Grant: Op Gr.: Mech. in Brain Aging/dementia-Caregiving/Care Prov. + Aging with Neurod.

Caregivers often describe respite as an internal experience where they can recuperate without removing themselves from a situation. Respite should be ongoing, flexible, and easily implemented and controlled by the caregiver. While home-based respite arguably removes barriers to receiving support for persons with disability and frailty (e.g., transportation, financing), it remains poorly understood how to best deliver effective respite programming. This gap in understanding disproportionately affects essential caregivers (mostly women) of people living with dementia (PwD) who experience high levels of burden. There has been a recent increase in interest in the therapeutic use of Virtual Reality (VR) with older adults, with a number of studies suggesting VR's potential to manage BPSD and promote quality of life. VR-based interventions can be tolerated and enjoyed by PwD long enough for caregivers to take a short break. However, VR's potential to provide caregiver respite at-home has not yet been explored. This will be an open-label, pragmatic effectiveness trial including a four-week home-based intervention and two-week follow-up. Following an initial training and observation usability session, PwD will experience immersive VR stimulation, as frequently as they choose. Caregivers will be able to engage in a desired activity at this time, remaining close by to assist only if needed. Outcomes (caregiver respite, burden, wellbeing, resilience) will be evaluated using mixed methods, including researcher observations and standardized pre/post-session questionnaires, semi-structured interviews, and objective metrics of VR usage. This is the first study to explore how different types of virtual reality experiences (solo and social) can be used to achieve much needed respite time for caregivers, as well as reduce apathy, depression and agitation for PwD, and in turn promote well-being and quality of life for both parties.