Wider Horizons

Lethbridge College researchers are creating an immersive virtual reality training platform to help caregivers manage scenarios they may face when caring for people with dementia.

For people living with dementia, their families and healthcare professionals who work with them, the condition presents a host of challenges. Communicating with loved ones and carrying out basic tasks like eating or getting dressed become difficult. Confusion, anxiety and agitation can lead to mood swings and even physical confrontations. But Lethbridge College researchers are offering help in the form of a new immersive virtual reality training platform designed to help caregivers manage scenarios involving people with dementia.

The CareGiVR project is a partnership between Lethbridge College’s Spatial Technologies Applied Research and Training (START) initiative and Calgary tech studio Red Iron Labs made possible by a $250,000 grant from Alberta Innovates eXtended Reality Health Economic Acceleration and Development (xR HEAD) program. The heart of the project is an interactive application that will place users into highly realistic virtual reality scenarios where they interact with virtual subjects created with sophisticated performance capture technology who demonstrate a range of emotions and responses.

“Interacting with a client with dementia is so much about reading body language and facial expressions to know if the client is responding well to you or if they’re getting agitated or are going to lash out, so we want to create scenarios that are as realistic as possible,” explains Mike McCready (Multimedia Production 1999), Lethbridge College’s President’s Applied Research Chair in Virtual and Augmented Reality and lead on the CareGiVR project. “The virtual clients we’re creating will be powered through actors whose body movements and facial expressions we’ll capture so you’ll be able to see if they are grimacing or clenching their fists or other movements that are difficult to create in code.”

“The virtual clients we’re creating will be powered through actors whose body movements and facial expressions we’ll capture so you’ll be able to see if they are grimacing or clenching their fists or other movements that are difficult to create in code.”

Laura Vogelsang (Nursing 2011), the college’s Associate Dean of the Centre of Health and Wellness, is working with McCready’s team and Red Iron Labs to develop the virtual scenarios that caregivers will enter through the app. She says with the app, caregivers will be able to practise responses to a wide range of virtual clients in a variety of scenarios, receive immediate feedback on their performance and repeat the process as many times as necessary to improve their responses and the quality of care. “With dementia clients, behaviours can potentially escalate to a point where we have to use what we call chemical restraints, which is medication to keep them or others safe. With CareGiVR, we can explore different scenarios and see how you can approach a situation in different ways so that you don’t have to employ those restraints.”

Vogelsang says finding opportunities to upgrade their skills can be difficult for healthcare workers, nor do trainees get many chances to work with actual people with dementia. “Given the nature of shift work, it’s hard to go to workshops or have invigorating professional development days, but with CareGiVR, we’re able to provide on-site, just-in-time learning for healthcare professionals,” she says.

“Some [caregivers]can be quite afraid to go into dementia care settings or may not feel able to manage difficult situations in a way that’s safe for both themselves and the client, so we are hoping [CareGiVR] will increase their self-confidence in a way that’s therapeutic and safe.”

According to the Canadian Mental Health Commission, fully half of all negative physical and verbal experiences reported by nurses occur during care of clients with dementia. Vogelsang, a practising Registered Nurse with first-hand dementia care experience in long-term and acute-care environments, says CareGiVR could help reduce negative interactions by ensuring healthcare workers are better able to predict them, with benefits for all involved. “People who care for clients with dementia may be at higher risk for injury or burnout and staffing turnover can be quite high. If you’re better equipped to manage aggressive behaviours, you’re also going to be enjoying the work you do and feel more fulfilled, which is good for client outcomes as well as employers.”

While Vogelsang, McCready and the rest of the team at Lethbridge College will bring subject matter expertise to developing the scenarios and capturing the performances for the app, Calgary’s Red Iron Labs is providing the technical direction. “Working with Red Iron Labs is extremely important for us because this is [START’s] first large research project,” says McCready. “We wanted to tap into the industry as we build our own internal research capacity and they bring that experience and expertise in VR [to the project].”

“Interacting with a client with dementia is so much about reading body language and facial expressions to know if the client is responding well to you or if they’re getting agitated or are going to lash out, so we want to create scenarios that are as realistic as possible."

“We are using a combination of cutting-edge game development practices and understanding of [Extended Reality] simulation development to create one-of-a-kind experiences to help educate, teach and empower caregivers,” explains Red Iron Labs co-founder Lloyd Summers, adding that Red Iron Labs has leveraged the partnership to start employing students from the college’s XR program.

McCready says he expects to have a first scenario and alpha release of CareGiVR developed by the end of 2020, with a full version ready for commercial release by early 2022. And while the app could transform dementia caregiver training, McCready says there are a range of potential applications for the technology in the future. “Through our partnership with Red Iron Labs, we’re looking at potentially adding in various other types of caregiver training, whether it’s for other cognitive disorders like schizophrenia or even for training applications outside of health care like law enforcement.”

But Vogelsang says it’s not just healthcare professionals who might benefit from VR training. “For family members and friends of clients with dementia, these behaviour changes can be quite traumatic emotionally. It’s not easy when someone is behaving in an unpredictable way by virtue of their medical condition, but CareGiVR could give them the opportunity to practise different ways they could respond to their loved ones."

 

Worldwide, around 50 million people have dementia, and there are nearly 10 million new cases every year. With Alberta Health Services projecting the number of Albertans aged 40 and older living with dementia to climb from 56,050 in 2014 to 228,949 over the next 30 years, the need for well-trained dementia caregivers and the demand for solutions like CareGiVR is only going to grow.

Wider Horizons
Story by Jeremy Franchuk | Photos by Rob Olson
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