Evaluating the use of interactive virtual reality technology with older adults living in residential aged care

Issues with the handheld controllers were reported in 5/13 of the studies, including poor ergonomics, awkward feeling and positioning, and smoothness of the buttons.

“Issues with the handheld controllers were reported in 5/13 of the studies and included poor ergonomics of the controllers [15,45] and the awkward feeling and positioning [15,45] and smoothness of the buttons [45].”

Specific risks for wheelchair users included overreaching for an object in the virtual environment and falling from their chair, injuring their arms when interacting with the virtual environment because of high armrests, and releasing the brakes of the wheelchair to allow for more movement causing simulator sickness.

“Specific risks for wheelchair users described in 1/13 of the studies included overreaching for an object in the virtual environment and falling from their chair, injuring their arms when interacting with the virtual environment because of high armrests, and releasing the brakes of the wheelchair to allow for more movement causing simulator sickness [15].”

Participants reported feeling more energetic, content, relaxed, and adventurous, and less anxious, worried, or stressed after the intervention.

“In the study by Baker et al. (2020), participants reported feeling more energetic, content, relaxed, and adventurous, and less anxious, worried, or stressed after the intervention.”

In recent years, there has been an increase in qualitative studies examining older adults' experiences and perceptions of IVR.

“In recent years, we have also seen an increase in qualitative studies examining older adults’ experiences and perceptions of IVR [14-16].”

Participants in 11/13 of the studies reported issues with the HMD, including that it was too heavy, caused general discomfort, caused disorientation and imbalance, and caused feelings of being trapped, confined, afraid, or anxious.

“Participants in 11/13 of the studies reported issues with the HMD, including that it was too heavy [9,44,45,48,50]; caused general discomfort [9,15,16,44,50]; caused disorientation and imbalance [44,46]; and caused feelings of being trapped, confined [45], afraid, or anxious [16,45].”

Some studies reported that participants could use the handheld controllers confidently and enjoyed the added control they gave them in the virtual environment.

“some studies reported that participants could use the handheld controllers confidently [15,44] and enjoyed the added control that the handheld controllers gave them in the virtual environment [44].”

In 3/13 of the studies, the HMD was generally tolerated by participants.

“Although a range of issues were raised regarding the HMD, 3/13 of the studies reported that the HMD was generally tolerated by participants [9,14,15].”

11/13 of the studies described feedback on the content presented, with participants preferring still content to moving content, preferring familiar content similar to past experiences, showing a strong preference for tailoring content to their own interests, enjoying the adaptive nature of the content, suggesting more diversity in content, and giving only a few negative comments about content.

“A total of 11/13 of the studies described feedback on the content presented, specifically the various objects and scenes inside the virtual environment and participants’ experiences navigating them [9,14-16,44,46-48,50-52]. Participants preferred still content to moving content [44,51] and preferred content that was familiar [52], in particular, content similar to past experiences in real life [44”

There was a temporal pattern in older adults' perceptions of IVR across stages of use, illustrating the importance of users' preconceptions and how they can differ from actual experience, with a generally negative impression before use changing to a generally positive impression after use.

“There was a temporal pattern identified in the data that consisted of older adults’ perceptions of IVR across stages of IVR use (perceptions of IVR [9,14-16,44-52]). It began with older adults’ perceptions of IVR before use, followed by their perceptions during and immediately after use. This pattern illustrates the importance of users’ preconceptions of a given technology and how they can differ”

10/13 of the studies reported participants' experiences and perceptions of presence and immersion in IVR, with participants reporting that the feeling of presence made the experience feel more real and allowed them to engage with objects as if they were really present, 3/13 explicitly reporting enjoying the experience of presence, and 1/13 reporting some feelings of anxiety and nervousness because

“A total of 10/13 of the studies reported participants’ experiences and perceptions of presence and immersion in IVR [9,14-16,46,48-52]. Participants reported that the feeling of presence made the experience feel more real [15] and allowed them to engage with objects in the virtual environment as if they were really present [9]. Participants from 3/13 of the studies explicitly reported enjoying the”

Most of the preconceptions reported were negative, with a general sense that IVR was a frivolous undertaking with little benefit to older adults and better suited to younger generations, some participants worried they would forget how to use the handheld controllers, others were concerned about glasses and HMD damage, and 1/13 hoped IVR would broaden their horizon.

