The Problem
Shalom Village is an assisted living community exploring whether virtual reality could improve residents' quality of life. There was no app to redesign, no wireframes to sketch, and no existing product to fix. The organization needed something different first: evidence. Residents range widely in mobility, cognitive engagement, and prior comfort with technology, and that range shaped the evaluation framework and workshop design from the start.
Before any resident put on a headset, three questions had to be answered honestly. Does VR actually work for people in assisted living, or is that just marketing? Which of the many headsets and platforms on the market are actually built for this population? And is it worth the money?
I met separately with David Neumann, my academic advisor, and Tracy Humphreys, Shalom Village's wellness coordinator and the project's main stakeholder, to understand what each of them needed by the end of this project. Tracy's priority was resident-centric: whether this would genuinely improve quality of life for people she works with every day, not whether the technology was impressive on its own. She also brought her own knowledge of individual residents into every decision along the way, from recruitment to how to read reactions in the room. Those conversations shaped the three questions above.
Research
A systematic review of the published research on VR in aging care: 43 studies, spanning 2019 to 2026, synthesized to separate what the evidence actually supports from what vendors claim.
What the evidence supports
- Consistent reductions in stress, anxiety, and negative affect across multiple study designs
- Improved social connectedness and reduced isolation, particularly through shared/group VR experiences
- Staff consistently report visible increases in resident engagement, energy, and mood
What the evidence warns about
- Cybersickness, dizziness, and eye strain are real and exclude some participants. One study reported 18.6% exclusion
- Heavy headsets and complex controllers create real barriers for frail residents and those with dexterity limitations
- Staff cite Wi-Fi instability, technical difficulty, and lack of time/confidence as adoption barriers, not just cost
Technology landscape. Six VR options were compared: three general-purpose consumer headsets, one prosumer mixed-reality headset, and two subscription platforms purpose-built for senior living.
| Option | Type | Specialized for Older Adults? | Facilitator Required? | Approx. Price |
|---|---|---|---|---|
| Meta Quest 3 | Hardware | No | Recommended | $829.99 CAD |
| Meta Quest 3S | Hardware | No | Recommended | $479.99 CAD |
| HTC Vive Focus Vision | Hardware | No | Yes (enterprise-configured) | ~$1,000 USD |
| Samsung Galaxy XR | Hardware | No | Recommended | $1,799 USD |
| Rendever | Platform + Service | Yes | Required (staff-controlled tablet) | ~$8,000 CAD Yr 1 |
| Mynd Immersive (MyndVR) | Platform + Service | Yes | Recommended | ~$5,500 CAD Yr 1 |
Only Rendever and Mynd Immersive are purpose-built for senior care. They bundle hardware, curated content, staff training, and support. The consumer headsets are cheaper but require sourcing content, training, and facilitation separately. Meta Quest 3 was selected as this project's working headset. No senior-specific design, but the best balance of adjustable IPD, passthrough support, and price for a pilot that still needed to evaluate content independently.
Who the Pilot Was For
A composite drawn from the Tier 1 and Tier 2 residents identified in the targeting strategy below, not any single participant: a woman in her late 70s or 80s, novice-to-moderate with technology, whose caution isn't really about VR. It's about not wanting to get something wrong she can't undo.
What Moves Her
- Personal relevance, not novelty. The clearest emotional shift in the whole dataset followed a resident being handed a real choice, not repeated exposure to the headset
- A concrete use, not an abstract one. The resident managing post-physical-therapy pain responded most to content tied to that specific need
- Someone demonstrating first. Residents rated themselves meaningfully less confident using VR alone (2.0/4) than with support (2.57/4)
What Holds Her Back
- Not fear of the technology itself, fear of being bad at it, a distinction one resident put directly: "I wasn't scared, I just didn't want to be bad at it"
- A physical detail as small as strap tension. One resident's only complaint across three sessions was that the strap "was too tight"
- Initial skepticism that scores low going in. Two of eight residents rated usefulness at the bottom of the scale before their first session
She isn't the resident who needs convincing VR is interesting. She's the resident who needs one good, personally relevant session before she'll trust it, which is exactly why the targeting strategy below starts with residents who already found that relevance, and treats everyone else as a longer, individual runway rather than a lost cause.
