Authors: Ahmed B., Eklundh J., Hellström S., Lindvall J., Yenkong E., Hellstén T.
WHO (2012) states that life expectancy has already exceeded 75 years in 57 countries in the world. In the next few years the number of people aged over 65 years in the population will outnumber children less than 5 years of age. With a growing older population there are also a number of factors regarding their quality of life and wellbeing that need to be considered. The elderly population can run the risk of being left outside social contact because of physical and mental obstacles. Loneliness is a factor, which has a major impact on the elderly’s mental health and wellbeing (Aylaz et al 2012). This blog is written in Arcada summer school 2018 in the course eHealth and the aim of this blog is to present preventive digital measures and take a closer look at virtual reality as a solution to loneliness, in order to promote elderlies health and wellbeing status.
There’s overwhelming research that point out that loneliness can be a factor with an adverse effect on elderly’s health. Loneliness correlates with diminishing cognitive functions (Boss et al 2015, Perissinotto et al 2012), depression (Aylaz et al 2012) and a higher suicide rate (Stravinsky & Boyer 2001). There are also studies showing that a feeling of belonging supports elderly’s health (Tomaka et al 2012).
Predictors of feelings of loneliness are being a woman, being older, living alone, having fewer economic resources, having lower perceived health, and being dissatisfied with the frequency of contact with relatives and friends. (Losada et al 2012). Meanwhile, social security and a higher income has a positive effect on the feeling of loneliness. Social support such as befriending schemes, social group schemes, regular home visits, telephone contacts by family and friends as well as the society play a role in supporting elderly. (Aylaz et al 2012)
Virtual reality as a solution
Loneliness among the elderly is a known phenomenon and there are several digital solutions developed to reduce loneliness. Examples of different solutions are video conferencing (Skype, Facetime etc), different apps (Huoleti) or tablets (Sanoste). There are even projects like Speaking Exchange where elderly get to meet and talk to students over the internet to teach english (Brave). Then there is virtual reality that can create various of possibilities for the elderly to cope with there loneliness (VRscout).
What do studies tell us about virtual reality and loneliness among elderly?
According to research, many of the elderly declines from social interactions leading to loneliness since their brain activity tend to slow down due to ageing. Their brains can be stimulated by using virtual reality in the form of games. Some resident elderly establishments use virtual reality to help residents to escape their mental and physical limitations. (Miller et al 2013)
In an experiment lonely people showed more social responses to a virtual environment where there was a social embodied agent involved. The elderly had a better experience of the contact with the agent when taking on a physical form as opposed to experiencing the contact through sound (Lee et al 2006) This shows having contact with a person, even a virtual one, can have an impact on elderly’s feelings of loneliness. If the cause behind the loneliness is shyness, virtual reality is considered an easier way to make contact with others, as opposed to face-to-face communication where there are visual and auditory cues to act on (Hammick and Lee 2014).
A practical example
In a study with elderly in a senior’s activity center in Taiwan their values and perceived meaning of using virtual reality as a leisure activity was explored. The elderly were using a virtual reality game called Wii, where they could choose to play alone or together in a group. The research came to the conclusion that the elderly like the combination of fun and safety and that is something that Wii can provide. Which means that Wii virtual reality game can be suitable as a leisure activity for the elderly to help them improve aspects in their life like friendship, communication as well as a feeling of belonging. (Lin et al 2018)
Elderly and technology as a combination can be a bit of a hurdle to pass in order to implement eHealth-solutions, such as virtual reality-devices. The elderly are often scared of not being able to use the technology, although it might be good for them (Lin et al 2018). Can virtual reality then help elderly decrease the feeling of loneliness?
Leisure activity for elderly is important for maintaining or upbringing a good physical and mental well-being. More focus should be put on giving the elderly the possibility to participate in some leisure activity no matter disability or isolation. It’s here that virtual reality can be a solution because of its capacity to adapt to the elderly’s needs and values. (Lin et al 2018)
Studies show, that although the elderly might be hesitant users at first, the more they learn and use the technologies, the better their attitudes towards using them get (González et al 2012). As some elderly struggle with the lack of user-friendliness and education in using the devices (Demiris et al 2004), these might be considered a focus point when developing solutions targeting elderly. It is also important to take into account the fact that people are different. Creating different VR-solutions for different elderly is therefore paramount in giving the elderly a solution fitting their needs and interests.
It might seem counterintuitive that as population is growing older and running a risk at detaching them from society (Theng et al 2012), the solution would be more screen time. It has been observed that when older adults are exposed to the virtual environment for longer periods some of them may feel uncomfortable and as a result feel reluctant in its use. The study concludes that virtual programs, organized by health facilities for older adults, must execute these programs within safe environments, preferably in groups. (Kim, A et al 2017)
Studies have shown that virtual reality games environment support the decreasing cognitive and communicative skills in elderly. (Antunes et al 2018) However, some of the users think that it is better to form relationships in face to face interactions. Elderly might experience social discomfort in making online relationships. Some of the obstacles experienced included the elderly’s own personality, language differences, rejection by others and uncomfortable sexual interactions. In order for this technology to be more effective and appealing, there is a need to address these obstacles. (O’Brien et al 2016)
A stumbling stone for implementing this technology is how the elderly will gain access to the devices enabling them to join a virtual reality: eyewear, headphones and gloves (Tech terms 2018). As service residences for elderly usually accommodate different needs of the elderly, these sorts of devices wouldn’t be farfetched to acquire considering the potential health benefits mentioned before. As elderly living in service residences already have living conditions where socializing with others is a possibility regardless of physical and psychological ailments, the real obstacle is how to reach elderly suffering from loneliness in their homes. The requirements to use the virtual reality is both acquiring the equipment and the knowledge how to use it. This might be something society would benefit from, lending equipment and seing to the elderly would have access to someone educating them in the use of the technology. Reducing loneliness among elderly can help support their health (Boss et al 2015, Perissinotto et al 2012).
Virtual reality is not seen as a solution to replace direct social interaction among elderly, but as an opportunity to interact with other elderly in a virtual environment. Some precautions need to be taken when introducing this technology, like doing it in a safe environment and doing the sessions shorter in the beginning (Kim, A et al 2017). As the studies and practical examples we’ve mentioned have shown, elderly have already benefited, albeit skeptical at first, from these eHealth solutions once introduced. These solutions will enable the elderly to feel that sense of connection, social role and belonging in society. The biggest obstacles are access to equipment and training how to use the technology. We conclude that virtual reality is a viable option to meet the needs of elderly suffering from loneliness. More focus should be put on giving the elderly the possibility to participate in some leisure activity no matter their disability or isolation (Lin et al 2018). It’s here that virtual reality can be a solution because of its capacity to adapt to the elderly’s needs and values.
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