Virtual Reality Is Helping Hospice Patients Check Off Their Bucket Lists

  • Image courtesy of Royal Trinity Hospice and Flix Films.

    Image courtesy of Royal Trinity Hospice and Flix Films.

In the past year, a charity hospice in London has enabled end-of-life patients to run with wild horses in Iceland, tour Venice’s canals aboard a gondola, go skydiving—all without leaving their beds.

It’s all part of a pilot program at Royal Trinity Hospice that’s exploring the potential of using virtual reality for palliative care—a fast-growing specialty geared toward improving quality of life for those suffering from serious, life-threatening, and in many cases terminal illness.

Since VR prototypes first landed in the hands of creatives in 2013, artists from Jon Rafman to Paul McCarthy have used the devices as a new artistic medium. They’ve brought powerful psychological experiences to art fairs and biennales, sending viewers on apocalyptic joyrides and into dark underworlds.

But how can VR be useful in a completely different context, for patients nearing the end of their lives?

Virtual Reality Is the Most Powerful Artistic Medium of Our Time

This is precisely the question that Royal Trinity, in collaboration with London-based film production house Flix Films, is determined to answer.

The project has its roots in 2016, when Flix Films director Leon Ancliffe met an artist and mother of two, Sarah Ezekiel, who’d been paralyzed with motor neuron disease for the past 16 years. Among her deepest regrets, she told him, was never having swam with dolphins. “I thought, wouldn’t it be amazing if we were able to give Sarah that bucket-list experience using virtual reality?” says Ancliffe.

After calling up a friend in the VR department of BBC, they outfitted Ezekiel with a headset and sent her plunging into the depths of the sea. The impact was astonishing. “That was when the penny dropped; just seeing how much joy it had given her,” he says. From there, Ancliffe approached Royal Trinity about a partnership using VR technology, which is now evolving into a fully fledged medical study focused on the impact of VR on chronic pain and general well being.

At the hospice, patients are consulted about their memories and their dreams—where they got engaged, where they thought they’d never go again—and given a Google Daydream or Samsung Gear headset loaded with a visual playlist. Although this initial stage of the project has relied on existing 360-degree footage, Flix Films has recently invested in a camera to shoot original material custom-tailored to patients.

So far, patients have donned goggles to surf the waves of Tahiti or ski the slopes of the Austrian Alps.

While similar healthcare initiatives have brought seriously ill children on virtual roller coasters or dementia patients to underwater coral reefs, according to Letizia Perna-Forrest, head of patient and family support at the hospice, the potential for end-of-life care is tremendous—and still largely untapped. “If we can help people alleviate their pain without increasing their dosages, or if we can alleviate some of their anxiety by taking them somewhere else, or reduce their breathlessness or their fatigue, that’s a win,” she says.

  • Image courtesy of Royal Trinity Hospice and Flix Films.

    Image courtesy of Royal Trinity Hospice and Flix Films.

At its core, the program brings patients beyond the physical limitations of their bodies, or to “think outside the body,” as Ancliffe says. One cancer patient named Suzy, unable to travel because of her condition, had a dream of returning to Jerusalem before she died. They brought her there. Another, named Hege, floated through the canals of Venice, where she’d gotten engaged, before ticking a visit to the dancing Northern Lights off her bucket list. Her husband participated, too; a key aspect of palliative care is support for patients’ families. So often, hospices bring families back together around a loved one, though they’ve potentially shared no common experience in decades. Virtual reality could possibly bridge that gap by helping them bond over old, or new, experiences.

But beyond the thrills of escapism, the technology has potential to fundamentally improve patients’ level of pain. Under the basic concepts of distraction therapy, commonly used for depression and anxiety, it diverts a patient’s attention away from their reality, says Perna-Forrest. It also draws from reminiscence therapy, used to trigger past memories in dementia patients.

It also has the potential to encourage transformation of the brain. Unlike acute pain (an ankle sprain, a bee sting) chronic pain gets wired into the brain. Alternative therapies—using images, music, scent—fire up other parts of the brain, like the visual cortex, breaking established pathways and creating new ones.

A recent patient, a woman named Susi with a cancer diagnosis, was taken to the white-sand beaches of the Maldives. “We asked her to give us a number, to quantify her pain before the VR,” says Perna-Forrest. When they took off the goggles, she cried tears of joy; her pain had dramatically dropped from a seven to a three. “It gave us what we’re hoping to achieve through our research,” says Perna-Forrest. “Finding that link.” Both Perna-Forrest and Ancliffe, however, are quick to acknowledge that this research is in its early stages.

  • Image courtesy of Royal Trinity Hospice and Flix Films.

    Image courtesy of Royal Trinity Hospice and Flix Films.

“It’s really ignited something in me again,” says Ancliffe. And for the filmmaker and his team at Flix Films, the possibilities are boundless—particularly with their new camera, which allows them to shoot original 360-degree content complete with livestream, self-stitching, and surround sound. For one patient who is separated from his children, they are considering creating a custom experience in his home so that he can feel closer to his family; another patient has asked for a way to visit her church. And given the camera’s ability to live stream, they’ll have the ability to reunite patients with far-away families. As much as Royal Trinity is trying to understand whether VR can improve pain, Ancliffe is also determined to understand what makes for good VR, from a filmmaker’s perspective.

“What’s really key for us is we want to understand how to develop virtual reality content and understand the key elements that make it good,” he says. “If you put the goggles on someone they feel like they have to keep them on at all costs, even when they’re petrified,” he says; the last thing you want to do is see an old person terrified by a roller coaster. “It can be used irresponsibly and have a damaging impact on people. That’s why what we’re doing at Trinity is so important, because we’re working with the most vulnerable people in our society.”


—Molly Gottschalk