Key Insight
Operational Barriers, Not Efficacy, Are the Real Risk. The literature is genuinely positive on outcomes, but almost every study also flags the same operational barriers: staff training, Wi-Fi reliability, and hardware comfort. None of that has anything to do with whether VR "works." A recommendation based only on the outcome studies would have missed half the real problem, which is why the next step was building an evaluation framework that scores operational fit, not just content quality.
The Evaluation Framework
Rather than judging VR experiences by feel, I built a 20-point heuristic evaluation template. Section A is Nielsen Norman Group's 10 core usability heuristics for VR. Section B is 10 Older Adult Accessibility heuristics I wrote myself, each one derived directly from a specific finding in the literature review and cited back to its source. Every experience under consideration was evaluated against all 20 before it was allowed near a resident.
| Heuristic | SoulRetreat | YouTube VR |
|---|---|---|
| Section A · NNG Core Usability | ||
| H1 · Visibility of System Status | Pass | Pass |
| H2 · Match Between System & Real World | Pass | Pass |
| H3 · User Control & Freedom | Pass | Pass |
| H4 · Consistency & Standards | Pass | Pass |
| H5 · Error Prevention | N/A | Pass |
| H6 · Recognition Rather Than Recall | Pass | Pass |
| H7 · Flexibility & Efficiency of Use | Pass | Pass |
| H8 · Aesthetic & Minimalist Design | Pass | Partial |
| H9 · Recognize, Diagnose & Recover From Errors | N/A | Pass |
| H10 · Help & Documentation | Pass | Partial |
| Section B · Older Adult Accessibility | ||
| OA-1 · Visual Clarity & Sensory Adjustability | Pass | Fail |
| OA-2 · Auditory Accessibility & Noise Load | Pass | Pass |
| OA-3 · Cybersickness & Vestibular Safety | Pass | Partial |
| OA-4 · Physical Comfort & Seated Accessibility | Pass | Pass |
| OA-5 · Simplified Interaction & Motor Accessibility | Pass | Partial |
| OA-6 · Cognitive Accessibility & Reduced Overload | Pass | Partial |
| OA-7 · Spatial Orientation & Wayfinding | Pass | Pass |
| OA-8 · Multi-Modal Feedback & Sensory Redundancy | Pass | Pass |
| OA-9 · Emotional Safety, Cultural Relevance & Reminiscence | Pass | Pass |
| OA-10 · Facilitator Accessibility & Staff Operability | Partial | Pass |
The gap between 94% and 70% isn't a judgment on content quality. Both were selected for the workshops. It's the difference between an experience designed to require nothing from the user and one that needs a facilitator managing the parts residents shouldn't have to see. In practice, YouTube VR was often the easier one to run: a facilitator could load and position the video in advance, so a resident's headset went on already set up and all they had to do was press play. SoulRetreat scored higher and had simpler interactions once running, but getting to "running" still meant a resident, or a facilitator standing over them, working through its own launch sequence first. The heuristic score measures the experience once it starts, and for this population, what happens before that mattered more.
Key Decisions
SoulRetreat to Gibraltar Peak Meditation
Workshop 3 was originally planned as SoulRetreat, the meditation app that scored highest in the heuristic evaluation (94% pass rate, fully passive once launched). After watching residents struggle to operate the controllers in earlier live sessions, we swapped it for Gibraltar Peak Meditation, a YouTube VR video the facilitator could load in advance and hand over ready to go, removing controller interaction from the resident's side entirely. A strong heuristic score describes an interface on paper. It doesn't guarantee a specific resident's hands will get along with a specific controller in the room. The swap cost us nothing: Workshop 3 posted the highest average emotional rating of the series (3.33/5).
