Virtual Reality in Combating Dementia

Virtual reality, dementia

Singaporean startup Mind Palace uses VR for reminiscence therapy, helping dementia patients enjoy a little escapism. 

We’ve seen virtual reality (VR) in gaming, in fashion, in training, and in sport. It’s captured our imaginations through everything from Monsters, Inc. to Black Mirror. But Singapore-based VR startup Mind Palace is putting this futuristic technology to therapeutic use: helping dementia patients remember their pasts and feel closer to their loved ones. 

The startup is using VR as a form of reminiscence therapy, a technique that uses senses and objects to help dementia patients remember familiar faces and places from their past. Not only does this help with memory, it also provides a soothing influence that can reduce stress and feelings of isolation among elderly nursing home residents.

The seed that became Mind Palace began after Founder Eugene Soh took his VR goggles to a nursing home upon the request of a connection from his creative VR startup, Dude Studios. It was a rewarding and eye-opening experience for the residents, but the interface was not optimized for the purpose and was little more than a novelty. This irked him.

“Being a developer and a programmer, there was an itch in my heart to go and solve this problem,” says Soh. “So I went to develop my own app to make it easier for [nursing home residents] to experience VR.” 

The prototype that Soh put together ultimately gained so much traction that he spun it off into what became Mind Palace. It’s now a non-profit that actively formulates new ways to access and exercise dementia patients’ memories using virtual reality.

Spreading wonder with VR

Traditional reminiscence therapy involves showing patients old photographs of family and places from their past. This exercises the memory and can help them feel calmer, since as Soh explains, late-stage dementia patients are often confused and scared by the present.

In Mind Palace’s VR reminiscence therapy sessions, patients are shown places in old Singapore that they might have visited in the past. This can trigger memories that may be attached to sensory cues like sounds and colors. As the patients become immersed in VR Singapore, Soh asks them questions about what they are seeing, gently initiating conversations and triggering memories.

“One example is how this lady, when we brought her back to Chinatown, she started talking about how she would be shopping at Chinatown and haggling with the store owners about items,” Soh recalls. “Once she managed to haggle down to a specific price that she wanted, she would say, ‘Oh, I’ll think about it.’”

The VR session had triggered such a nuanced, intimate memory that even the woman’s daughter, present at the time of the session, was hearing about it for the first time. Such examples serve to validate Mind Palace’s approach: though the therapy doesn’t always work, when it does, the results can be astonishingly heartwarming. One particular session is a standout in Soh’s mind.

“When I was asking [the patient] the questions, he was reading out the route, the street name, the roads to me. The therapist and the nurse, they were looking at me with wide eyes, like I did something wrong,” says Soh.

But when the session ended, Soh learned that the patient, who had so clearly been naming roads and landmarks, usually never spoke above a mumble. The nurse and therapist were stunned to hear him speaking confidently for the very first time. 

However, Soh cautions that VR is not a miracle cure for dementia: at present, it can simply help calm patients and help them to remember things better.

In keeping with traditional reminiscence therapy, which involves all the five senses, Soh also incorporated environmental scents into one of the Mind Tour episodes. That particular recording was of Singapore’s Michelin-starred street hawker stall Hawker Chan, run by Chef Chan Hon Meng. Soh asked Chan to talk to the camera as if he were speaking to nursing home residents, while preparing a steaming plate of chicken rice.

“For them it feels very personal, as if it’s one-on-one [and] he’s making chicken rice for them,” says Soh.

“Then, while they are watching him and the chicken rice, they start to smell the chicken rice too. They don’t know why they can smell it. They think the technology is so good that they can smell it at the end of the session.”

Once Chan presented the chicken rice virtually, he asked the residents to take off their goggles. The residents were surprised to find a steaming plate of chicken rice in front of them. Soh had hidden the chicken packets in another room and placed them in front of the residents while they were engrossed in the session.

While the residents were both amazed and touched by the gesture, Soh understood the session’s real impact a week later. Usually, dementia patients do not remember him after a session. But a week after the chicken rice session, the residents not only remembered him, but wanted to know if there was going to be food in the next session as well.

A timely pivot

According to Soh, Mind Palace’s goal is to provide “escapism” for nursing home residents who may feel cooped up.

“Sometimes they have excursions, but we want to make experiences like this easier for them, so that they can [visit] even further places. And that solution was with VR,” says Soh.

The nursing homes usually buy a few headsets that are sold at cost, since Mind Palace is a non-profit organization. Since there aren’t enough headsets to go around, they are therefore shared between the patients. But late last year, Soh discovered a glaring issue with this system.

“After doing a few sessions, my headsets were getting gross, and they were getting smelly,” he says. “And whenever I was updating new software, when I put it to my own face, my eyebrows started to itch.”

Soh tried the easiest solution first: he washed the foam pads on the headsets which come in contact with skin. But the goggles still irritated the skin around his eyes.

“Then we also tried all sorts of hygiene methods where we put a hygiene mask on the user first and then put the headset,” he says. But even this was not a satisfactory solution, since Soh remained worried about the spread of conjunctivitis and other diseases.

Soh’s priority was to ensure the safety of the elderly patients, who are more susceptible to disease due to their age. Without feeling too remorseful about the sunk costs of his VR headsets, Soh pivoted to create immersive VR rooms.

In January, long before COVID-19 was declared a pandemic, Mind Palace finished building its first immersive VR room in an NTUC Health nursing home. When the pandemic’s spread called for social distancing and contactless technologies, the immersive room became even more useful.

Despite being called an ‘immersive room,’ VR headsets still provide a more immersive effect. However, Soh believes the immersive rooms are much safer for vulnerable elderly patients. His goal is to improve the immersive rooms and enable them to track individual residents’ progress. To that end, he’s also incorporated an element of gamification. 

Alongside the travel experiences, Soh has built basic games into the rooms which encourage exercise. If residents are only able to reach the second level in the first week, but reach the fifth or sixth level after a few weeks, they’ve shown physical improvement. Soh wants to utilize this performance data to keep patients’ families abreast of their relatives’ progress.

For Soh, the ultimate goal is to support and treat dementia patients and elderly nursing home residents. With no profit motive to distract from this vision, Mind Palace has the freedom to keep innovating, exploring emerging technologies, and above all, improving the lives of those who are so often overlooked.

Originally published in Jumpstart Magazine Issue 31 as ‘Mind Over Matter’


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