A sunny beach under an azure sky in Mexico, a bustling market in Reykjavik, a sparkling lake in Quebec's Laurentians, a string quartet playing Bach…
What if we could offer individuals in palliative care a whole range of peaceful, familiar or exhilarating experiences that they could enjoy from the comfort of their chair? What if such experiences could not only allow them to travel, discover, explore and relax, but also decrease their anxiety and physical pain?
Neuropsychologist Jhon Alexander Moreno, a professor in Université de Montréal's Department of Psychology and a researcher at the Montreal University Institute of Geriatrics Research Centre, decided to take up the challenge.
Moreno is now preparing to test the use of virtual reality headsets on patients in the palliative care unit of Hôpital Notre-Dame. Participants will be immersed in videos filmed with a 360-degree camera and transported on a completely realistic - but virtual - visual and auditory journey. Their levels of pain and anxiety will be measured before and after the experience.
To create this innovative new tool, Moreno teamed up with Guillermo Lopez Pérez, a filmmaker and the founder of Nipper Media, a Montreal company specializing in creating virtual reality content. Lopez Pérez filmed the images used in the virtual experiences and then combined them with music, voices and details of the places presented.
Rethinking end-of-life care
Moreno's idea to use this non-pharmacological approach came from a desire to help ease the suffering of people at the end of life.
"The end-of-life experience is probably the most emotionally demanding of all experiences," said Moreno. "Individuals can experience considerable suffering due to not only physical pain, but also great existential anguish or anticipatory anxiety about death."
He pointed out that palliative care typically relies on a combination of approaches to relieve physical, psychological, spiritual, existential and social discomfort. In his view, non-pharmacological approaches offer numerous advantages.
"Drugs can cause confusion and interfere with the individual's ability to communicate their wishes and reflect on what's happening to them," explained Moreno.
"We find that using a combination of pharmacological and non-pharmacological approaches allows patients to interact more with loved ones and caregivers, which can have a big impact on shaping their end-of-life experience."
Moreno also pointed out that those in palliative care have often been hospitalized previously and so have already spent a long time in bed. He sees virtual travel as a way for them to escape, stop thinking about their situation and have fun. It gives them "something to look at other than the ceiling of their room."
An experience for loved ones too
Moreno also suspects that virtual reality can benefit loved ones who are accompanying someone dear to them at the end of life. He's going to test this by having them also put on a headset and share in the virtual experience. Again, he will measure their anxiety before and after the intervention.
"Facing death can be just as difficult for loved ones. The emotions can be extreme and overwhelming," said Moreno. "I believe that virtual reality can help make the whole experience less arduous and traumatic for them."
Moreno is confident that virtual reality can soothe those about to lose a person dear to them, and even possibly help with acceptance and preparation for bereavement.
Fostering social innovation
This study, entitled "Using virtual reality to manage anxiety and pain in palliative care," was launched in response to the Quebec government's call for social innovation projects aimed at reducing vulnerabilities and social inequalities in health. It is being funded by the Ministry of Economy, Innovation and Energy, in partnership with the Ministry of Health and Social Services.