Quest 3 Over Quest 3S
Quest 3 beat the cheaper Quest 3S despite the higher price. Its passthrough camera reads as working to residents, where the 3S's grainier passthrough read as broken technology, a difference that matters more for this population's trust in the hardware than the price gap does.
Running the Workshops
Three experiences were selected against six criteria drawn from the literature review: low motion-sickness risk, simplified controls, adjustable visual settings, cognitive accessibility, reminiscence potential, and the ability to exit or pause without penalty. Delivered across three consecutive weekly 90-minute sessions (July 13, 20, and 27), each followed the same four-part structure: orientation, the VR activity itself, a semi-structured debrief, and a short anonymous survey for residents and staff.
Three measurement tools ran alongside the sessions: a Self-Reported Emotional Scale completed before and after each session, an Observed Emotion Rating Scale completed by staff during the activity, and a Senior Technology Acceptance Model questionnaire tracking comfort with the technology over the series.
I facilitated all three sessions myself: running the protocol, taking observational notes, troubleshooting headsets in the moment, and talking directly with residents throughout. Tracy Humphreys and Kristhel supported headset setup, resident orientation, and additional observation.
· Facilitator script, Step 2 safety briefing
Something happened early that reshaped how I read the rest of the pilot: coming in, I'd quietly assumed residents would struggle to adapt to the headsets. Most didn't. Several were genuinely excited to try something new and picked up the interaction faster than the operational-barrier research had prepared me for. The friction that did show up, mainly controller dexterity, had nothing to do with willingness or ability to engage with new technology. That distinction shaped how I read every session after it, including the controller swap in Key Decisions above.
Recruitment ran through word of mouth and a printed poster displayed at Shalom Village, with sign-up coordinated through the recreation team.
Every resident who signed up was screened against basic health and safety criteria and completed informed consent before their first session, coordinated with Shalom Village's wellness team given the range of cognitive ability across the resident population.
Attendance & Retention
All three workshops ran as scheduled. Eight residents attended across the series, tracked through the Self-Reported Emotional Scale and the Observed Emotion Rating Scale.
| Workshop | Experience | Attendance | Avg. Self-Reported Emotion |
|---|---|---|---|
| 1 · Jul 13 | Beethoven's 5th Symphony | 5 residents | 3.0 / 5 |
| 2 · Jul 20 | Versailles in 3D | 4 residents | 3.25 / 5 |
| 3 · Jul 27 | Gibraltar Peak Meditation | 6 residents | 3.33 / 5 |
Retention wasn't uniform, and the pattern says more than the average would. Four participant types emerged across the three sessions.
The Loyal Anchor
Attended all 3 workshops · steady 3/5 every time
Undramatic, consistent attendance despite observer notes ranging from "quiet, unsure" to "no visible enjoyment." This resident kept coming and said outright: "I would enjoy the VR experience on a regular basis at Shalom." A stable presence a program can be built around.
The Enthusiast Returnee
Joined at Workshop 2 · 5/5 both sessions attended
The highest and most consistent emotional ratings in the cohort. Briefly dizzy at the Gibraltar cliffside, took the headset off, and stayed for the rest of the session anyway: "I felt so calm, my eyes shut."
The Agency-Seekers
Three residents · moderate, control-dependent engagement
Engagement tracked closely with how much choice they had. One resident only came alive once allowed to pick their own experience, smiling and laughing for the first time only after that. Control wasn't a nice-to-have for this group, it was the difference between disengagement and delight.
Did Not Return
Two residents · attended Workshop 2 only
Both attended once and didn't re-register. Neither reported discomfort or safety concerns. One said plainly, "I don't understand how this could help me," a confidence and framing gap, not a harm signal, and the clearest argument for a longer onboarding runway.
Six residents completed a post-experience survey covering Emotional Experience, Physical Comfort, and Intent to Return.
Headset comfort was the one soft spot in an otherwise strong picture: it scored 2.83 out of 5, well below every other item on the survey. Every other physical-comfort item (pain, dizziness, eye strain, neck strain) scored at or near the ceiling.
