments, then found creative ways to simulate them using the VR equipment.

“We programmed in random noises, such as muffled voices, and also memory gaps, in which users are going through and doing their tasks, and then suddenly, they are in different room and the clock has advanced by ten minutes,” Pio said.

By the end of the semester the student team had a functional VR environment to hand off to Ashour and Eaton, who will oversee final development. They hope to have the app available for use in fall 2020.

“Numerous studies show that we can enhance the empathy of health-care professionals and students, which can lead to improvements in patient outcomes,” Eaton said.

“We hope our research, including the VR dementia simulation, will help caregivers understand dementia to better manage people who have it, reduce stress on caregivers, and prevent unnecessary hospitalization,” Ashour said.