Twenty-five percent of Americans are predicted to be 65 or older by 2030 (U.S. Census). The overwhelming majority of these baby boomers (approximately 90%) aim to age-in-place. However, a recent LeadingAge survey suggests that only 60% of older adults want to age-in-place when physical and mental deterioration sets in, and only 30% want to remain at home if they have dementia and need help with daily activities. These statistics are telling and further suggest a rapidly growing need for in-home and in-facility services and supports.
Caregivers continue to play a central role in this supply-demand equation. Senior care professionals must be well-trained and competent in those skills needed to care for seniors, but the best senior care professionals also possess high levels of emotional intelligence; in particular, empathy.
Interacting with others, and especially with seniors who might be dealing with physical and mental declines, requires empathy. These highly personal interactions demand far more than a cognitive understanding. Empathy is about an emotional, experiential and visceral understanding, as if you have “walked a mile in a senior’s shoes” and have shared their experiences. Empathy is also about behavior. Empathy is something that you can see in (and through) another’s actions.
In this report, we show that text or PowerPoint are ineffective at training empathy because they target a cognitive — as opposed to an experiential, emotional or behavioral — understanding of empathy. Although role play and simulation are better than text, we show that these are not time- or cost-effective, nor are they scalable.
Instead, we argue that interactive storytelling with VR provides an effective empathy building solution and readily-available path forward for senior care professional development.
Empathy training, as with any training in a person, requires an understanding of the psychology and neuroscience of learning so that we can effectively engage the parts of the brain that matter. The human brain is comprised of at least four distinct learning systems.
The experiential learning system has evolved to represent the sensory aspects of an experience, whether visual, auditory, tactile or olfactory. Critical brain regions include the occipital, temporal, and parietal lobes. Every experience is unique, adds rich context to the learning and is immersive. Experience is at the heart of empathy training, especially in senior care. The more one can vicariously experience the feelings, thoughts, and experiences of a senior, the more empathetic they will become.
The cognitive system is the information system. The critical brain region here is the prefrontal cortex. The cognitive system processes and stores knowledge and facts using working memory and attention. Critically, these are limited resources and form a bottleneck that slows learning with more information coming in than can be processed. A cognitive understanding of empathy toward seniors is important, but not nearly as important as the experiential, emotional or behavioral components.
The behavioral system in the brain has evolved to learn motor skills. The critical structure is the striatum whose processing is optimized when behavior is interactive and is followed in real-time (literally within milliseconds) by corrective feedback. This system builds the “muscle memory” that drives empathetic behaviors toward seniors. This system links rich experiential contexts (represented by the experiential learning system) and emotions with the appropriate behavioral responses. It is one thing to know the definition of empathy, to know that eye contact is important, and to know that you need to show understanding, but it is completely different (and mediated by different systems in the brain) to know how to show empathy with eye contact and behaviors that demonstrate true understanding.
More than anything, it is the emotional learning system in the brain that builds the interpersonal understanding, awareness, and sensitivity that are at the heart of empathy and an understanding of others’ behaviors. If one can “walk a mile in a senior’s shoes” and gain that vicarious understanding, awareness and sensitivity of a senior’s situation, they can build empathy. The critical brain regions are the amygdala and other limbic structures.
Emotional learning, when combined with context rich experiences, builds rich repertoires of empathetic understanding and behavior.
Text and Powerpoint are ineffective methods for training empathy in senior care professionals because they engage only cognitive systems. Role play and simulation are better than text-based counterparts because they are interactive and involve emotion-laden situations and behavior; however, even here it is often difficult to suspend reality. For example, it is challenging for a 30-something to role play what it is like to be 65 with short-term memory loss. Crucially, simulation and role-play are time-consuming, costly, and not scalable.
Interactive storytelling with virtual reality, on the other hand, can address the shortcomings of traditional approaches to empathy building in senior care professionals. With interactive storytelling in virtual reality you “learn through experience”. Experiential learning with VR is far superior to information learning with text because VR broadly engages multiple learning and memory systems in the brain in synchrony.
Imagine using interactive storytelling with VR during the recruitment or onboarding process to evaluate empathy — and even to help build it. For example, suppose your newest assisted living or memory care candidates experience a “Day in the Life of Senior Caregiving” in VR. The immersive VR experience emphasizes communication, responsiveness, and empathy by allowing the recruit to “walk a mile in a senior’s shoes”. They can obtain a first-person virtual experience with an apathetic or non-communicative frontline worker. They can obtain a first-person virtual experience of the senior’s frustration when a frontline worker states that they will “only be a minute”, but don’t return for ten to twenty minutes. Analogously, they can experience what it is like to interact with an empathetic frontline worker. These “walk a mile in my shoes” experiences are visceral. They engage emotional learning centers in the brain that quickly and effectively build empathy.
Consider another scenario in this experience where the memory care professional witnesses a challenging situation between two residents or between a resident and a clinical nursing associate (CNA). The recruit can observe as a seasoned CNA diffuse the situation through empathy and understanding, then using voice-over to offer tricks and tips on how to mitigate similar situations that they might face. The senior care professional can even experience an emergency situation and observe the seasoned CNA follow the emergency protocols in a calm and methodical manner, empathetically (but efficiently) leading seniors to safety.
These are just a couple examples of the numerous ways that VR can be used to build empathy in senior care professionals. Emotion-laden, experiential empathy training via interactive storytelling with VR can provide the senior care professional with the confidence that they need to address the many needs of their seniors, and to do it with empathy. With VR training for senior care professionals you can achieve this goal—one experience at a time.