Cost. Four acquisition pathways were modeled at pilot and full-program scale over a three-year horizon.
| Pathway | One-time (Year 1) | Annual Ongoing | 3-Year Total |
|---|---|---|---|
| Pilot · 2 Meta Quest 3 headsets | $2,161.92 | ~$220 | ~$2,800 CAD |
| Full program · 6 Meta Quest 3 headsets | $4,696 | ~$470 | ~$7,000 CAD |
| Platform: MyndVR | ~$5,500 | ~$5,100 | ~$15,700 CAD |
| Platform: Rendever | ~$8,000 | ~$7,000 | ~$22,000 CAD |
The hardware-only pilot costs a fraction of even the cheapest platform subscription, but the platforms bundle training and support that a hardware-only path leaves entirely to Tracy Humphreys. The cost model doesn't make that decision, it makes the tradeoff visible, which led to the recommendation below: start hardware-only and small.
The Answer: Yes, With Conditions
Bottom-line recommendation: proceed with purchasing 2 Meta Quest 3 headsets. All three questions from the start of this project now have real answers. VR is viable and desirable for Shalom Village's residents, provided it's facilitated and the content is chosen thoughtfully rather than assigned. The cost is modest relative to the impact: a 2-headset pilot runs about $2,161.92 CAD one-time plus roughly $220 CAD a year after that.
The plan is staged, not a single purchase. Start with 2 headsets and the four residents most likely to build early momentum. Expand to 10–15 residents and 6 headsets by month six if the evaluation metrics hold, and fold VR into standard programming, alongside art, music, and physical therapy, by month twelve.
The single point of failure
Shalom Village's Wellness department is Tracy Humphreys and no one else. She'll facilitate the pilot directly, which fits the data: residents rated themselves less confident using VR alone (2.0/4) than with someone demonstrating (2.57/4). But a program that depends entirely on one person's calendar isn't a program, it's a risk. A backup facilitator from outside Wellness needs to be identified and trained before this scales past the pilot.
Immediate next steps
- Budget approval for ~$2,161.92 CAD in pilot hardware
- Identify and begin training a backup facilitator
- Procure 2 Meta Quest 3 headsets and assemble a curated content library
The full methodology, data set, and final recommendations report were delivered to Shalom Village leadership at the end of the placement.
Takeaways
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Evidence has to come before advocacy
It would have been easy to walk in enthusiastic about VR and design a workshop to prove it. Building the literature review and heuristic framework first meant the final recommendation is defensible, not just optimistic.
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Retention isn't one number, it's four different stories
A 75% return rate on its own says almost nothing about how to run this program. The Loyal Anchor, the Enthusiast, the Agency-Seekers, and the residents who didn't come back each needed something different from the experience. The average was the least useful number in the dataset.
-
Ageism was a design input I hadn't checked, and it was mine
I'd planned around the assumption that older adults would need extra hand-holding with unfamiliar technology. Most needed less than I expected. The barrier worth designing for was rarely willingness or ability, it was hardware ergonomics and onboarding pace. Worth remembering on the next project involving a population I don't already understand well.
-
A facilitated room measures one kind of engagement, not the only kind
Everything here happened with staff watching and a fixed session length. If I ran this again, I'd send headsets home with a subset of residents between workshops: self-paced, unsupervised use over weeks, with residents choosing their own content, would surface preferences a 90-minute observed session can't reach and remove the "stranger in the room" effect from at least part of the dataset.
What This Shows
This project demonstrates:
- The ability to operate without a design brief: building research and evaluation methodology from scratch
- Rigorous, literature-grounded thinking applied to a real vendor and technology decision
- Facilitation of human-subjects research with a vulnerable population, with safety and dignity built into every step
- Comfort presenting an honest cost-benefit picture instead of a predetermined recommendation
- Synthesizing self-report, staff-observed, and qualitative data into one coherent, honest narrative, including the outlier that complicates it
- Applied UX skills, heuristic evaluation and accessibility thinking, outside of a traditional product design context