One of the darker aspects of dementia is the aggressive and sometimes violent behaviour people with dementia can exhibit.
It’s unintentional behaviour borne of frustration and confusion on the patient’s part, but dealing with these outbursts is one of the hardest things carers and aged care staff have to deal with.
Often, when situations like these occur in hospitals or aged care facilities, staff are unequipped to manage violent behaviour (particularly if the aggressor is male) and security or even police are called in to handle it.
But meeting the patient’s aggression with more aggression is almost always just going to inflame the situation further – but how do you de-escalate a situation when the patient isn’t able to comprehend what’s happening?
Training for such an event is difficult, as every patient – and every outburst – will be different.
But Dementia Australia has launched a new high-tech training program that intends to do just that – and we went along to see how it all works
Introducing D-Esc
To learn how to react appropriately in a given situation, you need to live the experience. But how do you do that without actually, you know, living the experience?
To overcome that significant hurdle, Dementia Australia has developed D-Esc, a virtual reality (VR) training program that puts the user in an immersive simulation of various health and aged settings.
The immersive nature of VR lets trainees feel like they’re actually there, interacting with patients in real-time. It also helps participants build empathy and understanding towards people with dementia, as the characters in the simulation react to you as if you were there.
Dr Kaele Stokes, executive director of services, advocacy and research at Dementia Australia, says the training program has been primarily designed with the aim of reducing the use of restrictive practices and the number and severity of dangerous incidents.
“Behavioural emergencies and occupational violence in aged care are time-critical emergencies,” says Dr Stokes.
“We know that dementia can change people’s behaviour. People living with dementia may feel anxious, fearful, distressed, confused. They may also be in pain or disorientated.”
How does it work?
I can personally attest to the immersion factor of D-Esc, having been given a chance to try the VR program out for myself.
Upon putting on the headset, I was immediately transported to the foyer of what looked like a hospital. Granted, the graphics don’t quite match real life, but it is certainly more immersive than watching a video.
Inside my digital world, a nurse was standing in front of me pleading for help. A patient was displaying some violent behaviour and she could not restrain him alone.
I could hear yelling and banging off to my right and, sure enough, turning my head right brought the image of a frustrated older gentleman banging on a door and shouting obscenities. As soon as I looked at the older man, he ran towards me at a sprint, causing me to jump back in real life.
Unfortunately, with such a large crowd waiting to try the device out as well, my demonstration ended there. I might not have got a chance to talk the man down, but I definitely understood how valuable this tool could be to frontline workers.
When given enough time during a full training session, the D-Esc program hopes to teach healthcare workers how to recognise emotional and physical signs of escalation and understand how increased stress impacts a person with dementia from a first-person perspective.
“Sometimes the way they [people with dementia] are experiencing a situation may mean a person is unable to communicate how they feel or what they are experiencing in the familiar ways,” Dr Stokes says.
“Additionally, the way a care worker communicates with people living with dementia is vital. Communication is not just talking.
The immersive and interactive training provides a number of different situations a healthcare professional may encounter and how to approach the situation from a number of different aspects.
“Gestures, movement and facial expressions can all convey meaning,” says Dr Stokes.
“Body language and physical contact become significant when speech is difficult for a person with dementia.”
Dr Stokes says she hopes the D-Esc program can reduce incidents of stress for people living with dementia, carers and families, while simultaneously increasing the confidence and personal safety of aged care workers.
“Course participants will build their empathy, increase their understanding of dementia and skills in communication, recognising emotional and physical signs of escalation and how to reduce the risk of harm for both the person with dementia, other residents, visitors and staff.
“D-Esc leverages technology to build participants’ confidence and capability to assess and respond effectively to changed behaviours safely.”
The D-Esc training program can be booked through Dementia Australia.
Do you think this will be effective at reducing these types of incidents? Is virtual reality close enough to actual reality in this case? Let us know what you think in the comments section below.
Also read: What’s the difference between Alzheimer’s and dementia