Background Technology is increasingly being used and evolving in the dementia care landscape. One such technology that has gained traction over the last decade is virtual reality (VR). VR is being applied in many areas of dementia care, including cognitive assessment and training, reminiscence therapy, music therapy, and other recreational VR applications. Despite the plethora of applications, they are often not shaped by the experiences and perceptions of older adults living with dementia. Currently, there is no qualitative evidence synthesis (QES) to explore this area. This review aimed to provide qualitative evidence supporting existing systematic reviews in this area. Objective The aim of this QES was to explore key stakeholders’ experiences and perceptions of VR for older adults living with dementia. It aimed to explore the barriers and facilitators to VR use and provide recommendations for future design and implementation. Methods QES was used, which involved a systematic search of 6 databases to identify studies that qualitatively explored key stakeholders’ experiences and perceptions of VR for older adults living with dementia. Thematic synthesis was used to integrate the findings of 14 studies (from 15 reports). The Critical Appraisal Skills Programme tool was used to assess the methodological quality of the included studies. The confidence placed in the review findings was assessed using the GRADE-CERQUAL (Confidence in the Evidence from Reviews of Qualitative research). Results A total of 15 reports from 14 studies were included in the review, consisting of a range of levels of VR immersion, stages of dementia, and care contexts. Three analytical themes were generated: stepping into virtuality, a virtual world, and returning to reality. The results indicate the importance of sensitively designing and introducing VR to this population, as older adults living with dementia often have no prior experience of using this technology. VR can be a positive experience for older adults living with dementia and can provide meaningful interactions, positive expressions, and long-term impacts on everyday functioning. However, it should be acknowledged that some negative associations must be accounted for before, during, and after use. Conclusions This review highlights the positive implications as well as negative associations of VR use. It emphasizes the need for VR design and implementation driven by the needs and views of older adults living with dementia as well as with other key stakeholders. Future research needs to explore the vital role that older adults living with dementia can play in the design process and how they can be empowered to meaningfully design and use this technology.

Background Immersive virtual reality (IVR) can be defined as a fully computer-generated environment shown on a head-mounted display. Existing research suggests that key features of IVR can assist older adults in their everyday lives, providing opportunities for health promotion and tackling social isolation and loneliness. There has been a surge in qualitative studies exploring older adults’ experiences and perceptions of IVR. However, there has been no systematic synthesis of these studies to inform the design of new, more accessible IVR technologies. Objective This study aimed to systematically review and synthesize qualitative studies exploring older adults’ experiences and perceptions of IVR. Methods A systematic review and thematic synthesis were conducted following the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines. In total, 2 reviewers completed title and abstract screening, full-text screening, data extraction, and quality appraisal. Thematic synthesis is derived from the qualitative method, thematic analysis. It involves 3 key steps: initial coding and grouping of these codes, the formation of descriptive themes from these codes, and going beyond these data to form analytical themes. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach. Results Overall, 13 studies were included in the final synthesis, including 224 participants across 9 countries and 5 continents. Confidence in the evidence ranged from high to moderate. Three descriptive themes were generated: practical aspects of IVR use, experiencing unique features of IVR, and perceptions of IVR. The findings from the descriptive themes suggested that there are several improvements that need to be made to existing IVR devices to facilitate older adults’ use of this technology. However, older adults’ responses to IVR were generally positive. Three analytical themes were generated: tolerating the bad to experience the good, buying in to IVR (don’t judge a book by its cover), and “it proves to me I can do it.” The analytical themes illustrated that older adults were willing to tolerate discomforts that accompany existing IVR technologies to experience features such as immersive social networking. There was a discrepancy between older adults’ perceptions of IVR before use—which were generally negative—and after use—which were generally positive—and IVR provided a platform for older adults to access certain activities and environments more easily than in the real world because of limitations caused by aging. Conclusions This review offers insights into older adults’ experiences and perceptions of IVR and suggests how a few improvements to its existing hardware and software as well as how it is first presented could offer new opportunities for older adults to take part in meaningful activities tailored to their needs and preferences. Trial Registration PROSPERO CRD42020200774; https://tinyurl.com/8f48w2vt International Registered Report Identifier (IRRID) RR2-10.1177/16094069211009682

