How VR is being used in senior centers and nursing homes

On Wednesday mornings, residents at Citrus Place, a retirement community in Riverside, California,  gather for a weekly institution: 30 minutes in virtual reality. 

The activity is voluntary, and participation is high. On this day, about a dozen peoplefrom the facility's assisted-living wing sat on love seats in a circle, wearing VR headsets that looked like big goggles. Their virtual schedule was packed: a hot-air balloon ride, then a safari, then to the grocery store.

As the scenes passed, participants laughed or gasped as they experienced their "movement" by using only their fingers and a controller. At one point, Debbie Townsend, 65, bumped a nearby potted plant while she reached for a virtual apple — "Oops," she said.

Citrus Place's director of wellness programming, Maribel Echeverria, watched from the sidelines.

"He never comes out for activities," Echeverria said, nodding toward a man in a wheelchair while he looked at the virtual clouds sailing by. "But he loves this."

The resident was in the U.S. military, and VR is the closest he comes to world travel these days, Echeverria added.

If VR companies are to be believed, this technology is a blessing for the young and old, making video conferences fun and concerts less crowded. Consumers, for their part, have been lukewarm so far — vendors shipped an estimated 2.9 million virtual reality devices in the United States in 2023, down from 3.4 million in 2022, according to market research firm IDC. But in hundreds of senior living facilities across America, VR is finding fans.

That population is a prime candidate for the therapeutic and social benefits of VR, advocates say. The technology is relatively intuitive, and some studies show it can help with memory loss, mood and loneliness. In the competitive elder-care market, a VR program is a selling point. (Rendever, one company developing VR for older adults, says it has more than 500 partner organizations.) And, at least for the residents at Citrus Place, VR is a hit.

"I've never been to Spain — I want to see something there." Townsend said. "It's like traveling when you're not traveling."

A social activity for patient and caregiver

Before the pandemic, about 1 in 4 adults ages 50 to 80 reported feeling isolated from others, according to data from the University of Michigan. By June 2020 — during the peak of pandemic restrictions — that percentage spiked to 56%, and now it's hovering at 34 percent. Loneliness is a major health risk among older adults, and factors such as mobility and hearing loss make things harder.

For new Citrus Place residents, walking into the cafeteria on Day 1 is like showing up to a new high school: Lots of faces and zero friends, Echeverria said. Caregivers try to draw quiet residents out of their shells and find opportunities to connect, like a favorite song or a story from the past.

When Echeverria first heard from higher-ups that she and her staff would be implementing a VR regimen, she wasn't thrilled — would the new tech be a blessing for her staff, or a burden?

But the reception from the residents won her over, Echeverria said. People who tended to self-isolate were joining VR activities such as flight simulators and beachside meditations. One woman who usually didn't speak started accepting visits from Echeverria's assistant — if the headset came along.

Then there's the maps feature — picture Google street view if you were actually standing on the street. Some residents wanted to travel to Japan, Echeverria said. Others wanted to visit their childhood homes. Once, she took them on a virtual jaunt to her own house on a nearby mountain. Why not?

Other virtual experiences from companies catering to older adults include a 10-part road trip down Route 66 and a hike around the Grand Canyon. Users can scuba dive or row a gondola through a Venice canal. The experiences are diverse and, with a subscription, never-ending: Rendever, the VR company that works with Citrus Place, adds new experiences to its system every week, it says.

A 2018 study in conjunction with the Massachusetts Institute of Technology's AgeLab showed seniors using Rendever felt less depressed and isolated than a control group watching TV. But the program wouldn't work without time and patience from caregivers, Echeverria said. So far, she says it's worth the effort.

"You could have someone sitting there at the VR headset who was super quiet or nonverbal most of the time, and all of a sudden they're telling you things that you never even knew because of what they're seeing," she said.

A future 'elderverse'? 

In a November study from researchers at Stanford University, about half of older adults said using VR alongside their caregivers was "very or extremely" beneficial to their relationship. More than half of caregivers in the study said the same.

But as America's population ages, the labor shortage in elder care is worsening, at times with disastrous consequences. Future caregivers may not have time to guide residents through virtual experiences. But the technology could still be useful, Mynd Immersive CEO Chris Brinkler said: VR and chatbots could help keep residents engaged when staff members aren't around.

It could connect them with loved ones in faraway places, Brinkler said — picture a grandmother and grandson hiking virtually together around the rim of the Grand Canyon.

Will that "grandson" ever be a non-player character — an invention of the game rather than a real person?

Maybe someday, Walter Greenleaf, a neuroscientist and medical technologist on the Mynd Immersive advisory board, said. If the automated characters had a positive impact for lonely people, scientists would want to know.

"Right now, all too often, seniors are just parked in front of a television set," Greenleaf said. "That's using technology to address their concerns and entertain them, in a way. But we can do so much better."

"The elderverse" — Brinkler's term for a shared virtual space built specifically for older adults — isn't here yet. But VR proponents have their sights set on elder care, so it's important to set standards and boundaries now, said Kavya Pearlman, founder of X Reality Safety Intelligence, an organization advocating for safety and privacy in emerging technologies.

Along with studies demonstrating the benefits of VR, researchers must also hunt for drawbacks, Pearlman said.

"This industry is hellbent on proving that their approach to technology is working, and they are probably not looking at stuff that could be concerning," she said.

VR health companies need clear privacy rules, Pearlman said. Right now, companies come to her asking how to protect their sensitive biometric data from marketers, law enforcement and the government. The industry also needs stricter standards for health care products, especially those intended for older adults who may not be able to evaluate privacy policies and withhold their consent, Pearlman said.

As we weigh VR's costs and benefits for elder care, it's important to be realistic, said Jeremy Bailenson, founding director of Stanford's Virtual Human Interaction Lab and co-founder of VR training company Strivr.

"We're not advocating for a world in which seniors are sticking on goggles for hours at a time," Bailenson said. "They put on the goggles, they have great experience, and then they take them off and talk about it with their friends in the dining hall."

"Seniors" is an extremely diverse group, and VR will only be a good fit for certain people in certain contexts, Bailenson said. Caregivers in facilities like Citrus Place may use VR in short bursts to bond with residents. Geriatric physical therapists could see their field revolutionized by virtual sessions with engaging visuals and real-time biometric feedback, he said.

In the meantime, Citrus Place resident Sherri Izzi, 72, will keep taking it all in stride.

"Try new things," she advised after taking off the VR headset. "If you get disappointed in it, then move on. But first give it a shot."