Aged Care Insite Issue 105 | Feb-Mar 2018 | Page 37

technology workers in the home. How do you improve an experience? This is a very tangible way to bring something that is entertaining, something that becomes a topic of conversation. Imagine if you’re a nurse. You go in daily for a dressing and you’ve seen this person four times a week, five times a week. This other element gives a new avenue for conversation to go down, so it actually provides a level of variety, both for the nurse and for the client. It improves the communication between the two. Client Peter Russel enjoys a virtual reality experience while Bolton Clarke nurse Rajwind Kaur changes his wound dressings. that cause anxiety and/or pain, and how with virtual reality we can intervene with something other than a drug to try and distract them from the thing they are anxious about, or the procedure that causes them pain. There’s great research to show that it works really well in dental clinics, and we used to use it in a dental clinic, in a cancer hospital, as well as for taking blood, lumbar punctures and wound dressings. There’s been extensive research in the burns units in hospitals [that shows] how virtual reality can improve the patient experience. What are some of the environments that users are transported to? Interestingly, most people like the underwater content. Now, when I first started working with virtual reality I would often use nature scenes and photographs, because we were concerned that animation might cause nausea, dizziness or other unwanted side effects. But that wasn’t the case. People loved being underwater, and what they liked more was the computer- generated underwater experience with dolphins, whales, starfish and turtles. That seemed to transport them more. We know, scientifically, that immersing yourself in water does lower your blood pressure. So this gives us a hint that there is something relaxing and transportive about the underwater environment. What differences have the VR headsets made to clients and to their approach to receiving wound care? What feedback have you received? The clients we’ve trialled it on tend to think the wound dressing procedure went for a shorter time. So their sense of time perception is altered when using virtual reality, which is a positive because they think the dressing happened very quickly, compared to those having their wounds dressed without the virtual reality. As well as a change in time perception, they experience less pain, because the distractive technique of virtual reality means your brain can’t compete with two overwhelming stimuli. So with the pain stimuli and the experience of being surrounded and disoriented underwater, your brain can’t process both of these stimuli with the same intensity. Something loses, and what usually loses is pain. So clients in the end use less pain medication. The other thing with repeat procedures is there is a lot of anticipatory anxiety with clients. So just imagine if you’re having a blood test every day, or every week. There’s a level of anxiety before it occurs, a level of anxiety before the needle is inserted. So virtual reality runs active interference with that anxiety. We see from the research and our own clients’ feedback that they experience less anxiety. What impact has it had on staff and their ability to complete the wound management procedure? I think the staff can make the procedure longer, because they have to prepare another level of equipment: they have to be familiar with the headsets, know how to work them and troubleshoot problems. But the staff are really motivated to try something different, because we’ve had a lot of focus at Bolton Clarke on improving the client experience, and what that means for nurses and care So will virtual reality be used only for clients who are anxious or resistant to wound dressings being changed? Or are there plans to use it for clients with different care needs in the future? We’ll be exploring a range of applications of virtual reality within the organisation. There’s certainly emerging evidence of its use within aged care facilities, and how to reduce anxiety and distress with residents who have dementia. So there is a real application for virtual reality in those contexts, especially if the only alternative is to sedate people. We want to be looking at all the non-pharmacological interventions that can improve a person’s state of mind. We have also purchased a 360-degree camera so we can make our own video content. One idea we’ve had is for people in residential aged care who have dementia – we could record their family members, home and other familiar environments. When they are distressed, we can play that content that is specifically tailored to them to see if it calms their mood and reduces their anxiety and fear, because they are looking at things that are familiar to them, and it’s an immersive environment. So we’re really keen to explore its use in aged care facilities. We are also keen to explore its use for those people that are going through death and dying and how an experience in a forest may provide a mental break for them during that period. We see lots of other applications. For example, to use with our staff, so they can experience what it is like to do an assessment, what it’s like to walk into a person’s home, and they can learn from each other, start to video-tape and document how we do things. It is a great training tool as well. ■ agedcareinsite.com.au 35