Background Pet robots have been employed as viable substitutes to pet therapy in nursing homes. Despite their potential to enhance the psychosocial health of residents with dementia, there is a lack of studies that have investigated determinants of implementing pet robots in real-world practice. This study aims to explore the determinants of implementing pet robots for dementia care in nursing homes, from the perspectives of healthcare professionals and organisational leaders. Methods A descriptive qualitative study, conceptualised and guided using the Consolidated Framework of Implementation Research (CFIR), was conducted. We conducted semi-structured interviews with healthcare professionals and organisational leaders from nursing homes. Data was transcribed and analysed using Framework Analysis, based on the CFIR as an a priori framework. Results A total of 22 participants from eight nursing homes were included. Determinants were mapped to constructs from all five CFIR domains. Determinants relating to the characteristics of pet robots include their design, realisticness and interactivity, affordability, cleanability, perceived evidence strength and comparative advantages to live pets. Determinants relating to external influences (outer setting) include national regulatory guidelines, funding and networks with other organisations. With regards to characteristics of nursing homes (inner setting), determinants include the relevance of pet robots in relation to the needs of residents with dementia, alignment with care processes, infection control mandates and their relative priority. In the domain ‘characteristics of individuals’, determinants were associated with individuals’ beliefs on the role of technology, desires to enhance residents’ quality of life, and differential attitudes on the use of robots. Finally, in the domain ‘implementation process’, assessments and care planning were identified as determinants. Conclusions Overall, while sentiments around determinants within CFIR domains of pet robots’ characteristics, outer setting and implementation process were similar, participants’ opinions on the determinants within the ‘inner setting’ and ‘characteristics of individuals’ were more varied. This could be due to different organisational structures, disciplinary differences and personal experiences of using pet robots. Many determinants in different domains were interrelated. Findings provide a springboard for identifying and designing implementation strategies to guide the translation of pet robots from research into real-world practice.

Background: In the current digital age, new opportunities arise to support healthy ageing in older adults as frailty and immobility become more prominent. Immersive virtual reality, which can be defined as a fully computer-generated environment that is displayed through a headmounted display, is one of these technologies. Recently, there has been an increase in the number of qualitative studies exploring the potential for immersive virtual reality in assisting older adults—providing opportunities in health promotion and tackling social isolation and loneliness. With this in mind, the current review aims to explore the following research questions: (1) What are older adults’ experiences and perceptions of immersive virtual reality? (2) What are the specific barriers and facilitators to older adults’ use of immersive virtual reality? (3) Do older adults find immersive virtual reality acceptable? The objective of the current study is to systematically review and synthesize qualitative data exploring older adults’ experiences and perceptions of immersive virtual reality. Methods: A systematic review and thematic synthesis will be conducted. Two reviewers will complete title and abstract screening, full-text screening and, data extraction and quality appraisal. A thematic synthesis will be conducted by the lead author, after which the research team and other key stakeholders will discuss the findings and make any necessary changes. Thematic synthesis is derived from the qualitative method, thematic analysis. It involves three key steps: initial coding and grouping of these codes, the formation of descriptive themes from these codes and finally, going beyond the data to form novel insights and theories known as analytical themes. The following protocol has been written following the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guidelines.