“Most of the preconceptions reported were negative [15,44,45], with a general sense that IVR was a “frivolous undertaking” with little benefit to older adults and better suited to younger generations [45]. Some participants worried that they would forget how to use the handheld controllers [15], whereas others were concerned about whether their glasses could be worn with the equipment and, if so,”

1/13 of the studies reported that the more participants were immersed in the virtual environment, the more it enhanced their experience, greater immersion provided a heightened travel experience, enabled escape from reality, and simulated past experiences realistically, while some participants were not convinced and felt like passive observers, and participants needed to interact with content and

“A total of 1/13 of the studies reported that the more participants were immersed in the virtual environment, the more it enhanced their experience [48]. Greater immersion provided a heightened travel experience when exploring places around the world [15,16], enabled participants to escape from their own reality [50], and simulated past experiences in a realistic way [49]. Some participants were”

The physical capabilities of the participants influenced their experience with IVR, with impaired hearing or vision hindering the experience, a lack of mobility preventing some from making the most of the full 360° experience, and some finding it difficult to turn themselves to see other features in the environment.

“The physical capabilities of the participants and how that influenced their experience with IVR were also reported [9,15,16,44,47,48,50,51]. Having impaired hearing or vision hindered the participants’ experience with IVR [16,50,51]. A lack of mobility also prevented some participants from making the most of the full 360° experience [9,47,48,50], where some found it difficult to turn themselves to”

Being able to visit places where they could not physically go themselves brought about a heightened sense of immobility, but participants also reported that IVR could give back agency lost through aging because of physical and mental decline, affording them the opportunity to explore places and take part in activities that might raise concerns about safety among family members and other key Stake

“In one case, being able to visit places where they could not physically go themselves brought about a heightened sense of immobility [16]. However, in contrast, participants also reported that IVR could give back agency lost through aging because of physical and mental decline [14,15,50], affording them the opportunity to explore places and take part in activities that, if they were to do in”

Older adults enjoyed and ascribed meaning to their IVR experiences, with reports that, in some cases, the activities in IVR were more appealing than those offered to them in their real environment.

“Moreover, it was clear that older adults enjoyed and ascribed meaning to their IVR experiences, with reports that, in some cases, the activities in IVR were more appealing than those offered to them in their real environment [15].”

Conflicting participant experiences were present across the synthesis, including differences in experiences of dizziness and nausea, wearing the HMD, and sitting while using IVR.

“Conflicting participant experiences were present across the synthesis. These conflicts included differences in older adults’ experiences of dizziness and nausea [14,44], wearing the HMD [9,14,15,44,46,48,50,51], and sitting while using IVR [15,44,50].”

Participants were generally happy to tolerate certain nuisances inherent to some existing IVR technology features to experience what they considered to be meaningful activities.

“There were clear signs that participants were generally happy to tolerate certain nuisances inherent to some of the existing IVR technology features to experience what they considered to be meaningful activities [15].”

Social connection in IVR was a sought-after activity for many participants because of the added opportunity it gave them to meet others outside their sometimes restrictive environment.

“Social connection in IVR was one of these sought-after activities for many participants because of the added opportunity it gave them to meet others outside their sometimes restrictive environment [14,15].”

IVR afforded older adults added agency in several studies.

“This analytical theme conveys the added agency that IVR afforded older adults in several studies.”

Some researchers had success in identifying and offering solutions to some of the nuisances reported by participants through the methodologies they used to explore this topic, such as participatory action research.

“A key finding of this review is the success some researchers had in identifying and offering solutions to some of the nuisances reported by participants through the methodologies they used to explore this topic [7,14,15], such as participatory action research.”