Background: Technology is increasingly being used in dementia care as a means of non-pharmacological intervention. One such technology, Virtual Reality (VR) has shown to be a promising vehicle to deliver interventions for people living with dementia. The views of people living with dementia and key stakeholders must be considered to inform future research. There is a lack consensus regarding VR design considerations for this population which makes it difficult for researchers and practitioners to develop meaningful VR spaces. Methods: This qualitative evidence synthesis (QES) protocol aims to explore key stakeholders’ experiences and perceptions of VR for older adults living with dementia. A systematic search will be conducted across six electronic databases. Forward and backward citation searching, and hand searching will identify additional articles. Two authors will independently complete title and abstract, and full text screening. Quality appraisal will be conducted using the CASP qualitative checklist. Included studies will be analyzed using a thematic synthesis approach. The GRADE-CERQual will assess the researcher’s confidence in the findings. Discussion: This QES will constitute part of a larger project which aims to develop a VR social connecting space for older adults living with dementia. The findings will also add to the existing body of literature exploring VR in dementia care contexts. It is anticipated that this review will add to the momentum toward holistic design practices, resulting in usable and acceptable VR spaces for older adults living with dementia.

Virtual Reality (VR) is increasingly being applied in dementia care across a range of applications and domains including health and wellbeing. Despite the commercial availability of VR, informants of design are not always aware of its functionality and capabilities, to meaningfully contribute to VR design. In designing VR applications for people living with dementia, it is recommended that older adults living with dementia and their support persons be involved in the design process using participatory approaches, thereby giving them a voice on the design of technology from the outset. A VR technology probe is a useful means of familiarising older adults living with dementia and their informal caregivers with the knowledge and understanding of interactive VR to employ technology that supports them to maintain their social health. This paper charts the implementation and evaluation of a VR technology probe, VR FOUNDations. To explore their experiences, nine older adults living with dementia and their nine informal caregivers trialled VR FOUNDations and completed semi-structured interviews after its use. Overall, older adults living with dementia and their informal caregivers perceived VR FOUNDations to achieve its aim of increasing understanding and inspiring future design decisions. The findings also identified promising positive experiences using a VR technology probe which may be indicative of its applicability to social health and wellbeing domains. This paper advocates for the structured design and implementation of VR technology probes as a pre-requisite to the participatory design of VR applications for the health and wellbeing of people living with dementia. The use of such technology probes may afford older adults living with dementia and their informal caregivers the best opportunity to contribute to design decisions and participate in technology design to support their health and wellbeing.

No abstract

Background Pet robots are a type of social robots that have been used to benefit the psychosocial health of people living with dementia, particularly in nursing home settings. Despite the body of literature that have been conducted to evaluate their impacts, research to understand how pet robots can be translated from research into real‐world practice have been largely overlooked. This study seeks to address this knowledge gap by exploring the multilevel barriers and facilitators to implementing two pet robots for dementia care in nursing homes. Methods We conducted a descriptive qualitative study, conceptualised and guided using the Consolidated Framework of Implementation Research (CFIR), which consists of 39 constructs within five domains salient to implementation. Maximum variation sampling was used to identify and recruit healthcare professionals and organisational leaders from nursing homes. Individual, semi‐structured interviews were conducted with each participants face‐to‐face or over Zoom. Data was transcribed and analysed using Framework Analysis, supported by the NVivo12 qualitative data management software. Results A total of 22 participants from eight nursing homes were included in this study, of which 9 had seen or used a pet robot with residents with dementia. Barriers and facilitators were mapped to constructs from all five CFIR domains: 1) intervention characteristics, 2) outer setting, 3) inner setting, 4) characteristics of individuals and 5) process. Facilitators include the realisticness and familiarity of pet robots, identification of residents’ needs that can be met (or were met) using a pet robot, compatibility with prevailing regulatory guidelines and organisational care process, intrinsic desires to improve residents’ quality of life, and buy‐in from stakeholders. Barriers include a lack of customisability of pet robots to suit residents’ abilities and preferences, doubts about long‐term use, prohibitive costs, lack of external funding, lack of resources and knowledge, infection prevention mandates, and conflicting views on the anthropomorphisation of pet robots. Discussion Overall, this study highlights an incongruence between the characteristics of pet robots, organisational considerations (such as available resources), and external contextual factors. These findings have practical utility in informing the development of implementation strategies to guide the translation of pet robots from research into real‐world practice.